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Device for modeling of intra-arterial circulation: application in experimental cardiology

DOI:10.1093/eurheartj/ehab724.0299
Authors:
Olga Germanova at Samara State Medical University
Olga Germanova
V A Germanov
V A Germanov
V A Germanov
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Y V Shchukin
Y V Shchukin
Y V Shchukin
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A V Germanov
A V Germanov
A V Germanov
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Abstract

Purpose of study Using an original device for modeling of intra-arterial blood circulation, to study the features of intravascular hemodynamics with a regular heart rhythm and with various rhythm disturbances. Material and methods We used an original device developed by us to simulate intra-arterial circulation (Document of invention No. RU 202780 U1). The main part of the device is a glass tube of a rotameter with a length of 365 mm, an inlet end with a diameter of 20 mm, an outlet end of 16.5 mm, which is a model of an arterial vessel. Flexible silicone tubes are attached to the rotameter on both sides, with free ends connected to an electric pump, with various modes of operation (imitation of pulse waves with regular rhythm, premature ventricular contractions (PVCs), atrial fibrillation (AF). An aqueous solution of glycerin was introduced into a closed system diluted with water corresponding to the viscosity of the blood. A 5 mm long silk thread was alternately installed inside the tube, an intravascular piezoelectric crystal pressure probe connected to an oscilloscope. Also it was injected inside the tube a dye - clerical ink. Results With electric pump, we simulated the spreading of the pulse wave in regular heart rate, PVCs and AF. We observed the effect of a pressure wave (deflection of a silk thread, the appearance of a turbulent flow when using a dye) on the walls of the rotameter, with the formation of standing, reflected waves during the PVCs and AF. The pressure probe registered an increase in pressure inside the tube during the spread of the 1st post-extrasystolic contraction wave up to 58%, the wave after a long pause of more than 2 seconds with AF by 44% compared to the regular rhythm. Conclusion A device for modeling of intra-arterial circulation allows a wide range of experimental work in cardiology, normal and pathological physiology, and biophysics. FUNDunding Acknowledgement Type of funding sources: None.
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Arrhythmias and Device Therapy – Arrhythmias, General, Diagnostic Methods 299
Device for modeling of intra-arterial circulation: application in experimental cardiology
O. Germanova1, V.A. Germanov1, Y.V. Shchukin1, A.V. Germanov1, G. Galati2
1Samara State Medical University, Samara, Russian Federation; 2San Raffaele Hospital, Milan, Italy
Funding Acknowledgement: Type of funding sources: None.
Purpose of study: Using an original device for modeling of intra-arterial
blood circulation, to study the features of intravascular hemodynamics with
a regular heart rhythm and with various rhythm disturbances.
Material and methods: We used an original device developed by us to
simulate intra-arterial circulation (Document of invention No. RU 202780
U1). The main part of the device is a glass tube of a rotameter with a
length of 365 mm, an inlet end with a diameter of 20 mm, an outlet end of
16.5 mm, which is a model of an arterial vessel. Flexible silicone tubes are
attached to the rotameter on both sides, with free ends connected to an
electric pump, with various modes of operation (imitation of pulse waves
with regular rhythm, premature ventricular contractions (PVCs), atrial fibril-
lation (AF). An aqueous solution of glycerin was introduced into a closed
system diluted with water corresponding to the viscosity of the blood. A 5
mm long silk thread was alternately installed inside the tube, an intravascu-
lar piezoelectric crystal pressure probe connected to an oscilloscope. Also
it was injected inside the tube a dye - clerical ink.
Results: With electric pump, we simulated the spreading of the pulse wave
in regular heart rate, PVCs and AF. We observed the effect of a pressure
wave (deflection of a silk thread, the appearance of a turbulent flow when
using a dye) on the walls of the rotameter, with the formation of standing,
reflected waves during the PVCs and AF. The pressure probe registered
an increase in pressure inside the tube during the spread of the 1st post-
extrasystolic contraction wave up to 58%, the wave after a long pause of
more than 2 seconds with AF by 44% compared to the regular rhythm.
Conclusion: A device for modeling of intra-arterial circulation allows a
wide range of experimental work in cardiology, normal and pathological
physiology, and biophysics.
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... For studying of intra-arterial hemodynamics, we used an original "Device for modeling intra-arterial circulation" [11,12]. The device in a physical model of arterial vessel created by the group of researches that included cardiologists, cardiac surgeons and engineers. ...
ATHEROMA PROGRESSION: PHYSICAL MODELING IN EXPERIMENTAL CARDIOLOGY
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Prototype models of intra-arterial circulation is one of the priority aims of experimental cardiology, as well as for the study of atherosclerosis. Purpose: To study the features of intra-arterial hemodynamics in the area of atheroma of the artery in physical modeling. Materials and methods: We used an original "Device for modeling intra-arterial circulation". The main parts of the model: glass rotameter tube in the form of a truncated cylinder, inlet and outlet ends of which are fixed with elastic plastic tubes connected to an electric water pump immersed in a container with glycerol solution. Inside the rotameter, using a fitting from the inlet, it is possible to install a pressure sensor that transfers data to the oscilloscope; indicators - a silk thread or dye - ink. The variable pump mode allowed us to simulate a regular heart rhythm, extrasystole (ES) and atrial fibrillation (AF). Results: In the first post-extrasystolic wave, a turbulent fluid flow formed after the plaque, standing waves and waves reflected from the walls of the rotameter were observed; the sensor registered an increase in pressure 1,6 times more compared with a regular heart rate wave. The marginal plaque zones along and against the fluid flow, especially the areas bordering the intact part of the arterial vessel, underwent the main mechanical impact. The same patterns were observed in AF with a maximum duration of a pause between pulse waves of ≥1,5 s. Conclusions: Heart arrhythmias play an important role in the intra-arterial hemodynamics changes and are the part of the pathophysiological changes in the arteries in atherosclerosis. The main danger is not the ES itself, but by the first post-extrasystolic contraction or the first pulse wave after a long pause between ventricular contractions in AF.
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... Выявленные клинические закономерности были подтверждены нами экспериментальной работой с применением разработанного и запатентованного "Устройства для моделирования внутриартериального кровообращения" [15]. ...
Maximum time between cardiac cycles in atrial fibrillation for assessing the risk of arterial thromboembolism
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Full-text available
  • Aug 2022
Aim. To assess the development of thromboembolic events in different types of atrial fibrillation (AF), which differ in the maximum time between cardiac cycles. Material and methods . The main group included 80 patients with permanent AF, while the control one — 88 people without AF. The following investigations were performed: echocardiography, 24-hour electrocardiographic (ECG) monitoring; ultrasound of extracranial arteries, aortic branches, lower limb arteries; sphygmography of the common carotid and posterior tibial arteries. If required, coronary angiography, cerebral angiography, brain computed tomography were performed. According to 24-hour ECG monitoring, all patients of the main group were divided into 2 subgroups (A and B) depending on the maximum time between cardiac cycles in AF: subgroup A (n=42) — patients with a maximum time between cardiac cycles <1,5 seconds, subgroup B (n=38) — ≥1,5. The followup period lasted 1 year. During the follow-up period, the development of arterial thromboembolic events was analyzed. Results. The patients were comparable in key paraclinical characteristics and comorbidity profile. One-year follow-up period revealed a significantly higher incidence of stroke, transient ischemic attack, myocardial infarction, and distal arterial embolism of lower limb arteries in subgroup B. With an increase in the maximum time between cardiac cycles in AF, an increase in hemodynamic parameters of arterial vessels occurred as both proximal and distal arteries. A similar trend was also observed in the analysis of arterial kinetic parameters. Conclusion. Not only the fact of AF presence is important for assessing the risk of arterial thromboembolism, but also its features. The most unfavorable for prognosis is AF with a maximum time between cardiac cycles ≥1,5 seconds. An increase in intra-arterial hemodynamic parameters after a long pause between ventricular contractions in AF without intracardiac thrombosis can become a key factor in the development of complications with existing plaques, which can become a source of distal embolism.
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... Moreover, this mechanism of the additional mechanical impact is the universal mechanism that also is observed in other arrhythmias, for example, in first post-extrasystolic wave after the compensatory pause of extrasystole, in atrioventricular blockades, the first regular wave after sinus rhythm restoration after AF or heart palpitation, in activation of the pacemaker after prolonged asystole as well as in the other situations when the pulse wave with increased hemodynamic characteristics spreads after the long pause between ventricular contractions. We described these effects in our previous publications [38,39]. And in this case the main importance will play not only the quantity of such situations but also more the characteristics of these pulse waves. ...
Cryptogenic stroke in atrial fibrillation without intra-heart thrombi: possible mechanisms
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Full-text available
  • Apr 2022
Background. Up to 45% of ischemic strokes are cryprogenic. Aim is to study which variant of permanent AF without intra-heart thrombi is the most unfavorable in appearing of stroke. Methods . We observed 202 patients with permanent AF without intra-heart thrombi and hemodynamically not significant carotid bifurcation atherosclerotic stenosis. We performed echocardiography, 24-hours monitoring of electrocardiography (ECG), ultrasound of brachiocephalic arteries, sphygmography of common carotid arteries, computer tomography of the brain, hemostasiograms, lipid profile, hemoglobin A1c. According to the 24-hours ECG monitoring data, we divided patients into two groups up to the maximum pauses between ventricular complexes in AF: patients with a pause <1,5 seconds (113); ≥1,5 seconds (89). Both groups were on the same standard therapy including novel oral anticoagulants. We observed the patients during 1 year to analyze the verified stroke or transient ischemic attack (TIA). Results . In ultrasound, there was an increase of linear blood flow velocity in the area of carotid stenosis during the spread of the pulse wave after the long pause between ventricular contractions in group 2 up to 2,5 m/sec as in hemodynamically significant stenosis. In 1-year observation, there was the higher stroke in group 2. Conclusion . The appearance of stroke and TIA in AF is higher in patients who have 1,5 seconds and more of maximum duration pauses between ventricular contractions. The reason of cryptogenic stroke can be the atherosclerotic plaque defragmentation with further embolism, caused by additional mechanical impact of increased hemodynamical parameters of pulse wave after long pause between ventricular contractions.
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Atrial fibrillation: a new independent risk factor for thromboembolic events - hemodynamics and vascular consequence of long ventricular pauses
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Background: Atrial fibrillation (AF) is a leading risk factor of arterial thromboembolic events. Aim is to study the main arteries hemodynamics and kinetics in AF and to propose the functional classification of AF. Methods: We included 188 patients (80 as the control). We performed 24-hours ECG monitoring, blood lipids analysis, echocardiography, stress echocardiography, coronary angiography, renal arteries angiography, ultrasound Doppler of brachiocephalic arteries, abdominal aorta branches, renal arteries, lower extremities arteries, sphygmography. Patients were divided into 3 groups up to the duration of maximum pauses between ventricular complexes in AF: 1) with a pause < 1 second (64); 2) with a pause of ≥1, but <2 seconds (62); 3) ≥ 2 seconds (62). We analyzed the thromboembolic events within 1 year. Results: We observed the increase of linear blood flow velocity and volume flow in patients with AF during the spreading of the wave after a long pause between ventricles' contractions. The longer the pause between the ventricles' contractions, the more increase of arteries kinetics parameters is observed. The most frequent incidence of thromboembolic events within 1 year was in group 3. Conclusions: We propose a functional classification of AF: 1) AF with the pauses of less than 1 second; 2) more 1, but less than 2 seconds; 3) 2 or more seconds. The most unfavorable is AF with pauses of 2 seconds or more. We supplemented the CHA₂DS₂-VASc score with the new independent risk factor - type of AF - in accordance with the maximum duration of pauses between cardiac cycles.
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