Constitutive interpretation of arterial stiffness in clinical studies: a methodological review
| Autor: | Bart Spronck, Koen D. Reesink |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty ANKLE VASCULAR INDEX Physiology extracellular matrix pulse wave velocity vascular remodeling BLOOD-PRESSURE Pulse Wave Analysis 030204 cardiovascular system & hematology MATRIX GLA-PROTEIN Increased aortic stiffness Muscle Smooth Vascular Interpretation (model theory) 03 medical and health sciences Vascular Stiffness 0302 clinical medicine INCREASED AORTIC STIFFNESS Physiology (medical) Internal medicine Matrix gla protein medicine Humans Vascular Diseases EXPERT CONSENSUS DOCUMENT Serum 25 hydroxyvitamin d Pulse wave velocity smooth muscle cell Extracellular Matrix Proteins biology business.industry Models Cardiovascular HUMAN ABDOMINAL-AORTA Arteries MECHANICAL-PROPERTIES medicine.disease 030104 developmental biology Blood pressure PULSE-WAVE VELOCITY biology.protein Arterial stiffness Cardiology SERUM 25-HYDROXYVITAMIN D distensibility GLYCATION END-PRODUCTS Cardiology and Cardiovascular Medicine business |
| Zdroj: | American Journal of Physiology-Heart and Circulatory Physiology. 316:H693-H709 |
| ISSN: | 1522-1539 0363-6135 |
| Popis: | Clinical assessment of arterial stiffness relies on noninvasive measurements of regional pulse wave velocity or local distensibility. However, arterial stiffness measures do not discriminate underlying changes in arterial wall constituent properties (e.g., in collagen, elastin, or smooth muscle), which is highly relevant for development and monitoring of treatment. In arterial stiffness in recent clinical-epidemiological studies, we systematically review clinical-epidemiological studies (2012–) that interpreted arterial stiffness changes in terms of changes in arterial wall constituent properties (63 studies included of 514 studies found). Most studies that did so were association studies (52 of 63 studies) providing limited causal evidence. Intervention studies (11 of 63 studies) addressed changes in arterial stiffness through the modulation of extracellular matrix integrity (5 of 11 studies) or smooth muscle tone (6 of 11 studies). A handful of studies (3 of 63 studies) used mathematical modeling to discriminate between extracellular matrix components. Overall, there exists a notable gap in the mechanistic interpretation of stiffness findings. In constitutive model-based interpretation, we first introduce constitutive-based modeling and use it to illustrate the relationship between constituent properties and stiffness measurements (“forward” approach). We then review all literature on modeling approaches for the constitutive interpretation of clinical arterial stiffness data (“inverse” approach), which are aimed at estimation of constitutive properties from arterial stiffness measurements to benefit treatment development and monitoring. Importantly, any modeling approach requires a tradeoff between model complexity and measurable data. Therefore, the feasibility of changing in vivo the biaxial mechanics and/or vascular smooth muscle tone should be explored. The effectiveness of modeling approaches should be confirmed using uncertainty quantification and sensitivity analysis. Taken together, constitutive modeling can significantly improve clinical interpretation of arterial stiffness findings. |
| Databáze: | OpenAIRE |
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