Jeremi Mizerski Modeling and Simulation of the Cardiovascular System - PowerPoint PPT Presentation

Jeremi Mizerski Modeling and Simulation of the Cardiovascular System Magdeburg, October 22-24 2018

Roger Bacon (~ 1214–1294) „For the things of this world cannot be made known without a knowledge of mathematics .” Opus majus (1267) : A translation by Robert Belle Burke. Vol 1 (1962). p. 128

• Acute aortic dissection of the ascending aorta is highly lethal, with mortality ranging between 1–2% per hour early after symptom onset. • Acute type A dissection is always a surgical emergency. • Medical management alone is associated with a mortality of nearly 20% by 24 hours , 30% by 48 hours after presentation, 40% by day 7 , and 50% by one month . • Even with surgical repair , mortality rates are 10% by 24 hours , 13% by 7 days , and nearly 20% by 30 days • The true incidence of acute aortic dissection is difficult to determine, as many cases may go undiagnosed, but its documented incidence is approximately 2.9 per 100,000 per year Springer 2007

Tunica media is responsible for the viscoelastic properties of the aorta Tunica adventitia is responsible for n utrition of the tunica media 12

¡ Smooth muscle cells: § Volume of single muscle cell is ~ 1630 ± 640 µm 3 § Density in media ~3,7 ± 0,6×10 5 cells/mm 3 ¡ Collagen § It is large heterogenous family of about 30 proteins classified as collagens § It is constantly synthesized in smooth muscle cells ¡ Elastin § Protein of extremely slow turnover time § It is presented in form of sheets in 71%, fibers 21%, struts 2%

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Blood stream Diffusion Flow Vasa vasorum

Atherosclerotic plaque casts a “shadow” over oxygen diffusion area

¡ Smooth muscle cells require a lot of oxygen to live! ¡ Smooth muscle cells produce a lot of collagen! ¡ Smooth muscle cells do not produce elastin! (or very little)

Wolinsky&Glagov(1985) 21

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¡ Elastin sheets § Cystic media degeneration ¡ Collagen matrix § Marfan syndrome § Ehlers-Danlos syndrome ¡ Smooth muscle cells § Hypoxia 24

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Elastin Collagen matrix Smooth muscle cells 30

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Forrest Gump (1986) written by Winston Groom