A dynamical system that describes vein graft adaptation and failure

JOURNAL OF THEORETICAL BIOLOGY

卷:336

Article

Garbey, Marc^1,2,3  Berceli, Scott A.^4,5 

[1] Univ Houston, Dept Comp Sci, Houston, TX 77204 USA

[2] Methodist Hosp, Dept Surg, Houston, TX 77030 USA

[3] Univ La Rochelle, LaSIE, La Rochelle, France

[4] Malcom Randall VAMC, Gainesville, FL USA

[5] Univ Florida, Dept Surg, Gainesville, FL USA

关键词: Dynamical system;    Remodeling;    Vein graft;    Biomechanics;    Hemodynamics;   

DOI  :  10.1016/j.jtbi.2013.07.006

来源: Elsevier

【 摘 要 】

Adaptation of vein bypass grafts to the mechanical stresses imposed by the arterial circulation is thought to be the primary determinant for lesion development, yet an understanding of how the various forces dictate local wall remodeling is lacking. We develop a dynamical system that summarizes the complex interplay between the mechanical environment and cell/matrix kinetics, ultimately dictating changes in the vein graft architecture. Based on a systematic mapping of the parameter space, three general remodeling response patterns are observed: (1) shear stabilized intimal thickening, (2) tension induced wall thinning and lumen expansion, and (3) tension stabilized wall thickening. Notable is our observation that the integration of multiple feedback mechanisms leads to a variety of non-linear responses that would be unanticipated by an analysis of each system component independently. This dynamic analysis supports the clinical observation that the majority of vein grafts proceed along an adaptive trajectory, where grafts dilate and mildly thicken in response to the increased tension and shear, but a small portion of the grafts demonstrate a maladaptive phenotype, where progressive inward remodeling and accentuated wall thickening lead to graft failure. (C) 2013 The Authors. Published by Elsevier Ltd. All rights reserved.

【 授权许可】

Free