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The Physics of Pulsatile Blood Flow With Particular Reference to Small Vessels a1

The Physics of Pulsatile Blood Flow With Particular Reference to Small Vessels a1

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04/19/2013

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The physics of pulsatile blood flow withparticular reference to small vessels
E. O. Attinger
Theoretical aspects of the analysis of pulsatile blood flow are discussed in the first part of thepaper. In the second part the physical characteristics of the vascular system are described, andin the last part the behavior of the system is analyzed in terms of the outlined theory.
F
JLoi
ollowing the work of Frank
1
and Witzig
2
early in this century, an increasing num-ber of attempts have been made during thelast decade to increase our understandingof pulsatile blood flow by applying analyti-cal rather than purely descriptive methodsfor its investigation.
3
"
6
While for a numberof biological systems appropriate theorieswere already available from the physicalsciences, the situation in the cardiovascularfield was much more complicated. Thetheoretical hydrodynamicists concernedthemselves primarily with ideal fluids andwere never particularly interested in pul-satile flow of real liquids through pipes.The general theoretical development intheir field was limited primarily by the factthat nonlinearities and instabilities are soubiquitously present in fluid flows. As a
From the Research Institute, Presbyterian Hos-pital, The School of Veterinary Medicine, andthe Moore School of Electrical Engineering,University of Pennsylvania, Philadelphia, Pa.The original work reported in this paper was doneduring the tenure of a special fellowship fromthe National Institutes of Health 5-F3-GM-14037 and supported by Research Grants H-6836 and FR 00148 from the United StatesPublic Health Service.
consequence, the practical applications ofhydrodynamics are based primarily onempirical relationships rather than on theo-retical predictions. The situation in therapidly developing field of rheology issimilar. Because of its practical impor-tance, large efforts have gone into thestudy of stress-strain and pressure-flow re-lations of various materials such as plasticsand wood, and of suspensions. The similar-ity of the problems in rheology, hydro-dynamics, and cardiovascular physiologyhas resulted in a rather extensive exchangeof ideas between these different disci-plines, beginning with Poiseuille, a physi-cian interested in blood flow through cap-illaries, who first described laminar flowthrough tubes and stimulated much of thelater theoretical work.The analysis of a system aims at a quan-titative description which permits the pre-diction of its behavior under a variety ofcircumstances. This behavior is considera-bly more complex in biological than inman-made systems. In order to make ananalytical approach to a biosystem at allpossible it becomes necessary to introducesimplifying assumptions, the judicious se-lection of which represents one of the mostcritical points of departure for any analy-sis and requires considerable insight into
973
 
974
Attinger
Inoestigative
Ophthalmology
December
1965
biological phenomena. No matter how so-phisticated the theoretical approach, itsvalidity cannot be established by argumentalone; experimental evidence is necessaryto support it, and here we find ourselvesfaced with a major problem. The primarydata required for such an analysis are pres-
sure,
flow, and volume. These variableschange in pulsatile flow both with time andwith location within the system. At manysites they are not measurable without seri-ously disturbing the system and even if thebest available equipment and utmost careare used, measurement errors in the orderof 5 per cent are unavoidable. Since theeffects of some of the parameters whichhave been introduced in various analyticaltreatments are of the same order of mag-nitude, they cannot be assessed with anyreal confidence.The first part of this paper deals withthe theoretical aspects of the analysis ofpulsatile blood flow. In the second part thephysical characteristics of the vascular sys-tem are described and in the last part thebehavior of the system is analyzed in termsof the outlined theory. For the sake ofbrevity, only the more significant aspectsof the various problems are discussed; formore complete and detailed discussions thereader is referred to two recent publica-
tions.
7
'
s
Theoretical aspects
We begin with Newton's second equa-tion:Force = mass x acceleration,which we apply to a unit volume of anincompressible Newtonian liquid in a cy-lindrical, elastic vessel segment under con-ditions of laminar flow (Fig. 1). To get apicture of laminar flow, imagine that theflowing liquid is composed of an infinitenumber of concentric layers, each forminga sleeve around the layers inside it. Theoutermost layer is in contact with the ves-sel wall and moves the same way as thewall does. Let this velocity be zero. Theadjacent layer has a finite velocity, the nextmoves even faster, and so on. In the centerof the tube, the velocity is largest. Thisvelocity difference between adjacent layersproduces shear forces, and the fluid ele-ments within are subjected to shear strains.The ratio between this shearing stress (ve-locity gradient) and the rate of strain iscalled the coefficient of viscosity
(/A).
Fora Newtonian liquid, the relation betweenstress and rate of strain must satisfy twoconditions; The coefficient of viscosity isconstant; and if stress is zero, the rate ofstrain is also zero. In other words, a plot ofthese two variables must yield a straightline going through the origin.Now consider the motion of fluid in thisvessel segment. The pertinent dimensionsof the vessel are: R
o
, outside radius; Rj,inside radius; h, wall thickness; and 1, thelength along the z-axis. The fluid elementmoves with a velocity, V, which has twocomponents, one parallel to the z-axis (V
z
)and one parallel to the r-axis (V
r
). Simi-larly, the pressure gradient
V
P,
which pro-vides the net driving force for the element,also has two components (SP/8z and
SP/8r).
(Since the vessel has a circularcross section, the third components in thetangential direction VQ and SP/89 areeliminated on the basis of symmetry.) Ac-cording to Newton's equation the totalpressure gradient is equal to the total ac-celeration of the fluid element minus theforce necessary to overcome viscous resis-tance, as shown in the tipper equation ofFig. 1. In steady flow the accelerationterm disappears, and the only force neces-sary to maintain the motion of fluid is thatrequired to balance the viscous resistanceof the liquid. Under these conditions thereis no motion of the elastic vessel wall andthe relation between flow and pressurereduces to the familiar equation of Poi-seuille:
(1)
8
A
In pulsatile flow the vessel wall movesduring each cardiac cycle: during systolethe radius increases, during diastole it de-creases. We therefore have to write not
 
Volume
4
Number
6
Physics
of
pulsatile blood flow
975
only two equations for the fluid motion(one in the direction parallel to the vesselaxis and one in the radial direction) butwe also have to consider the forces in-volved in the movement of the vessel wallitself (Panel C in Fig. 1). The force whichcauses this motion is the pressure gradientbetween the inside and the outside of thevessel (transmural pressure). The ratio be-tween transmural pressure and the result-ing deformation of the wall is called theelastic modulus E.
(2)
E =stressstrainAx/x,,
where Ax/x
0
is the relative change in onedimension, say length. Since the vessel wallis three dimensional, there are three elasticmoduli, one relating pressure to change inradius (tangential modulus), one relatingpressure to change in length (longitudinalmodulus), and one relating pressure tothe change in wall thickness (radial modu-
lus).
These three moduli are related by sixPoisson ratios (o^), where Poisson ratiois defined as
(3) strain in a direction i at right anglesto the stress
<r,j z=
strain in the direction j of the stress
SCHEMA OF FLUID AND WALL MOTION IN DISTENSIBLE ELASTIC TUBEPRESSURE GRADIENT = DENSITY X TOTAL ACCELERATIONMINUS (ELASTIC AND VISCOUS LOSSES)
Fig. 1. Diagram to illustrate the equations of motion for a fluid and a wall element in anelastic tube.

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