An active approach of pressure waveform matching for stress‐based testing of arteries

• Published in: Artificial organs 2021-12, Vol.45 (12), p.1562-1575
• Main Authors: Agrafiotis, Emmanouil, Geith, Markus A., Golkani, Mohammad A., Hergesell, Vera, Sommer, Gerhard, Spiliopoulos, Sotirios, Holzapfel, Gerhard A.
• Format: Article
• Language: English
• Subjects: active compliance chamber; Aorta; arterial physiology; Arteries; Arteries - physiology; Balancing; Biomechanics; Blood circulation; Blood flow; Blood pressure; Blood Pressure - physiology; Cardiovascular Physiological Phenomena; Cardiovascular system; Compliance; Congestive heart failure; Diastole; Distension; Evaluation; Feedback control; Hemodynamics; Humans; Hypertension; in vitro testing of arteries; Main Text; mock circulation loop; Models, Cardiovascular; Oscillations; Physiology; Pressure oscillations; Stroke volume; variable compliance; Vascular implants; Veins & arteries; Waveforms
• ISSN: 0160-564X; 1525-1594
• DOI: 10.1111/aor.14064

Background Arterial compliance assists the cardiovascular system with three key roles: (i) storing up to 50% of the stroke volume; (ii) ensuring blood flow during diastole; (iii) dampening pressure oscillations through arterial distension. In mock circulation loops (MCLs), arterial compliance was simulated either with membrane, spring, or Windkessel chambers. Although they have been shown to be suitable for cardiac device testing, their passive behavior can limit stress‐based testing of arteries. Here we present an active compliance chamber with a feedback control of variable compliance as part of an MCL designed for biomechanical evaluation of arteries under physiological waveforms. Materials and Methods The chamber encloses a piston that changes the volume via a cascaded controller when there is a difference between the real‐time pressure and the physiological reference pressure with the aim to equilibrate both pressures. Results The experimental results showed repeatable physiological waveforms of aortic pressure in health (80–120 mm Hg), systemic hypertension (90–153 mm Hg), and heart failure reduced ejection fraction (78–108 mm Hg). Statistical validation (n = 20) of the function of the chamber is presented against compared raw data. Conclusion We demonstrate that the active compliance chamber can track the actual pressure of the MCL and balance it in real time (every millisecond) with the reference values in order to shape the given pressure waveform. The active compliance chamber is an advanced tool for MCL applications for biomechanical examination of stented arteries and for preclinical evaluation of vascular implants. The arterial compliance is responsible for the physiological pressure waveform. In mock circulation loops, this effect is incorporated with compliance chambers passively, generating a non‐physiological waveform. Thus, these approaches are not suitable for stress testing of arteries. The active compliance chamber is presented here reproduces a physiological pressure waveform, via a cascaded controller, that benefits stress‐based testing of arteries.