Non-invasive measurement of mechanical properties of arteries in health and disease

Abstract

Major conduit arteries should, by their elastic nature, be able to store blood volume temporarily during systole and release it during diastole. This reduces the systolic blood pressure required for the flow of a given volume quantity and gradually suppresses the pulsatile flow pattern. The haemodynamic characteristics of arteries have consequences for the load of the heart but also for the mechanical load of the arterial wall. The repetitive stretching of the wall (strains of up to 10 per cent) may cause fragmentation of the elastic fibres in the wall, modifying wall elasticity. To maintain wall stress the elastic arteries respond with a diameter increase in combination with an increase of arterial wall thickness. A larger diameter for a smaller distension (change in artery diameter from diastole to systole) will restrict the reduction in storage capacity. Alternatively, pulse pressure may go up, increasing the mechanical load on the wall. In recent years various methods have been developed to assess and monitor the above interaction. Most of these methods are based on ultrasound techniques because of its wide availability and its non-invasive and non-traumatic nature. Presently these techniques enable the assessment of wall thickness, diastolic diameter, distension waveform, i.e. the time-dependent change in diameter, the relative pulsatile increase in diameter, and pulse wave velocity, for elastic and muscular arteries in humans but also in small animals such as rats and mice. The present paper discusses the techniques in more detail.