Artículos de revistas
The dicrotic notch analyzed by a numerical model
Fecha
2016-05Registro en:
Politi, Teresa; Ghigo, Arthur; Fernández, Juan Manuel Francisco; Khelifa, Ismaïl; Gaudric, Julien; et al.; The dicrotic notch analyzed by a numerical model; Pergamon-Elsevier Science Ltd; Computers In Biology And Medicine; 72; 5-2016; 54-64
0010-4825
CONICET Digital
CONICET
Autor
Politi, Teresa
Ghigo, Arthur
Fernández, Juan Manuel Francisco
Khelifa, Ismaïl
Gaudric, Julien
Fullana, José María
Lagrée, Pierre Yves
Resumen
Divergent concepts on the origin of the dicrotic notch are widespread in medical literature and education. Since most medical textbooks explain the origin of the dicrotic notch as caused by the aortic valve closure itself, this is commonly transmitted in medical physiology courses. We present clinical data and numerical simulations to demonstrate that reflected pressure waves could participate as one of the causes of the dicrotic notch. Our experimental data from continuous arterial pressure measurements from adult patients undergoing vascular surgery suggest that isolated changes in peripheral vascular resistance using an intravenous bolus of phenylephrine (a selective alpha 1-receptor agonist and thus a potent vasoconstrictor) modify the dicrotic notch. We then explore the mechanisms behind this phenomenon by using a numerical model based on integrated axisymmetric Navier-Stokes equations to compute the hemodynamic flow. Our model illustrates clearly how modifications in peripheral artery resistance may result in changes in the amplitude of the dicrotic notch by modifying reflected pressure waves. We believe that this could be a useful tool in teaching medical physiology courses.