论文标题

生理血流是动荡的:重新审视血管血流动力学原理

Physiologic Blood Flow is Turbulent: Revisiting the Principles of Vascular Hemodynamics

论文作者

Saqr, Khalid M., Tupin, Simon, Rashad, Sherif, Endo, Toshiki, Niizuma, Kuniyasu, Tominaga, Teiji, Ohta, Makoto

论文摘要

血管血液动力学的当代范式认为正常的血液流量是脉动层流。过渡到湍流会导致诸如动脉粥样硬化或大脑动脉瘤等疾病。最近,我们证明了脑动脉瘤实验模型中的湍流。在动脉瘤囊中以及主动脉中。因此,我们很感兴趣地探索是否可以对血流的层流进行如此长期的假设。我们使用了混乱理论,流体动力稳定理论和湍流物理学的方法和工具来探索正常血管血流中湍流的存在。我们使用Womersley精确解决了Navier-Stokes方程的精确解决方案,并使用了生理血流测量数据库的数据库,为我们的发现提供了可再现的证据,以及来自健康志愿者的多普勒超声测量的证据。我们用来研究血液湍流特性的工具在混乱理论,流体动力稳定性和湍流动力学领域中得到了很好的确定。我们显然表明,血流本质上是混乱而动荡的,而不是层流。我们提出了血管血液动力学理论的范式转变,该理论需要重新考虑有关生理和病理过程的血流动力学联系。

Contemporary paradigm of vascular hemodynamics considers normal blood flow to be pulsatile laminar flow. Transition to turbulence can cause diseases such as atherosclerosis or brain aneurysms. Recently, we demonstrated the existence of turbulence in experimental models of brain aneurysm; in the aneurysm sac as well as in the main artery. Thus, we were intrigued to explore if such a long-standing assumption of the laminarity of blood flow could be challenged. We have used methods and tools from chaos theory, hydrodynamic stability theory and turbulence physics to explore the existence of turbulence in normal vascular blood flow. We used Womersley exact solution of the Navier-Stokes equation with the HaeMed database of physiologic blood flow measurements, to offer reproducible evidence for our findings, as well as evidence from Doppler ultrasound measurements from healthy volunteers. The tools we used to investigate the properties of blood turbulence are well established in the fields of chaos theory, hydrodynamic stability and turbulence dynamics. We show, evidently, that blood flow is inherently chaotic and turbulent and not laminar. We propose a paradigm shift in the theory of vascular hemodynamics which requires rethinking the hemodynamic-biologic links governing physiologic and pathologic processes.

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