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clinmed/2001060002v1 (August 2, 2001)
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Mathematical simulation of hemodynamical processes and medical technologies

Nadiya Tsitsyura, Victor V. Novyc’kyy, Prof., Ph. D., Ulyana B. Lushchyk, MD.

Istyna Scientific Methodological Medical Ultrasound Center

Kyiv, Ukraine

ABSTRACT

Vascular pathologies constitute a significant part of human’s diseases and their rate tends to increase. Numerous investigations of brain blood flow in a normal condition and in a pathological one has created a new branch of modern medicine - angioneurology. It combines the information on brain angioarchitecture and on blood supply in a normal condition and in a pathological one. Investigations of a disease’s development constitute an important problem of a modern medicine.

Cerebrum blood supply is regulated by arterial inflow and venous outflow, but, unfortunately, in the literature available arterial and venous beds are considered separately. This causes an one-sided interpretation of atherosclerotical and discirculatory encefalopathies. As arterial inflow and venous outflow are interrelated, it seems to be expedient to perform a complex estimation of arteriovenous interactions, prove a correlation dependence connection between the beds and find a dependence in a form of mathematical function. The results will be observed clearly in the graphs.

There were 139 patients aged from 2 up to 70 examined in the "Istyna" Scientific Medical Ultrasound Center by means of a Logidop 2 apparatus manufactured by Kranzbü hler, Germany using a technique of cerebral arteries and veins ultrasound location (invented and patented by Ulyana Lushchyk, State Patent of Ukraine N10262 of 19/07/1995). A clinical interpretation of the results obtained was performed.

With the help of this technique and ultrasound Dopplerography the blood flow in major head and cervical arteries was investigated. While performing a visual graphic analysis we paid attention to the changes of carotid artery (CA), internal jugular vein (IJV) and supratroclear artery’s (STA) hemodynamical parameters. Generally accepted blood flow parameters: FS - maximal systolic frequency and FD - minimal diastolic frequency were measured. The correlation between different combinations of parameters in the vessels mentioned above was investigated.

Correlation analysis shows a significant (r=0.95) interdependence between different combination of hemodynamical parameters.

Keywords: arteriovenous interactions, hemodynamical parameters, correlation dependence.

Vascular pathologies constitute a significant part of human’s diseases and their rate tends to increase. Numerous investigations of brain blood flow in a normal condition and in a pathological one has created a new branch of modern medicine - angioneurology. It combines the information on brain angioarchitecture and on blood supply in a normal condition and in a pathological one. Investigations of the disease development constitute an important problem of a modern medicine.

Cerebrum blood supply is regulated by arterial inflow and venous outflow, but, unfortunately, in the literature available arterial and venous beds are considered separately. This causes an one-sided interpretation of atherosclerotical and discirculatory encefalopathies [2, 4, 6]. As arterial inflow and venous outflow are interrelated, it seems to be expedient to perform a complex estimation of arteriovenous interactions, prove a correlation dependence between the beds and find a dependence in a form of a mathematical function. The results will be observed clearly in the graphs [1, 3 ,5, 9].

During the recent years the interest in this problem has picked up. The position of the “venology” has not changed substantially despite its being behind other fields of medicine. Moreover, a complicated diagnostics encouraged a wrong idea that cerebral venous blood flow disturbances are rare [2, 6]. This resulted in inexact diagnoses to many patients and the absence of an adequate therapy.

There were 139 patients aged from 2 up to 70 examined in the “Istyna” Scientific Medical Ultrasound Center by means of a Logidop 2 apparatus manufactured by Kranzbühler, Germany using a technique of cerebral arteries and veins ultrasound location (invented and patented by Ulyana Lushchyk, State Patent of Ukraine N10262 of 19/07/1995).

With the help of this technique and ultrasound Dopplerography the blood flow in major head and cervical arteries was investigated. While performing a visual graphic analysis we paid attention to the changes in carotid artery (CA), internal jugular vein (IJV) and supratroclear artery’s (STA) hemodynamical parameters. As homolateral arterial and venous blood flow features the brain, the data of hemodynamical parameters measurement were taken regardless the side (left or right) of investigation, i.e. 278=138*2 cases were investigated.

Generally accepted blood flow parameters: FS (maximal systolic frequency) and FD (minimal diastolic frequency) were measured.

The hemodynamical parameters mentioned above were divided into two groups: the first comprised the data of “hypertensives” (children of the parents suffering from arterial hypertension were chosen) and the second - the data of “hypotonics” (children of the parents with arterial hypotonia). Both groups were divided in several subgroups depending on the patients age. Thus, we have formed four subgroups of hypertensive patients: aged 2 - 17, aged 8 - 17, aged 18 - 30 and the last one - people aged over 30. Hypotonic patients were divided in a similar way.

The present work is based on the clinical conception of arterio-venous cerebral balance by Ulyana B. Lushchyk [7, 8].

The correlation between the following combinations of parameters in different vessels in hypertensives and hypotonics was investigated:

CA (FS-FD) / IJV (FS-FD) with IJV (FS/FD), STA (FS/FD).

 

  1. In the first subgroup the dynamics of IJV (FS/FD) and STA (FS/FD) with CA (FS-FD) / IJV (FS-FD) changing in hypertensives and hypotonics aged 2 - 7.

For that purpose the patients in two subgroups were divided into three types depending on the value of CA (FS-FD) / IJV (FS-FD) (Fig. 1.1, 2.1):

    1. CA (FS-FD) / IJV (FS-FD) £ 2 (absent in hypertensives)
    2. 2 < CA (FS-FD) / IJV (FS-FD) £ 4 (absent in hypotonics)
    3. CA (FS-FD) / IJV (FS-FD) > 4

 

Fig.1.1 shows that when the ratio CA (FS-FD) / IJV (FS-FD) is increasing, IJV (FS-FD) remains stable while STA (FS/FD) decrease rapidly. This is an evidence of a moderate correlation dependence between the hemodynamical parameters CA, IJV and STA.

Unlike the hypertensives, the similar parameters in hypotonics (Fig. 2.1) show a weak correlation dependence.

  1. In the other groups the dynamics of CA (FS-FD) / IJV (FS-FD) with IJV (FS-FD) and STA (FS/FD) in patients aged 8 - 17 was investigated.

For that purpose the patients in two subgroups were divided into three types depending on the value of the part of CA (FS-FD) and IJV (FS-FD) (Fig. 1.2, 2.2):

    1. CA (FS-FD) / IJV (FS-FD) £ 2
    2. 2 < CA (FS-FD) / IJV (FS-FD) £ 4
    3. CA (FS-FD) / IJV (FS+FD) > 4

 

As Fig. 1.2 shows IJV (FS/FD) and STA (FS/FD) decrease in hypertensives while increasing CA (FS-FD) / IJV (FS-FD). High correlation coefficients found prove the presence of a strong correlation dependence between these parameters.

The coefficients found in the hypotonics of the same subgroup prove a moderate correlation dependence between the parameters mentioned above.

  1. The dynamics CA (FS-FD) / IJV (FS-FD) with IJV (FS/FD) and STA (FS/FD) in hypertensive and hypotonic patients aged 18 - 30 was investigated in a similar way.

The patients were divided into three subgroups depending on the value of the part of CA (FS-FD) and IJV (FS-FD) as in the preceding cases (Fig. 1.3, 2.3).

    1. CA (FS-FD) / IJV (FS-FD) £ 2
    2. 2 < CA (FS-FD) / IJV (FS-FD) £ 4
    3. CA (FS-FD) / IJV (FS-FD) > 4 (absent in hypotonics)

Fig. 1.3 shows IJV (FS/FD) diminishing and STA (FS/FD) soaring while increasing CA (FS/FD) / IJV (FS – FD) in hypertensives of this subgroup. The correlation coefficients found prove the presence of a strong correlation dependence.

The calculated correlation coefficients show a rapid increase of IJV (FS/FD) and STA (FS/FD), when CA (FS/FD) / IJV (FS – FD) is growing. This is an evidence of a moderate correlation dependence between these values.

  1. The dynamics of CA (FS - FD) / IJV (FS – FD) with IJV (FS/FD) and STA (FS/FD) in hypertensive and hypotonic patients aged over 30 was investigated.

The patients were divided into three subgroups depending on the value of CA (FS - FD) / IJV (FS – FD) similarly the case III (Fig. 1.4, 2.4).

Fig. 1.4 shows IJV (FS – FD) decreasing and STA (FS/FD) increasing when CA (FS - FD) / IJV (FS – FD) is growing in hypertensives of this subgroup. The calculated correlation coefficients prove the presence of a moderate correlation dependence. IJV (FS/FD) and STA (FS/FD) in hypotonics of this subgroup remain stable while increasing CA (FS - FD) / IJV (FS – FD). The correlation coefficients found show a strong correlation dependence between these parameters.

References

  1. S. Blinkov, I. Hlezer, “Human brain in figures and tables”, Leningrad, 1964, 305 p.
  2. N. Vereshyagin, E. Shmidt, Vascular diseases of spinal cord and cerebrum, Moscow, 1976.
  3. Hemodynamics in a normal and pathologic condition, articles, editors V. Almazov, V. Tsyrlin, 1978, 172 p.
  4. Hemodynamics during hypertension, articles, 1986, 86 p.
  5. M. Guryevich, S. Berstein, Fundamentals of hemodynamics, Kyiv, 1979, 232 p.
  6. V. Lesnitskaya, Spinal cord and cerebrum venous system in a normal and pathologic condition, Moscow, 1972, 224 p.
  7. U. Lushchyk, Pecularities of arterial and venous cerebral blood supply changes in diagnostics and treatment of cerebrovascular diseases in differently aged persons, doctoral thesis, Kyiv, 1998.
  8. U. Lushchyk, Fundamentals of techniques of cerebrovascular ultrasound diagnosis, Kyiv, 1996, 133 p.
  9. I. Polyakov, N. Socolova, A manual of medical statistics, Moscow, 1975, 150 p.





This Article
Right arrow Abstract Freely available
Services
Right arrow Similar articles in this netprints
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Branicka, N.
Right arrow Articles by Novyckyy, V.
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Right arrow Articles by Branicka, N.
Right arrow Articles by Novyckyy, V.
Related Collections
Right arrow Cardiovascular Medicine:
Other Cardiovascular Medicine

Right arrow CLINICAL:
Imaging Techniques

Right arrow Neurology:
Other Neurology

Right arrow Surgery:
Neurosurgery


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