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Transient stenotic-like occlusions as a possible mechanism for renovascular hypertension due to aneurysm.
MedLine Citation:
PMID:  20409959     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The pathophysiologic basis of hypertension secondary to a renal artery aneurysm has not been established. Changes in renal artery geometry and resultant hemodynamic alterations activate the renin-angiotensin-aldosterone system and lead to hypertension. Hemodynamic pressure losses created by blood flowing through an abnormally structured renal artery with an aneurysm predictably would provoke a similar circumstance. The present study provides a hemodynamic rationale for this hypothesis. Using computational fluid dynamics, we have modeled renal flow for selected aneurysmal geometries. These studies reveal that pressure loss across the renal artery does not change ( approximately 0.9 mm Hg) significantly when a nondeformable aneurysm is interposed on the system. The calculations, however, demonstrate that the pressure on the aneurysm walls supports the presence of forces deforming and thereby obstructing the renal artery. A deformed wall was assumed and various degrees of occlusion were modeled. A partial occlusion of 60% resulted in a renal artery pressure loss of approximately 10 mm Hg. These simulations, when applied to aneurysms at various locations on the renal artery and with various degrees of occlusion, consistently resulted in pathologically relevant pressure losses. These findings lead to a new hypothesis of how aneurysms are associated with renovascular hypertension.
Authors:
Linden A Heflin; Carrie B Street; Dimitrios V Papavassiliou; David C Kem; Dee H Wu; Edgar A O'Rear
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Publication Detail:
Type:  Journal Article     Date:  2009-04-09
Journal Detail:
Title:  Journal of the American Society of Hypertension : JASH     Volume:  3     ISSN:  1933-1711     ISO Abbreviation:  J Am Soc Hypertens     Publication Date:    2009 May-Jun
Date Detail:
Created Date:  2010-04-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101312518     Medline TA:  J Am Soc Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  192-200     Citation Subset:  -    
Affiliation:
University of Oklahoma Bioengineering Center; Department of Chemical, Biological and Materials Engineering, University of Oklahoma; Norman, Oklahoma, USA.
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