급성 동정맥루를 포함하는 인체 심혈관계의 혈류역학적 거동에 관한 수치 해석적 연구

Computational Study on the Hemodynamic Behaviors of the Human Cardiovascular System with an Acute Arteriovenous Fistula

  • 변수영 (서울대학교 대학원 기계항공공학부) ;
  • 손정락 (서울대학교 기계항공공학부) ;
  • 심은보 (강원대학교 기계메카트로닉스 공학부) ;
  • 노승탁 (서울대학교 기계항공공학부)
  • 발행 : 2003.08.01

초록

선천적 혹은 후천적인 이유로 인하여 인체 특정 부위의 정맥과 동맥이 서로 관통하여 동맥계의 혈류가 말초 혈관계를 우회하여 정맥계로 흐르게 되는 동정맥루는 인체 심혈관계의 혈류 역학적 거동에 큰 영향을 미치게 된다. 본 연구에서는 lumped parameter 모델을 기반으로 하는 수치 해석 방법을 사용하여 우측 하지에 위치한 급성 동정맥루가 전체 심혈관계에 미치는 영향을 해석적으로 고찰하였다. 이를 위하여 동정맥루가 포함된 인체 심혈관계를 전기 회로 상사계로 구성하였으며. 부위별 혈압과 관련된 상미분 연립 방정식을 4차의 Runge-Kutta방법으로 풀어서 시간에 따른 혈류 역학적 변수들을 구하였다 이때 급성 동정맥루의 생성에 따른 혈류 역학적 보상작용을 분석하기 위하여 arterial baroreflex 제어계를 모델에 포함하였다.

Blood in congenital or acquired AY fistula(arteriovenous fistula) flows from arteries directly to veins. detouring peripheral micro-circulation. This makes a great effect on the hemodynamics of human cardiovascular system. In this study, a computational method using lumped parameter mode) was proposed to simulate the cardiovascular hemodynamics of patients with acute AV fistula The cardiovascular system model with a fistula compartment in left lower limb was built using 17 standard lumped compartments. Using fourth order Runge-Kutta method. we solved numerically the unsteady linear set of the ordinary differential equations resulting from application of Kirchhoff's law to the lumped parameter hemodynamic model. The baroreceptor reflex system was implemented to explain the auto-regulation effect of the cardiovascular system with acute AV fistula.

키워드

참고문헌

  1. 제2회 한국유체공학학술대회 논문집 동정맥류의 복합성 혈류학 소견이 그 관리에 미치는 영향 이병붕
  2. Vascular Surgery(5th edition) Arteriovenous communications and congenital vascular malformations: Overview Riles,T.S.;Rutherford,R.B.(ed.)
  3. Vascular Surgery(5th edition) Arteriovenous communication and congenital vascular malformations: Hemodynamics and pathophysiology of arteriovenous fistulae Summer,D.S.;Rutherford,R.B.(ed.)
  4. Vascular Surgery(5th edition) Angioacess: Hemodialysis access Gelabert,H.A.;Freischlag,J.A.;Rutherford,R.B(ed.)
  5. Computer Aided Surgery v.4 Predictive medicine: computational techniques in therapeutic decision-making Taylor,C.A.;Draney,M.T.;Ku,J.P.;Parker,D.;Steele,B.N.;Wang,K.;Zarins,C.K. https://doi.org/10.3109/10929089909148176
  6. Master Thesis of Massachusetts Institute of Technology Teaching Physiology Through Interactive Simulation of Hemodynamics Davis,T.L.
  7. Circulatory system dynamics Noordergraaf,A.
  8. Mathematical physiology Keener,J.P.;Sneyd,J.
  9. Baroreflex control of the systemic arterial pressure and vascual bed, in Handbook of Physiology, Section 2: The Cardivascular System v.Ⅲ Sagawa,K.;Berne,R.M.(ed.)
  10. Journal of Applied Physiology v.92 Computational modeling of cardiovascular response to orthostatic stress Heldy,T.;Shim,E.B.;Kamm,R.D.;Mark,R.G. https://doi.org/10.1152/japplphysiol.00241.2001
  11. Lecture Notes in Comprter Science v.2526 Computational Modeling of the Cardiovascular System after Fontan Procedure Shim,E.B.;Youn,C.H.;Heldt,T.;Kamm,R.D.;Mark,R.G. https://doi.org/10.1007/3-540-36104-9_12
  12. 대한의용생체공학회 논문집 v.22 no.5 단기적 자율조절기능을 포함하는 심혈관계 혈류역학 모델링에 관한 수치적 연구 심은보;정찬일;최한고
  13. Stroke v.27 no.6 Risk of intracranial arteriovenous malformation rupture due to venous drainage impairment Hademenos,G.J.;Massoud,T.F. https://doi.org/10.1161/01.STR.27.6.1072
  14. American Journal of Physiology v.262 Mathematical medeling of human cardiovascular system for simualtion of orthostatic response Melchior,F.M.;Srinivasan,R.S.;Charles,J.B.
  15. Annual New York Academic Science v.940 The Bezold-Jarisch reflex A historical perspective of cardiopulmonary reflexes Aviado,D.M.;Guevara Aviado D.
  16. American Jourmal of Physiology v.256 Transfer function analysis of autonomic regulation-I. Canine atrial rate response Berger,R.D.;Saul,J.P.;Cohen,R.J. https://doi.org/10.1152/ajpcell.1989.256.1.C142
  17. American Jourmal of Physiology v.263 no.22 Hemodynamic fluctuations and baro-reflex sensitivity in humans: A beat-to-beat model Deboer,R.W.
  18. American Jourmal of Physiology v.262 Mathematical modeling of human cardiovascular system for simulation of orthostatic response Melchior,F.M.;Srinivasan,R.S.;Charles,J.B.
  19. Circ. Res. v.47 Epinephrine and the carotid sinus reflex: influence on capacitive and resistive properties of the total systemic vascular bed of the dog Shoukas,A.A.;Brunner,M.C. https://doi.org/10.1161/01.RES.47.2.249
  20. American Jourmal of Physiology v.207 no.6 Effect of arteriovenous fistula on systemic and poulmonary circulations Nakano,J.;Schryver,C.D.
  21. Journal of Clinical Investigation v.30 no.2 The effect of temporary occlusion of arteriovenous fistulas on heart rate, stroke volume, and cardiac output Nickerson,J.L.;Eldin,D.C.;Warren,J.V. https://doi.org/10.1172/JCI102435