Analysis of arterial wall remodeling in hypertension based on lamellar modeling

- New insight on alteration of aortic lamellar microstructure in hypertension.
- Unchanged circumferential stress profile across the media as remodeling criterion.
- Coupling the thickening and stiffening responses of the wall to hypertension.
- Such approach restores the disturbed load environment for smooth muscle cells across the wall.
- Incorporation of residual stresses for more precise stress analysis within the wall.

Arterial wall remodels its geometry and mechanical properties in response to hypertension to maintain functionality. The elevated pressure is sensed through cellular mechanotransduction pathways, and extra extracellular matrix is synthesized, leading to thickening and stiffening. The present study enquires the response of aortic lamellar structure to hypertensive blood pressure regarding unchanged circumferential stress “profile” across the media as remodeling criterion. We tested the hypothesis that alterations in the thickness of structural layers contributes to maintain stress profile with least deviation from normotensive conditions. To test this notion, finite element analysis was recruited to evaluate stress profile, considering wall residual stress, and lamellar structure was adjusted through an optimization algorithm. Our results indicated 47% increased thickness of the aortic media that originates from nonhomogenous thickening of the microstructural units. The thickening and stiffening responses of the wall tissue were coupled, and the optimized pattern of hypertension-induced remodeling was established.