Some Aspects of the Applied Hemodynamics in Diagnostic Angiology

1. Some Aspects of the Applied Hemodynamics in Diagnostic Angiology Author - Ulyana B. Lushchyk, MD, PhD, DSc Co-author - Novytskyy V. Viktor, Prof. D.Ph.&Math.Sc. Contacts Center of Innovative Medical Technologies “Victoria Veritas” Ukraine, 04070, Kyiv, PochayninskaStr 28 t. +380444676389 f.+380444676397 E-mail: u.lushchyk@gmail.com www.lushchyk.org.ua www.istyna.kiev.ua

2. Sometimes physical principles of some technologies, which are used very effectively by the human, are so confused and nebulous that many year passes when people clearly realize laws and rules, which these technologies were based on. М. H. Maxon, М. Аlbert, F.Hedowry

3. Hemodynamics (of Greekhaima – blood, dynamis – force) is a science, which appeared and is developing on the crossroads of hydromechanics and biology, it studies blood movement in the closed vascular system of the human organism taking into account morphological structure of blood, its physical-chemical characteristics, specific features of vascular wall, dynamics of the live system with applied adoption of the hydrodynamic postulates.

4. 1. The gradient of the hydrostatic pressure in various segments of the vascular system that is formed due to the pumping function of the myocardium. 2. Rheological properties of blood as the dispersion of the forming elements with properties of the non-Newton liquids. 3. Blood carrying vessels as the viscous-elastic tubes, whose properties (geometrical - size, branching and physical - viscosity, elasticity, penetration) vary in diameter and length.

5. HYDROMECHANICS Theoretical Technical hydromechanics hydromecanics (hydraulics) Hydrodynamics Rheology Hydrostatics Hemodynamics

6. Ideal Newton liquids – it is an abstract model that is used in order to simplify analytical investigations and is characterised with the absolutely unchangeable volume and complete absence of viscosity that’s friction forces under their moving. The profile of the velocity of movement of the ideal Newton liquid (viscosity = 0, F friction = 0)

7. Real Newton liquids are all liquids that exists in the nature and characterised by the viscosity - the force of the internal friction that appears in them while the layers are moving. Decreasing of their viscosity under increasing of the temperature is the characteristic feature of the real liquids (honey, tar, jam). The profile of the velocity of the real Newton liquid’s movement

8. Non-Newton liquids present various materials, whose only common properties are their fluidity and deviation from the friction law of Newton (marsh, emulsion, suspension, paint, blood). The profile of velocity of non-Newton liquids’ movement (viscous liquid)

9. As non-Newton liquids increase their viscosity under increasing of temperature, patients under hyperthermia and in the heat require more careful treatment.

10. The law of Hagen-Pausel A loss of liquids is proportional to decreasing of pressure per a unit of tube’s length and radius of the tube in the fourth power. Applied essence: is maintained with practically achieved velocities of movement of liquids in narrow tubes. This proportionality is not maintained for non-Newton liquids - with decreasing of velocity of the liquid’s movement the blood viscosity increases.

11. Hydrodynamic resistance with the pressure movement of real liquids 1. The variant of the pressure movement of the ideal liquid. 2. The variant of the pressure movement of the real liquid. 3. The variant of decreasing of the pressure movement of the real liquid in the conditions of the increased friction of the wall. Москва, 2005

15. The section that corresponds to the capillary net has the largest area Москва, 2005

16. According to the condition of the stream’s continuity in case of increasing of the system’s cross section area the velocity of blood flow decreases in the corresponding areas Москва, 2005

17. Hemodynamics Laws • The law of continuous movement • Stream of liquid can be continuous under condition of laminar stream and constant volumetric velocity (multiplication of velocity and cross section is the constant value): Sv = const • Volumetric velocity of blood flow is constant in any section of the cardio-vascular system.

18. 2. Bernoulli’s equation (1738) – it is a correlation for constant moving of tube of flow of ideal incompressible liquid. A product of geometric, piezometric and velocity height remains constant on the whole distance of the given flow of the liquid stream: z + p / + v2 / 2g = const, = g (– specific gravity of the liquid ) “energetic” presentation of the equation: zpg + p +  v2 / 2 = const, Zpg – hydraulic pressure, p – static pressure,  v2/2 – velocity (kinetic) pressure, that’s kinetic energy of the mass unit of the moving liquid.

19. A sum of three pressures - hydraulic, static and velocity (kinetic) - makes up complete pressure of the moving liquid and it is constant

20. That’s why separate kinds of mechanic energy can vary, but their sum remains the constant value - it is the law of the energy conservation of moving liquid, which is fundamental for the whole hydromechanics. Applying the Bernoulli’s equation to real liquid they take into account friction force too, which arises under liquids’ moving.

21. 3. The Puasel’s formula A magnitude of the volumetric velocity of liquid stream Q depends on the radius of the vesselr and is proportional to r4under condition of the relative stability of difference between pressure and length of the vessel.

22. Amount of blood that flow through a blood carrying bed per time unit is determined by the presence of two factors: 1) pressure gradient in the circulation system; 2) resistance of the blood carrying bed that depends on a degree of variance of the lumen of vessels and character of their branching.

23. All methods of the life-time investigation of the vascular system can be conditionally divided into the following directions: • Assessment of the heart’s and vessels’ structures • Assessment of the functional activity of the heart as a pump • Assessment of functions of vessels • Assessment of perfusion in organs and tissues • Assessment of the pressure in the vascular system • Assessment of the rheological features of blood flow

24. It is necessary to observe in order to realize and to realize in order to operate. Roman Rollan

25. Assessment of the venous channel and signs of the intracranial hypertension ASTd ACMd=s ACPd ASTs ACPs VJIs ACCs ACId=s ACCd VJId AB AVd=s

26. Hemodynamic efficiency of revascularization VJId VVs ACIs VJIs ACCs ACId VSTd AB ASTs VVd

27. Assessment of elastic- tonic features of vessels

28. Assessment of the hemodynamic importance ACCd ASTd ACCd after operation ACCs ASTs ACCs after operation ASTd after operation

29. Integrated approach to assessment of functioning of the hemodynamic system

30. Screening of ischemization of the myocardium with the correction of hemodynamics in the organism

33. Mathematical Modeling of Possible Tracts of Revascularization • Calculation of the size of the hydraulic stroke • Calculation of the required caliber of a vessel • Correction of the arteriovenous-liquor balance • An angle of incline of an artery in case of transposition The optimum angle up to 60° Present level of non-invasive investigation of the vascular bed requires profound knowledge of basics of hemodynamics and potential of the ultrasound devices not only from physicians, USD functional diagnostics, but also from vascular surgeons and neurosurgeons

34. 2 approaches: macrolevel of blood circulation; microcirculation

35. Thank you for attention