A systems approach to cardiovascular health and disease with a focus on aortic wave dynamics

Cardiovascular diseases (CVDs) have reached an epidemic proportion in the US and worldwide with serious consequences in terms of human suffering and economic impact. More than one third of American adults are suffering from CVDs. The total direct and indirect costs of CVDs are more than $500 billion per year. Therefore, there is an urgent need to develop noninvasive diagnostics methods, to design minimally invasive assist devices, and to develop economical and easy-to-use monitoring systems for cardiovascular diseases. In order to achieve these goals, it is necessary to gain a better understanding of the subsystems that constitute the cardiovascular system. The aorta is one of these subsystems whose role in cardiovascular functioning has been underestimated. Traditionally, the aorta and its branches have been viewed as resistive conduits connected to an active pump (left ventricle of the heart). However, this perception fails to explain many observed physiological results. My goal in this thesis is to demonstrate the subtle but important role of the aorta as a system, with focus on the wave dynamics in the aorta.

The operation of a healthy heart is based on an optimized balance between its pumping characteristics and the hemodynamics of the aorta and vascular branches. The delicate balance between the aorta and heart can be impaired due to aging, smoking, or disease. The heart generates pulsatile flow that produces pressure and flow waves as it enters into the compliant aorta. These aortic waves propagate and reflect from reflection sites (bifurcations and tapering). They can act constructively and assist the blood circulation. However, they may act destructively, promoting diseases or initiating sudden cardiac death. These waves also carry information about the diseases of the heart, vascular disease, and coupling of heart and aorta. In order to elucidate the role of the aorta as a dynamic system, the interplay between the dominant wave dynamic parameters is investigated in this study. These parameters are heart rate, aortic compliance (wave speed), and locations of reflection sites. Both computational and experimental approaches have been used in this research. In some cases, the results are further explained using theoretical models.

The main findings of this study are as follows: (i) developing a physiologically realistic outflow boundary condition for blood flow modeling in a compliant vasculature; (ii) demonstrating that pulse pressure as a single index cannot predict the true level of pulsatile workload on the left ventricle; (iii) proving that there is an optimum heart rate in which the pulsatile workload of the heart is minimized and that the optimum heart rate shifts to a higher value as aortic rigidity increases; (iv) introducing a simple bio-inspired device for correction and optimization of aortic wave reflection that reduces the workload on the heart; (v) deriving a non-dimensional number that can predict the optimum wave dynamic state in a mammalian cardiovascular system; (vi) demonstrating that waves can create a pumping effect in the aorta; (vii) introducing a system parameter and a new medical index, Intrinsic Frequency, that can be used for noninvasive diagnosis of heart and vascular diseases; and (viii) proposing a new medical hypothesis for sudden cardiac death in young athletes.

Dynamics of Granular Crystals with Elastic-Plastic Contacts

We study the behavior of granular crystals subjected to impact loading that creates plastic deformation at the contacts between constituent particles. Granular crystals are highly periodic arrangements of spherical particles, arranged into densely packed structures resembling crystals. This special class of granular materials has been shown to have unique dynamics with suggested applications in impact protection. However, previous work has focused on very low amplitude impacts where every contact point can be described using the Hertzian contact law, valid only for purely elastic deformation. In this thesis, we extend previous investigation of the dynamics of granular crystals to significantly higher impact energies more suitable for the majority of applications. Additionally, we demonstrate new properties specific to elastic-plastic granular crystals and discuss their potential applications as well. We first develop a new contact law to describe the interaction between particles for large amplitude compression of elastic-plastic spherical particles including a formulation for strain-rate dependent plasticity. We numerically and experimentally demonstrate the applicability of this contact law to a variety of materials typically used in granular crystals. We then extend our investigation to one-dimensional chains of elastic-plastic particles, including chains of alternating dissimilar materials. We show that, using the new elastic-plastic contact law, we can predict the speed at which impact waves with plastic dissipation propagate based on the material properties of the constituent particles. Finally, we experimentally and numerically investigate the dynamics of two-dimensional and three-dimensional granular crystals with elastic-plastic contacts. We first show that the predicted wave speeds for 1D granular crystals can be extended to 2D and 3D materials. We then investigate the behavior of waves propagating across oblique interfaces of dissimilar particles. We show that the character of the refracted wave can be predicted using an analog to Snell's law for elastic-plastic granular crystals and ultimately show how it can be used to design impact guiding "lenses" for mitigation applications.