Possible Assessment of Calf Venous Pump Efficiency by Computational Fluid Dynamics Approach

Niccolini, Gianni; Manuello, A.; Capone, Antonio; Marongiu, Giuseppe; Dell'Osa, A; Fois, Andrea; Velluzzi, Fernanda; Concu, Alberto

doi:10.3389/fphys.2020.01003

Cited by 4 publications

(3 citation statements)

References 60 publications

(77 reference statements)

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“…This observed, monotonic, pressor response to adjust blood flow demand towards limbs muscles enhancing power output, agrees to the muscle metaboreflex induced pressor response [7]. In fact, it may be that pilots contracted limb muscles while since, even though in a simulated way, they were strongly engaged in coping with the unforeseen mechanical emergency, thus suddenly increasing intramuscle pressure and diminishing, in this way, the blood flow from superficial towards central limb veins due to possible diameter constriction of perforating veins [8]. The relative stagnation of blood in the superficial venous circulation of muscle legs could induce accumulation of by-products of metabolism in muscles extra vascular space.…”

Section: Discussionsupporting

confidence: 54%

Cardiodynamic adjustments in skilled civil aircraft pilots while unexpected emergency conditions appeared during a simulated flight within a homemade Airbus A300 cockpit

Concu,

Melis,

Marcello

et al. 2024

J. Phys.: Conf. Ser.

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To highlight which cardiodynamic adjustments take place in civil aircraft pilots when unexpected mechanical accidents occur while they are in flight, in 8 skilled pilots we detected the mean blood arterial pressure (MAP) and heart rate (HR) while a unexpected failing of one engine occurred when they were engaged in a simulated flight with a homemade Airbus A300 cockpit. Comparing these two cardiovascular variables in a simulated flight test, just as when the accident happened, together with the values assessed in a simulated control flight without accidents, by the non-parametric Wilcoxon test for paired data it has been found a significant increase of MAP’s median (+ 20.3%, P = 0.008) without significant increase in HR one. However, in several tested pilots this sudden MAP increase tended to progressively recover baseline values while simulating the flight despite the event triggering this functional response was still present. We concluded that the cardiovascular apparatus of skilled aircraft civil pilots adapts in such a way of sudden respond to unexpected emergency conditions by adjusting mean arterial blood pressure for adequate blood flow to limb muscles, and this happens without a concomitant tachycardia response in order to maintain an optimal mechanical/metabolic efficiency of the heart.

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Section: Discussionsupporting

confidence: 54%

Cardiodynamic adjustments in skilled civil aircraft pilots while unexpected emergency conditions appeared during a simulated flight within a homemade Airbus A300 cockpit

Concu,

Melis,

Marcello

et al. 2024

J. Phys.: Conf. Ser.

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“…With properly functioning valves, contraction of the calf muscle compresses the vein and pumps blood upwards [19]. During walking, the calf muscle pump causes a decrease in the capacity of the venous system, which leads to a decrease in the pressure in the veins.…”

Section: Changes In the Vein Wall Structurementioning

confidence: 99%

Factors Influencing Venous Remodeling in the Development of Varicose Veins of the Lower Limbs

Gwozdzinski,

Pieniazek,

Gwozdzinski

2024

IJMS

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One of the early symptoms of chronic venous disease (CVD) is varicose veins (VV) of the lower limbs. There are many etiological environmental factors influencing the development of chronic venous insufficiency (CVI), although genetic factors and family history of the disease play a key role. All these factors induce changes in the hemodynamic in the venous system of the lower limbs leading to blood stasis, hypoxia, inflammation, oxidative stress, proteolytic activity of matrix metalloproteinases (MMPs), changes in microcirculation and, consequently, the remodeling of the venous wall. The aim of this review is to present current knowledge on CVD, including the pathophysiology and mechanisms related to vein wall remodeling. Particular emphasis has been placed on describing the role of inflammation and oxidative stress and the involvement of extracellular hemoglobin as pathogenetic factors of VV. Additionally, active substances used in the treatment of VV were discussed.

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“…Для улучшения диагностики CVCS актуальным является создание с помощью специального программного обеспечения для объемного рендеринга реалистичных и интерактивных 3D-моделей венозной системы с реалистичной трехмерной моделью нижних конечностей. Использование методов виртуальной реальности позволяет провести полное анатомическое исследование как глубоких, так и поверхностных вен, включая виртуальное рассечение конечностей [64,65].…”

Section: диагностика хронического компартмент-синдромаunclassified

Chronic compartment-syndrome of the lower limb: modern strategies for diagnosis and treatment

Katorkin

Kushnarchuk

2023

Ambulatornaya khirurgiya

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A review of the literature is presented, including data on the incidence, pathophysiology, and clinical picture of patients with chronic compartment syndrome (CCS) of the lower extremities. Chronic exercise compartment syndrome (CECS) is characterized by pain with repetitive exertion and increased intracompartmental pressure affecting the lower extremities in physically active patients. In severe chronic venous insufficiency of the lower extremities, chronic venous compartment syndrome (CVCS) develops, which is fundamentally different from previously known clinical pictures. Progressive dermatolipofasciosclerosis and cicatricial destruction of the fascia of the leg in patients with C4b-C6 clinical classes according to CEAP affect the pressure in the muscle-fascial compartments at each step. In severe cases, this leads to significant changes in the muscles, accompanied by chronic ischemia associated with necrosis and glycogen deficiency. The analysis of various diagnostic methods, conservative treatment and methods for performing surgical decompression of the CCS was carried out. The lack of a clear pathophysiology for CECS and CVCS complicates the diagnosis and treatment of this condition. Diagnosis of calf CCS is still based on pressure testing in the musculofascial compartments of the calf using the Pedowitz criteria, however standard procedures for this, including patient position, static or dynamic movements, muscles and equipment tested, are not agreed upon. In patients with CCS, if conservative treatment is ineffective, fasciotomy of the affected parts of the lower leg is the method of choice. Various techniques for fasciotomy of the lower leg include the traditional open fasciotomy, the semi-closed technique with one or more incisions, the minimally invasive technique using endoscopic compartment release, and the use of ultrasound guidance. Fasciectomy of the lower leg to correct CVCS is performed mainly for recurrence of trophic ulcers after shave therapy, severe calcification of the lower leg tissues and for the treatment of deep transfascial necrosis. Randomized, blinded, controlled trials are needed to further expand our knowledge of the diagnosis and treatment of CCS.

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Possible Assessment of Calf Venous Pump Efficiency by Computational Fluid Dynamics Approach

Cited by 4 publications

References 60 publications

Cardiodynamic adjustments in skilled civil aircraft pilots while unexpected emergency conditions appeared during a simulated flight within a homemade Airbus A300 cockpit

Cardiodynamic adjustments in skilled civil aircraft pilots while unexpected emergency conditions appeared during a simulated flight within a homemade Airbus A300 cockpit

Factors Influencing Venous Remodeling in the Development of Varicose Veins of the Lower Limbs

Chronic compartment-syndrome of the lower limb: modern strategies for diagnosis and treatment

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