A Theoretical Simulation of Maladaptive Remodeling in Response to Hypertension

Hypertension is a key risk factor for many adverse cardiovascular events. The sustained increase in pressure causes arterial remodeling, which results in long-term changes in the geometrical dimensions and mechanical properties of the vascular tissue. The remodeling response in experimental animal models of hypertension is often described according to the structurally determined change in lumen diameter. Depending on whether the process resulted in a decrease or increase in the diameter, remodeling is termed inward or outward, while depending on the increase, no change, or decrease in the amount of material, remodeling is hypertrophic, eutrophic, or hypotrophic [1]. Due to the multi-factorial and complex nature of remodeling, it is exceedingly difficult to evaluate the relative importance of any one factor in isolation. Predictive mathematical models based on continuum mechanics are powerful tools for studying the mechanical and remodeling response of blood vessels. So far, most theoretical studies addressed adaptive remodeling in response to sustained hypertension. An adaptive response manifests as preservation of the normotensive deformed diameter, change in residual strains and axial stretch ratio, and thickening of the arterial wall, such that the tensile wall stress and flow-induced shear stress remain at baseline values. Maladaptive remodeling could result from a variety of dysfunctional biological processes, and is characterized by the incomplete restoration of the baseline mechanical environment. This study is devoted to a theoretical simulation of some modes of maladaptive remodeling and aims to evaluate the relative importance of certain geometrical and mechanical factors in the remodeling response to hypertension.