BIOMECHANICAL APPROACH TO THE CLINICAL TREATMENT OF PULMONARY ARTERIAL HYPERTENSION

Negative clinical trend of severe pulmonary arterial hypertension (PAH) is due to right ventricular chamber dilatation and consequent dysfunction. On a biomechanical basis the clinical evolution is associated to a progressive mismatching of the artero-ventricular junction and a possible mechanical intervention may be foreseen. This paper demonstrates how the progressive right ventricular dysfunction, in terms of biochemical-mechanical efficiency, is related to the stress-strain curve of the pulmonary artery, simulated by superimposing different elastance tubes in a cardiovascular mock. Applying the experimental signals to an "ideal" normal and dilated ventricle, it was demonstrated that the very high pulmonary elastance at high pressure is the prime cause of a sharp efficiency drop, in comparison with an aortic similar condition. This evidence supports the proposal of mechanical interventions to reduce pulmonary arterial elastance to improve the artero-ventricular matching, increase th...