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Published Online
on February 6, 2006

Hypertension. 2006
Published online before print February 6, 2006, doi: 10.1161/01.HYP.0000205915.15940.15
A more recent version of this article appeared on March 1, 2006
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Submitted on October 5, 2005
Revised on October 21, 2005
Accepted on December 20, 2005

Smart Damping Modulation of Carotid Wall Energetics in Human Hypertension. Effects of Angiotensin-Converting Enzyme Inhibition

Ricardo L. Armentano*; Juan G. Barra; Daniel Bia Santana; Franco M. Pessana; Sebastian Graf; Damian Craiem; Laura M. Brandani; Hugo P. Baglivo; and Ramiro A. Sanchez

From the Facultad de Ingeniería y Ciencias Exactas y Naturales (R.L.A., J.G.B., F.M.P., S.G., D.C.) and the Departamento de Ciencias Fisiológicas (J.G.B.), Universidad Favaloro, Buenos Aires, Argentina; the Departamento de Fisiología (R.L.A., D.B.S.), Facultad de Medicina, Universidad de la República, Montevideo, Uruguay; and the Servicio de Hipertensión Arterial (L.M.B., H.P.B., R.A.S.), Hospital Universitario, Fundación Favaloro, Buenos Aires, Argentina.

* To whom correspondence should be addressed. E-mail: armen{at}favaloro.edu.ar.

Abstract--Damping is the conversion of mechanical energy of a structure into thermal energy, and it is related to the material viscous behavior. To evaluate the role of damping in the common carotid artery (CCA) wall in human hypertension and the possible improvement of angiotensin-converting enzyme (ACE) inhibition, we used noninvasive CCA pressure (tonometry) and diameter (B-mode echography) waveforms in normotensive subjects (NT group; n=12) and in hypertensive patients (HT group; n=22) single-blind randomized into HT-placebo (n=10) or HT-treated (ramipril, 5 to 10 mg/d during 3 months; n=12). Vascular smooth muscle (VSM) null tonus condition was achieved from in vitro pressure and diameter waveforms (Konigsberg microtransducer and sonomicrometry) measured in explanted human CCA (n=14). Arterial wall dynamics was described by viscous ({eta}), inertial (M), and compliance (C) parameters, mean circumferential wall stress, viscous energy dissipation (WD), peak strain energy (WSt), damping ratio ({xi}=WD/WSt), and modeling isobaric indexes CIso and WSt(Iso). The lack of VSM tonus isobarically increased wall stress and reduced {eta}, CIso, and damping (P<0.01). Wall stress, {eta}, and WD were greater in HT than in NT (P<0.015) and arrived near normal in HT-treated (P<0.032 respect to HT), with no changes in HT-placebo. Whereas CIso increased in HT-treated (P<0.01) approaching the NT level, {xi} did not vary among groups. During hypertension, because of the WSt increase, the arterial wall reacts increasing WD to maintain {xi}. ACE inhibition modulates VSM activation and vessel wall remodeling, significantly improving wall energetics and wall stress. This protective vascular action reduces extra load to the heart and maintains enhanced arterial wall damping.


Key words: carotid arteries • muscle, smooth, vascular • compliance • viscosity




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