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 Series on Bioengineering a nd Biomedica l E ngineering – Vol. 9

D Y N A M I C S o f the
VASCULAR SYSTEM
Interaction with the Heart
Second Edition

9807_9789814723749_TP.indd 1 6/8/18 10:23 AM

 SERIES ON BIOENGINEERING AND BIOMEDICAL
ENGINEERING

Series Editor: John K-J Li (Department of Biomedical Engineering,

Rutgers University, USA)

The aims of the book series are to present a publishing forum for established
researchers, educators and professionals in the field of bioengineering and
biomedical engineering to promote in-depth documentation of new scientific
findings, technological advances, and to provide effective teaching tools of the
fundamental aspects of the field. Single or multiple authored or edited books,
research monographs, textbooks, lab manuals and specialized conference pro-
ceedings are welcome. Topics of interest include biosensors, biomedical devices
and instrumentation, physiological modeling and signal processing, medical
imaging, drug delivery systems, clinical monitoring, tissue engineering, sys-
tems biology and bioinformatics, biomechanics and biomaterials, rehabilitation
and prostheses, nano and micro applications to biomedicine, biomedical optics,
biofluid mechanics, artificial organs and assist devices.

Published

Vol. 9: Dynamics of the Vascular System: Interaction with the Heart

(Second Edition)
by John K-J Li (Rutgers University, USA)

Vol. 8: Neuroprosthetics: Theory and Practice (Second Edition)

edited by Kenneth Horch (University of Utah, USA) and
Daryl Kipke (University of Utah, USA)

Vol. 7: Further Understanding of the Human Machine: The Road to

Bioengineering
edited by Max E Valentinuzzi (National Scientific and Technical
Research Council (CONICET), Argentina)

Vol. 6: Cardiac Fibrillation-Defibrillation: Clinical and Engineering Aspects

by Max E Valentinuzzi (University of Buenos Aires, Argentina &
University of Tucumán, Argentina)

Vol. 5: Biomedical Engineering Principles of the Bionic Man

by George K Hung (Department of Biomedical Engineering,
Rutgers University, USA)

For the complete list of volumes in this series, please visit

www.worldscientific.com/series/sbbe

Alex - 9807 - Dynamics of the Vascular System.indd 1 30-07-18 12:30:20 PM

 Series on Bioengineering and Biomedical Engineering – Vol. 9

DYNAMICS of the
VASCULAR SYSTEM
Interaction with the Heart
Second Edition

John K-J Li
Rutgers University, USA

World Scientific
NEW JERSEY • LONDON • SINGAPORE • BEIJING • SHANGHAI • HONG KONG • TAIPEI • CHENNAI • TOKYO

9807_9789814723749_TP.indd 2 6/8/18 10:23 AM

 Published by
World Scientific Publishing Co. Pte. Ltd.
5 Toh Tuck Link, Singapore 596224
USA office: 27 Warren Street, Suite 401-402, Hackensack, NJ 07601
UK office: 57 Shelton Street, Covent Garden, London WC2H 9HE

Library of Congress Cataloging-in-Publication Data

Names: Li, John K-J., 1950– author.
Title: Dynamics of the vascular system : interaction With the heart / by John K-J Li.
Other titles: Series on bioengineering and biomedical engineering ; v. 9.
Description: 2nd edition. | New Jersey : World Scientific, 2018. | Series: Series on bioengineering
and biomedical engineering ; volume 9 | Includes bibliographical references and index.
Identifiers: LCCN 2018010403 | ISBN 9789814723749 (hc : alk. paper)
Subjects: | MESH: Cardiovascular Physiological Phenomena | Models, Cardiovascular
Classification: LCC QP105 | NLM WG 102 | DDC 612.1--dc23
LC record available at https://lccn.loc.gov/2018010403

British Library Cataloguing-in-Publication Data

A catalogue record for this book is available from the British Library.

Copyright © 2019 by World Scientific Publishing Co. Pte. Ltd.

All rights reserved. This book, or parts thereof, may not be reproduced in any form or by any means,
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For photocopying of material in this volume, please pay a copying fee through the Copyright Clearance
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Desk Editor: Anthony Alexander

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Printed in Singapore

Alex - 9807 - Dynamics of the Vascular System.indd 2 30-07-18 12:30:20 PM

9in x 6in b3250 Dynamics of the Vascular System: Interaction with the Heart (2nd Edn) b3250-FM

Preface to the First Edition

This book is the first volume of the Bioengineering and Biomedical

Engineering Book Series. As the Series Editor, and to set a good
example, I have taken the task of writing yet another book on the
cardiovascular system.
The contents of this book extends from Arterial System Dynamics,
my first book published some fifteen years ago, to distinctly different
regimes of the microcirculation and the venous system, as well as the
assisted circulation.
The vascular system is indeed so vast, that a binocular vision is often
needed to unravel the mystery of the many concurrent interactions
occurring at different sites of the vascular tree. This becomes more
challenging with the imposition of studying its dynamic phenomena. The
Dynamics of the Vascular System is written employing mathematical
techniques to formulate the physical principles involved in the structural
and functional correlates of the underlying physiology. The intriguing
control and geometric perspectives are also included wherever possible.
The book also serves as a companion text to The Arterial Circulation:
Physical Principles and Clinical Applications.
Selected topics and references are provided, so that I and the readers
are not overwhelmed by the otherwise exhaustive presentations of the
many observed phenomena and the subsequent diverse interpretations of
their origins and mechanisms.
I hope professionals and students in the field of bioengineering and
biomedical engineering, biomathematics, biophysics, cardiovascular

v
9in x 6in b3250 Dynamics of the Vascular System: Interaction with the Heart (2nd Edn) b3250-FM

vi Preface to the First Edition

physiology and medicine will find this book a relevant source of

reference. Much of the work is the culmination of my three decades of
learning, experimenting and investigation. I am aware that there are
other works of notable items and newer advances which I have not yet
included in this book. I will continue to learn more of them. Finally, I
like to thank those who have contributed to the completion of this book.

John Kong-Jiann Li
New Jersey, USA
9in x 6in b3250 Dynamics of the Vascular System: Interaction with the Heart (2nd Edn) b3250-FM

Preface to the Second Edition

This book was originally published in 2004 as the first volume of the
Bioengineering and Biomedical Engineering Book Series. A decade has
quickly passed, together with the many advances in the sciences,
medicine and technology. I decided to take up the task to update some of
the materials for this second edition, while preserving the fundamental
concepts of the original text.
The contents of this second edition include explicitly a chapter on the
Interaction of the Heart and the Arterial System. This topic was
supported by the National Science Foundation that I began working on
right after completing my doctorate at the University of Pennsylvania
four decades ago with the late Professor Abraham Noordergraaf. This
chapter includes basic cardiac muscle mechanics, the contractile function
of the heart and its dependence on the operating relations with the
vascular system under normal and heart failure conditions, with emphasis
on their dynamic interaction. Examples of mechanical cardiac assist
devices and drug treatment are also included.
This second edition continues to emphasize on quantitative treatment
of the vascular system by analyzing the structural and functional
correlates of the underlying physiology. This may purposefully overlook
some of the clinical aspects in terms of diagnosis and treatment efficacies
of certain cardiovascular diseases. Similar to the first edition, rather than
being exhaustive, only selected topics and references are provided. In
this regard, worthwhile publications from some investigators may not
have been included.

vii
9in x 6in b3250 Dynamics of the Vascular System: Interaction with the Heart (2nd Edn) b3250-FM

viii Preface to the Second Edition

I hope many of the cardiovascular scientists, researchers and

clinicians, as well as students will continue to find this book a useful
reference. I like to thank those who have contributed to the completion
of this book.

John Kong-Jiann Li
New Jersey, USA
9in x 6in b3250 Dynamics of the Vascular System: Interaction with the Heart (2nd Edn) b3250-FM

About the Author

John K-J. Li obtained his Ph.D. in Bioengineering

from the University of Pennsylvania and has been a
Distinguished Professor of Biomedical Engineering
at Rutgers University since 1998. He has been an
elected Fellow of the American Institute for
Medical and Biological Engineering, the American
Colleges of Cardiology, the American College of
Angiology, and the Academy of Medicine of New
Jersey. He is also the Founding Editor-in-chief of
Springer’s Cardiovascular Engineering and Bioengineering and
Biomedical Engineering Book Series of World Scientific and Imperial
College Press, and is on the editorial boards of numerous journals. His
research has been founded by the NIH, NSF, AHA, and industry grants,
with interest in cardiac and vascular mechanics, modeling, medical
devices, controlled drug delivery, hypertension and heart failure,
neuroengineering, scaling in biology, and comparative physiology. He
has authored several books and published numerous articles and is a
frequently invited speaker at national and international conferences and
universities. He enjoys teaching and has been the adviser to more than 90
Ph.D. and M.S. students and 175 senior design students, and received
teaching excellence awards. He is also a holder of several US patents
and a recipient of the IEEE Millennium Medal.

ix
 b2530   International Strategic Relations and China’s National Security: World at the Crossroads

This page intentionally left blank

b2530_FM.indd 6 01-Sep-16 11:03:06 AM

9in x 6in b3250 Dynamics of the Vascular System: Interaction with the Heart (2nd Edn) b3250-TOC

Contents

Preface to the First Edition....................................................................... v

Preface to the Second Edition .................................................................vii
About the Author ...................................................................................... ix

Chapter 1. Historical Background and Book Contents ............................ 1

1.1 Discoveries of the Circulation .................................................... 1
1.2 Importance of the Vascular System ............................................ 7
1.3 Newer Concepts .......................................................................... 8
1.4 Book Contents ............................................................................ 9

Chapter 2. Vascular Biology, Structure and Function ........................... 15

2.1 Anatomical Organization of the Vasculature ............................ 15
2.1.1 The Closed-loop Circulatory System............................. 15
2.1.2 The Heart ....................................................................... 15
2.1.3 The Arteries ................................................................... 18
2.1.4 The Veins ....................................................................... 19
2.1.5 The Microvasculature .................................................... 20
2.2 Geometric and Mechanical Properties of Blood Vessels .......... 21
2.2.1 Geometric Nonuniformity of Blood Vessels ................. 21
2.2.2 Elastic Nonuniformity of the Blood Vessels ................. 24
2.2.3 Vascular Stiffness and Elastic Properties ...................... 25
2.3 Functional Properties of Blood ................................................. 31
2.3.1 Blood Plasma and Blood Gas ........................................ 31
2.3.2 Oxygen Saturation Curves and Hemoglobin ................. 32
2.3.3 Red Blood Cells, Hematocrit and Blood Volume.......... 35

xi
9in x 6in b3250 Dynamics of the Vascular System: Interaction with the Heart (2nd Edn) b3250-TOC

xii Contents

2.4 Control Aspects of the Vascular System .................................. 37

2.4.1 Control of the Central Cardiovascular System .............. 38
2.4.2 Functions of the Baroreceptors ...................................... 39
2.4.3 Arterial Chemoreceptors ................................................ 40

Chapter 3. Physical Concepts and Basic Fluid Mechanics .................... 43

3.1 Basic Mechanics and Dimensional Analysis ............................ 43
3.1.1 Mass, Length and Time System and the Pi-theorem
of Buckingham .............................................................. 43
3.1.2 Dimensional Matrix ....................................................... 45
3.1.3 Biological Scaling and Dynamics Similitude in
Vascular Biology ........................................................... 46
3.1.4 Elastic and Viscoelastic Properties of Blood
Vessels ........................................................................... 49
3.2 Frequency Domain and Fourier Analysis ................................. 56
3.2.1 Blood Pressure as a Periodic Function .......................... 56
3.2.2 Trigonometric Fourier Series ......................................... 57
3.2.3 Complex Form of Fourier Series ................................... 59
3.2.4 Other Aspects of Frequency Domain Analysis.............. 62
3.2.4.1 Dirichlet Conditions ........................................ 62
3.2.4.2 Line Spectrum and Nyquist Criterion.............. 63
3.2.4.3 Correlation, Coherence and Power
Spectrum .......................................................... 64
3.3 Fluid Mechanics and Rheology ................................................ 65
3.3.1 Steady Flow, the Poiseuille Equation and Flow
Velocity Profile.............................................................. 65
3.3.2 Bernoulli’s Equation and Narrowing Vessel Lumen
or Stenosis...................................................................... 70
3.3.3 Orifice Flow and Torricelli’s Equation.......................... 71
3.3.4 Valvular Cross-section and the Gorlin Equation ........... 72
3.3.5 Flow and Flow Acceleration .......................................... 72
3.3.6 Newtonian Fluid, No-Slip, Boundary Conditions
and Entry Length ........................................................... 75
3.3.6.1 Newtonian Fluid .............................................. 75
3.3.6.2 No-Slip Boundary Conditions ......................... 76
3.3.6.3 Laminar and Turbulent Flow ........................... 77
3.3.6.4 Entry Length .................................................... 78
9in x 6in b3250 Dynamics of the Vascular System: Interaction with the Heart (2nd Edn) b3250-TOC

Contents xiii

Chapter 4. Hemodynamics of Arteries ................................................... 79

4.1 Blood Pressure and Flow Relations .......................................... 79
4.1.1 Pulsatile Pressure and Flow Waveforms
in Arteries ...................................................................... 79
4.1.2 Pressure-flow Relations in the Aorta ............................. 82
4.2 Vascular Impedance to Blood Flow.......................................... 84
4.2.1 The Impedance Concept and Formulation ..................... 84
4.2.2 Input Impedance and Characteristic Impedance ............ 86
4.3 Pulse Wave Propagation Phenomena........................................ 90
4.3.1 The Pulse Wave Propagation Constant.......................... 90
4.3.2 Pulse Wave Velocity and the Foot-to-Foot
Velocity ......................................................................... 91
4.3.3 Apparent Propagation Constant and Transfer
Function ......................................................................... 94
4.3.4 Determination of the Propagation Constant
and Frequency Dependent Pulse Wave Velocity ........... 98
4.4 Pulse Wave Reflection Phenomena ........................................ 102
4.4.1 Influence of Wave Reflections on Pressure
and Flow Waveforms................................................... 102
4.4.2 The Reflection Coefficients ......................................... 108
4.4.3 The Augmentation Index ............................................. 111
4.4.4 Wave Reflection Sites and Multiple Reflections ......... 112
4.5 Modeling Aspects of the Arterial Circulation ......................... 114
4.5.1 Mathematical Formulations of Pulse Wave
Propagation .................................................................. 114
4.5.2 Linear Theories of Oscillatory Blood Flow in
Arteries ........................................................................ 118
4.5.3 The Lumped Model of the Arterial System and the
Windkessel Model ....................................................... 124
4.5.4 Nonlinear Aspects and Pressure-Dependent
Arterial Compliance..................................................... 130

Chapter 5. Vascular Branching ............................................................ 137

5.1 Branching Geometry ............................................................... 137
5.1.1 Complexity of Vascular Branching ............................. 137
5.1.2 Nonuniform Branching and 3-D Branching
Structures ..................................................................... 139
5.1.3 Space-Filling Properties and Modeling ....................... 141
9in x 6in b3250 Dynamics of the Vascular System: Interaction with the Heart (2nd Edn) b3250-TOC

xiv Contents

5.2 Fluid Mechanics of Vascular Branching................................. 144

5.2.1 Branching Geometry and Fluid Dynamic
Considerations ............................................................. 144
5.2.2 Fluid Mechanics Associated with Atherosclerosis
and Stenosis ................................................................. 149
5.3 Pulse Transmission Characteristics at Vascular
Branching ................................................................................ 151
5.3.1 Impedance Matching and Wave Reflections ............... 151
5.3.2 Area Ratio Concept...................................................... 154
5.3.3 Minimum Local Reflections at Vascular Branching
Junctions ...................................................................... 158
5.4 Optimization Aspects Applicable to Vascular Branching ...... 161
5.4.1 Optimizing Vessel Radius and the Cube Law ............. 161
5.4.2 Optimizing Branching Radii and Angles ..................... 164

Chapter 6. The Venous System ............................................................ 167

6.1 The Reservoir Properties and Venous Return ......................... 167
6.1.1 Venous Compliance and Reservoir Characteristics ..... 167
6.1.2 Structural Properties of Veins ...................................... 168
6.1.3 Venous Return ............................................................. 169
6.2 Pressure and Flow Waveforms in Veins ................................. 170
6.2.1 The Normal Pressure and Flow Waveforms
in Veins ....................................................................... 170
6.2.2 Respiration Effects on Venous Pressure and Flow
Waveforms................................................................... 172
6.2.3 Abnormal Venous Pressure and Flow Waveforms ...... 173
6.3 Modeling and Collapsible Vessel Properties .......................... 173
6.3.1 Steady Flow in Collapsible Tubes ............................... 173
6.3.2 Flow Limitation and Model Experiments .................... 175
6.3.3 Pulse Wave Transmission Characteristics in Veins ..... 180

Chapter 7. The Microcirculation .......................................................... 183

7.1 Structure of the Microcirculation ............................................ 183
7.1.1 Functional Organization of the Microvasculature ....... 183
7.1.2 The Capillary Circulation ............................................ 188
7.2 Pressure-Flow Relation and Microcirculatory Mechanics ...... 191
7.2.1 Flow-Related Mechanical Characteristics of the
Microcirculation .......................................................... 191
9in x 6in b3250 Dynamics of the Vascular System: Interaction with the Heart (2nd Edn) b3250-TOC

Contents xv

7.2.2 Some Pressure-Related Mechanical Characteristics

of the Microcirculation ................................................ 193
7.3 Pulse Transmission and Modeling Aspects ............................ 196
7.3.1 Pressure and Flow Waveforms in Arterioles
and Capillaries ............................................................. 196
7.3.2 Pulse Transmission Characteristics in the
Microcirculation .......................................................... 198
7.3.3 Modeling Aspects of the Microcirculation .................. 201

Chapter 8. Hemodynamic Measurements: Invasive and

Noninvasive Monitoring ................................................... 205
8.1 Catheterization for Blood Pressure Measurement .................. 205
8.1.1 Fluid-filled Blood Pressure Measurement
Systems ........................................................................ 205
8.1.2 Experimental Evaluation of the Frequency
Response of Catheter-Pressure Transducer
Systems ........................................................................ 208
8.2 Noninvasive Blood Pressure Measurements ........................... 213
8.2.1 Auscultation Measurement of Blood Pressure............. 213
8.2.2 Blood Pressure Measurement with the Oscillometric
Method ......................................................................... 215
8.2.3 Noninvasive Blood Pressure Monitoring with
Tonometer .................................................................... 217
8.2.4 The Photoplethysmograph (PPG) ................................ 219
8.3 Blood Flow Measurement ....................................................... 219
8.3.1 Electromagnetic Flowmeter ......................................... 219
8.3.2 Ultrasound and Doppler Flow Velocity
Measurement ............................................................... 221
8.3.3 Cardiac Output Measurement with Indicator
Dilution Methods and Thermodilution ........................ 224
8.4 Measurement of Vascular Dimensions ................................... 227

Chapter 9. Interaction of the Heart and the Arterial System ................ 229
9.1 Ventricular Outflow and the Aorta ......................................... 229
9.1.1 Ventricular Ejection ..................................................... 229
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