Form and function of fetal and neonatal pulmonary arterial bifurcations

Stephen H. Bennett, Marlowe W. Eldridge, Daniel Zaghi, Shaaron E. Zaghi, Jay M Milstein, Boyd W. Goetzman

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

Bifurcation is a basic form of vascular connection. It is composed of a parent vessel of diameter d0, and two daughter vessels, d1 and d2, where d0 > d1 ≥ d2. Optimal values for the bifurcation area ratio, β = (d1/2 + d2/2)/d0/2 and the junction exponent, x, in d0/(x) = d1/(x) + d2/(x), are postulated to be universal in nature. However, we have hypothesized that the perinatal pulmonary arterial circulation is an exception. Arterial diameters were measured in pulmonary vascular casts of a fetal lamb (140 days gestation/145 days term) and a neonatal lamb (1 day old). The values for β and x were evaluated in 10,970 fetal and 846 neonatal bifurcations sampled from the proximal and intermediate arterial regions. Mean values and confidence intervals (CI) for the fetus were β = 0.890 (0.886-0.895 CI) and x = 1.75 (1.74-1.76 CI); and for the newborn were β = 0.913 (0.90-0.93 CI) and x = 1.79 (1.75-1.82 CI). These values are significantly different from Murray's law (β > 1, x = 3) or the West-Brown-Enquist law (β = 1, x = 2). Therefore, perinatal pulmonary bifurcation design appears to be distinctive and exceptional. The decreasing cross-sectional area with branching leads to the hemodynamic consequence of shear stress amplification. This structural organization may be important for facilitating vascular development at low flow rates; however, it may be the origin of unstable reactivity if elevated blood flow and pressure occurs.

Original languageEnglish (US)
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume279
Issue number6 48-6
StatePublished - 2000

Keywords

  • Branching complexity
  • Heterogeneity
  • Pulmonary arterial morphometry

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

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