title: Does lower limb exercise worsen renal artery hemodynamics in patients with abdominal aortic aneurysm?
abstract: Renal artery stenosis (RAS) and renal complications emerge in some patients after endovascular aneurysm repair (EVAR) to treat abdominal aorta aneurysm (AAA). The mechanisms for the causes of these problems are not clear. We hypothesized that for EVAR patients, lower limb exercise could negatively influence the physiology of the renal artery and the renal function, by decreasing the blood flow velocity and changing the hemodynamics in the renal arteries. To evaluate this hypothesis, pre- and post-operative models of the abdominal aorta were reconstructed based on CT images. The hemodynamic environment was numerically simulated under rest and lower limb exercise conditions. The results revealed that in the renal arteries, lower limb exercise decreased the wall shear stress (WSS), increased the oscillatory shear index (OSI) and increased the relative residence time (RRT). EVAR further enhanced these effects. Because these parameters are related to artery stenosis and atherosclerosis, this preliminary study concluded that lower limb exercise may increase the potential risk of inducing renal artery stenosis and renal complications for AAA patients. This finding could help elucidate the mechanism of renal artery stenosis and renal complications after EVAR and warn us to reconsider the management and nursing care of AAA patients.
authors.affiliation: Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
authors.forename: Anqiang
authors.initials: A
authors.lastname: Sun
authors.affiliation: Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
authors.forename: Xiaopeng
authors.initials: X
authors.lastname: Tian
authors.affiliation: Radiologic Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.affiliation: College of Animal Science, Guizhou University, Guiyang, China.
authors.forename: Zaipin
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Deng
authors.affiliation: Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.affiliation: Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Liu
mesh_terms: D001012:Aorta, Abdominal / Q000503:physiopathology; D017544:Aortic Aneurysm, Abdominal / Q000503:physiopathology* / Q000601:surgery; D001783:Blood Flow Velocity / Q000502:physiology; D057510:Endovascular Procedures / Q000009:adverse effects; D015444:Exercise / Q000502:physiology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging; D035002:Lower Extremity / Q000503:physiopathology*; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012078:Renal Artery Obstruction / Q000503:physiopathology; D012079:Renal Circulation / Q000502:physiology; D013314:Stress, Mechanical; D014057:Tomography, X-Ray Computed