Compliance is the ability of a hollow organ (vessel) to distend and increase volume with increasing transmural pressure or the tendency of a hollow organ to resist recoil toward its original dimensions on application of a distending or compressing force. It is the
reciprocal of "elastance", hence elastance is a
measure of the tendency of a hollow
organ to
recoil
Recoil (often called knockback, kickback or simply kick) is the rearward thrust generated when a gun is being discharged. In technical terms, the recoil is a result of conservation of momentum, as according to Newton's third law the force r ...
toward its original
dimensions
In physics and mathematics, the dimension of a mathematical space (or object) is informally defined as the minimum number of coordinates needed to specify any point within it. Thus, a line has a dimension of one (1D) because only one coord ...
upon removal of a distending or compressing force.
Blood vessels
The terms elastance and compliance are of particular significance in
cardiovascular physiology and
respiratory physiology
In physiology, respiration is the movement of oxygen from the outside environment to the cells within tissues, and the removal of carbon dioxide in the opposite direction that's to the environment.
The physiological definition of respiration di ...
. In compliance, an increase in volume occurs in a vessel when the pressure in that vessel is increased. The tendency of the
arteries
An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the pul ...
and
veins
Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated ...
to stretch in response to pressure has a large effect on perfusion and blood pressure. This physically means that blood vessels with a higher compliance deform easier than lower compliance blood vessels under the same pressure and volume conditions.
Venous compliance is approximately 30 times larger than arterial compliance.
Compliance is calculated using the following equation, where ΔV is the change in volume (mL), and ΔP is the change in pressure (
mmHg):
:
Physiologic compliance is generally in agreement with the above and adds ''dP/dt'' as a common academic physiologic measurement of both pulmonary and cardiac tissues. Adaptation of equations initially applied to
rubber
Rubber, also called India rubber, latex, Amazonian rubber, ''caucho'', or ''caoutchouc'', as initially produced, consists of polymers of the organic compound isoprene, with minor impurities of other organic compounds. Thailand, Malaysia, a ...
and
latex
Latex is an emulsion (stable dispersion) of polymer microparticles in water. Latexes are found in nature, but synthetic latexes are common as well.
In nature, latex is found as a milky fluid found in 10% of all flowering plants (angiosper ...
allow modeling of the dynamics of pulmonary and cardiac tissue compliance.
Veins have a much higher compliance than arteries (largely due to their thinner walls.) Veins which are abnormally compliant can be associated with
edema
Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels tight, the area ma ...
.
Pressure stockings are sometimes used to externally reduce compliance, and thus keep blood from pooling in the legs.
Vasodilation
Vasodilation is the widening of blood vessels. It results from relaxation of smooth muscle cells within the vessel walls, in particular in the large veins, large arteries, and smaller arterioles. The process is the opposite of vasoconstricti ...
and
vasoconstriction
Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels, in particular the large arteries and small arterioles. The process is the opposite of vasodilation, the widening of blood ve ...
are complex phenomena; they are functions not merely of the
fluid mechanics
Fluid mechanics is the branch of physics concerned with the mechanics of fluids (liquids, gases, and plasmas) and the forces on them.
It has applications in a wide range of disciplines, including mechanical, aerospace, civil, chemical and ...
of pressure and tissue
elasticity but also of active
homeostatic regulation with
hormone
A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs by complex biological processes to regulate physiology and behavior. Hormones are required ...
s and
cell signaling
In biology, cell signaling (cell signalling in British English) or cell communication is the ability of a cell to receive, process, and transmit signals with its environment and with itself. Cell signaling is a fundamental property of all cellula ...
, in which the body produces
endogenous
Endogenous substances and processes are those that originate from within a living system such as an organism, tissue, or cell.
In contrast, exogenous substances and processes are those that originate from outside of an organism.
For example, ...
vasodilators and vasoconstrictors to modify its vessels' compliance. For example, the
muscle tone
In physiology, medicine, and anatomy, muscle tone (residual muscle tension or tonus) is the continuous and passive partial contraction of the muscles, or the muscle's resistance to passive stretch during resting state.O’Sullivan, S. B. (2007). ...
of the
smooth muscle tissue
Smooth muscle is an involuntary non- striated muscle, so-called because it has no sarcomeres and therefore no striations (''bands'' or ''stripes''). It is divided into two subgroups, single-unit and multiunit smooth muscle. Within single-unit m ...
of the
tunica media
The tunica media (New Latin "middle coat"), or media for short, is the middle tunica (layer) of an artery
An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts o ...
can be adjusted by the
renin–angiotensin system
The renin–angiotensin system (RAS), or renin–angiotensin–aldosterone system (RAAS), is a hormone system that regulates blood pressure, fluid and electrolyte balance, and systemic vascular resistance.
When renal blood flow is reduced, j ...
. In patients whose endogenous homeostatic regulation is not working well, dozens of
pharmaceutical drug
A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field and ...
s that are also
vasoactive
A vasoactive substance is an endogenous agent or pharmaceutical drug that has the effect of either increasing or decreasing blood pressure and/or heart rate through its vasoactivity, that is, vascular activity (effect on blood vessels). By adj ...
can be added. The response of vessels to such vasoactive substances is called vasoactivity (or sometimes vasoreactivity). Vasoactivity can vary between persons because of
genetic and
epigenetic
In biology, epigenetics is the study of stable phenotypic changes (known as ''marks'') that do not involve alterations in the DNA sequence. The Greek prefix '' epi-'' ( "over, outside of, around") in ''epigenetics'' implies features that are " ...
differences, and it can be impaired by pathosis and by age. This makes the topic of
haemodynamic response
In haemodynamics, the body must respond to physical activities, external temperature, and other factors by homeostatically adjusting its blood flow to deliver nutrients such as oxygen and glucose to stressed tissues and allow them to function. ...
(including vascular compliance and
vascular resistance) a matter of medical and
pharmacologic complexity beyond mere
hydraulic
Hydraulics (from Greek: Υδραυλική) is a technology and applied science using engineering, chemistry, and other sciences involving the mechanical properties and use of liquids. At a very basic level, hydraulics is the liquid counter ...
considerations (which are complex enough by themselves).
The relationship between vascular compliance, pressure, and flow rate is Q=C(dP/dt) Q=flow rate (cm
3/sec)
Arterial compliance
The classic definition by MP Spencer and AB Denison of compliance (C) is the change in arterial blood volume (ΔV) due to a given change in
arterial blood pressure (ΔP). They wrote this in the "Handbook of Physiology" in 1963 in work entitled "Pulsatile Flow in the Vascular System". So, C = ΔV/ΔP.
Arterial compliance is an index of the
elasticity of large arteries such as the
thoracic aorta
The descending thoracic aorta is a part of the aorta located in the thorax. It is a continuation of the aortic arch. It is located within the posterior mediastinal cavity, but frequently bulges into the left pleural cavity. The descending thoracic ...
. Arterial compliance is an important cardiovascular risk factor. Compliance diminishes with age and menopause. Arterial compliance is measured by
ultrasound
Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies fr ...
as a pressure (
carotid artery Carotid artery may refer to:
* Common carotid artery, often "carotids" or "carotid", an artery on each side of the neck which divides into the external carotid artery and internal carotid artery
* External carotid artery
The external carotid arte ...
) and volume (outflow into
aorta
The aorta ( ) is the main and largest artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it splits into two smaller arteries (the common iliac arteries). The aorta distributes ...
) relationship.
Compliance, in simple terms, is the degree to which a container experiences pressure or force without disruption. It is used as an indication of
arterial stiffness
Arterial stiffness occurs as a consequence of biological aging and arteriosclerosis. Inflammation plays a major role in arteriosclerosis development, and consequently it is a major contributor in large arteries stiffening. Increased arterial sti ...
. An increase in the age and also in the systolic
blood pressure
Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressur ...
(SBP) is accompanied with decrease on arterial compliance.
Endothelial dysfunction results in reduced compliance (increased arterial stiffness), especially in the smaller arteries. This is characteristic of patients with
hypertension. However, it may be seen in normotensive patients (with normal blood pressure) before the appearance of clinical hypertension. Reduced arterial compliance is also seen in patients with
diabetes
Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level (hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...
and also in smokers. It is actually a part of a vicious cycle that further elevates blood pressure, aggravates
atherosclerosis
Atherosclerosis is a pattern of the disease arteriosclerosis in which the wall of the artery develops abnormalities, called lesions. These lesions may lead to narrowing due to the buildup of atheromatous plaque. At onset there are usually ...
(hardening of the arteries), and leads to increased cardiovascular risk. Arterial compliance can be measured by several techniques. Most of them are invasive and are not clinically appropriate.
Pulse contour analysis is a non-invasive method that allows easy measurement of arterial elasticity to identify patients at risk for cardiovascular events.
See also
*
Cardiovascular System Dynamics Society
*
Windkessel effect
References
External links
*
{{Cardiovascular physiology
Respiratory physiology
Cardiovascular physiology