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Review
. 2021 Jun 10:9:678048.
doi: 10.3389/fbioe.2021.678048. eCollection 2021.

The Rheology of the Carotid Sinus: A Path Toward Bioinspired Intervention

Andrew Iskander  1 , Coskun Bilgi  2 , Rotem Naftalovich  3   4 , Ilker Hacihaliloglu  5 , Tolga Berkman  3 , Daniel Naftalovich  6   7 , Niema Pahlevan  2   7
Affiliations
Review

The Rheology of the Carotid Sinus: A Path Toward Bioinspired Intervention

Andrew Iskander et al. Front Bioeng Biotechnol. .

Abstract

The association between blood viscosity and pathological conditions involving a number of organ systems is well known. However, how the body measures and maintains appropriate blood viscosity is not well-described. The literature endorsing the function of the carotid sinus as a site of baroreception can be traced back to some of the earliest descriptions of digital pressure on the neck producing a drop in blood delivery to the brain. For the last 30 years, improved computational fluid dynamic (CFD) simulations of blood flow within the carotid sinus have demonstrated a more nuanced understanding of the changes in the region as it relates to changes in conventional metrics of cardiovascular function, including blood pressure. We suggest that the unique flow patterns within the carotid sinus may make it an ideal site to transduce flow data that can, in turn, enable real-time measurement of blood viscosity. The recent characterization of the PIEZO receptor family in the sinus vessel wall may provide a biological basis for this characterization. When coupled with other biomarkers of cardiovascular performance and descriptions of the blood rheology unique to the sinus region, this represents a novel venue for bioinspired design that may enable end-users to manipulate and optimize blood flow.

Keywords: PIEZO receptor; baroreceptor; blood flow; carotid sinus; viscosity.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Schematic representation of an in-vitro experimental model of the carotid sinus (Ku and Giddens, 1983). (A) The presence of vortical or flow recirculation during the peak of systole results in sheer stress “impulses” against the sinus wall. (B) The anatomy of the sinus causes flow separation from the non-dividing wall resulting in a region of low wall shear stress.
FIGURE 2
FIGURE 2
Flow dynamics inside the carotid artery at deceleration, (A) axial velocity profiles, (B) three-dimensional representation of axial velocity profile at 4, (C) representation of circulatory flow vectors at 4, (D) wall shear stress values along the outer carotid wall (Karner et al., 1999).
FIGURE 3
FIGURE 3
Wall shear stress (in Pa) on carotid bifurcations of differing geometries obtained by CFD (left), MPL (middle), k-NN (right) algorithms (Milos et al., 2011).
FIGURE 4
FIGURE 4
(A) Time-averaged wall shear stress, (B) oscillatory shear index on carotid artery. ICA, internal carotid artery; ECA, external carotid artery; CCA, common carotid artery; and CS, carotid sinus (Iskander et al., 2020).
FIGURE 5
FIGURE 5
The role of PIEZO1 receptors in alignment of endothelial cells during cardiovascular embryological development (Li et al., 2014).
See this image and copyright information in PMC

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