An In Vivo Data-Based Computational Study on Sitting-Induced Hemodynamic Changes in the External Iliac Artery

Although sedentary behavior (characterized by prolonged sitting without otherwise being active in daily life) is widely regarded as a risk factor for peripheral artery disease (PAD), underlying biomechanical mechanisms remain insufficiently understood. In this study, geometrical models of ten external iliac arteries were reconstructed based on angiographic data acquired from five healthy young subjects resting in supine and sitting (mimicked by side lying with bent legs) positions, respectively, which were further combined with measured blood flow velocity waveforms in the common iliac arteries (with each body posture being maintained for 30 min) to build computational models for simulating intra-arterial hemodynamics. Morphological analyses showed that the external iliac arteries suffered from evident bending deformation upon the switch of body posture from supine to sitting. Measured blood flow velocity waveforms in the sitting position exhibited a marked decrease in mean flow velocity while increase in retrograde flow ratio compared with those in the supine position. Hemodynamic computations further revealed that sitting significantly altered blood flow patterns in the external iliac arteries, leading to a marked enlargement of atheroprone wall regions exposed to low and oscillatory wall shear stress (WSS), and enhanced multidirectional disturbance of WSS that may further impair endothelial function. In summary, our study demonstrates that prolonged sitting induces atheropromoting hemodynamic changes in the external iliac artery due to the combined effects of vascular bending deformation and changes in flow velocity waveform, which may provide important insights for understanding the involvement of biomechanical factors in sedentary behavior-related PAD.