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May 20, 2026Artery Research0 citationsOpen Access

A Constitutive Modelling Outlook on Arterial (dys)function: Bridging the Gap with the Clinic

AGA. Giudici

Key Result

Constitutive modelling provides a useful framework to represent whole-artery mechanics as superimposed contributions of microstructural constituents, offering insights into arterial ageing and disease.

Key Points

  • This paper aims to bridge the gap between clinical indices of arterial function and the underlying microstructural changes using constitutive modelling.
  • Overview of career development lecture at ARTERY24 conference.
  • Illustrative examples of previous work on arterial mechanics and microstructure.
  • Discussion of biomechanical data requirements for effective model parametrisation.
  • Constitutive models reveal detailed insights into age-related arterial stiffening dynamics.
  • Viscoelastic characterisation aids in understanding microstructural disease mechanisms.
  • Proposed strategies for model parametrisation to enhance clinical decision-making capabilities.

PICO

P
Population
Arterial dysfunction
I
Intervention / Comparator
Constitutive modelling

Limitations

  • Scarcity of human tissue for ex vivo testing
  • Sparsity of arterial biomechanical data that can be acquired clinically in vivo
  • Risk of overfitting when parametrising complex models on sparse in vivo data
  • Extensive biomechanical data for model parametrisation is the main limiting factor to widespread adoption in clinical settings.

Abstract

Abstract The compliant properties of arteries are pivotal to cardiovascular function and arise from the concerted work of a highly specialised wall microstructure comprising compliant elastin, progressively recruited, stiff collagen fibres, and contractile vascular smooth muscle cells (VSMCs). Ageing and disease disrupt this (micro)structure–function coupling. While conventional clinical vascular indices allow for characterising the functional consequences of vascular ageing, they provide limited mechanistic insight into the underlying microstructural remodelling processes. Using illustrative examples from our group’s previous work, this paper, which provides an overview of my Career Development Lecture at the ARTERY24 conference (Cardiff, UK), proposes constitutive modelling as a useful framework to bridge this gap by representing whole-artery mechanics as the superimposed contributions of key microstructural constituents. The first example illustrates the ability of constitutive models to provide a detailed microstructural interpretation of the temporal dynamics of age-related arterial stiffening. The second example disentangles the microstructural determinants of arterial viscoelasticity and highlights the usefulness of viscoelastic characterisation to unravel microstructural disease mechanisms. The third demonstrates the formulation of a multi-scale model of the tri-layered arterial wall to highlight the functional uniqueness of the ascending aorta as the principal determinant of windkessel function. Finally, this paper recognises the need for extensive biomechanical data for model parametrisation as the main limiting factor to the widespread adoption of constitutive modelling in clinical settings. It discusses mechanobiologically informed constraints and longitudinal, multi-bed acquisitions of arterial waveforms as potential strategies to aid model parametrisation with sparse in vivo data, which may pave the way for future use of constitutive modelling to inform clinical decision-making.

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Cite This Study

A. Giudici (2026) conducted a review in Arterial dysfunction. Constitutive modelling was evaluated. Constitutive modelling provides a useful framework to represent whole-artery mechanics as superimposed contributions of microstructural constituents, offering insights into arterial ageing and disease.

synapsesocial.com/papers/6a0d4efcf03e14405aa9a365https://doi.org/10.1007/s44200-026-00116-z
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