1
|
Cheng Y, Chen J, Zhao Q, Zhang J, Gao J. Association of carotid wall shear stress measured by vector flow mapping technique with ba-PWV: a pilot study. Front Cardiovasc Med 2023; 10:1293106. [PMID: 38144371 PMCID: PMC10748391 DOI: 10.3389/fcvm.2023.1293106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/31/2023] [Indexed: 12/26/2023] Open
Abstract
Objective Arterial stiffness is an important tissue biomarker of the progression of atherosclerotic diseases. Brachial-ankle pulse wave velocity (ba-PWV) is a gold standard of arterial stiffness measurement widely used in Asia. Changes in vascular wall shear stress (WSS) lead to artery wall remodeling, which could give rise to an increase in arterial stiffness. The study aimed to explore the association between ba-PWV and common carotid artery (CCA) WSS measured by a newly invented vascular vector flow mapping (VFM) technique. Methods We included 94 subjects free of apparent cardiovascular disease (CVD) and divided them into a subclinical atherosclerosis (SA) group (N = 47) and non subclinical atherosclerosis (NSA) group (N = 47). CCA WSS was measured using the VFM technique. Bivariate correlations between CCA WSS and other factors were assessed with Pearson's, Spearman's, or Kendall's coefficient of correlation, as appropriate. Partial correlation analysis was conducted to examine the influence of age and sex. Multiple linear stepwise regression was used for the analysis of independent determinants of CCA WSS. Receiver operating characteristic (ROC) analysis was performed to find the association between CCA WSS and 10-year CVD risk. Results The overall subjects had a mean age of 47.9 ± 11.2 years, and males accounted for 52.1%. Average systolic CCA WSS was significantly correlated with ba-PWV (r = -0.618, p < 0.001) in the SA group. Multiple linear stepwise regression analysis confirmed that ba-PWV was an independent determinant of average systolic CCA WSS (β = -0.361, p = 0.003). The area under the curve (AUC) of average systolic CCA WSS for 10-year CVD risk ≥10% was 0.848 (p < 0.001) in the SA group. Conclusions Average systolic CCA WSS was significantly correlated with ba-PWV and was associated with 10-year CVD risk ≥10% in the SA group. Therefore, CCA WSS measured by the VFM technique could be used for monitoring and screening subjects with potential CVD risks.
Collapse
Affiliation(s)
- Yi Cheng
- Department of Diagnostic Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jie Chen
- Department of Diagnostic Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Qing Zhao
- Department of Diagnostic Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jinghan Zhang
- Department of Diagnostic Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Junyi Gao
- Department of Cardiovascular Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
2
|
Ding H, Gao B, Ren Y, Bai D, Wu Z. Study on typical ruptured and unruptured intracranial aneurysms based on fluid-structure interaction. World Neurosurg 2023:S1878-8750(23)00332-7. [PMID: 36914031 DOI: 10.1016/j.wneu.2023.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Most intracranial aneurysms (IA) are abnormal bulges on the walls of intracranial arteries, which are the result of the dynamic interaction of geometric morphology, hemodynamics and pathophysiology. Hemodynamics plays a key role in the origin, development and rupture of intracranial aneurysm. In the past, the hemodynamic studies of intracranial aneurysm were mostly based on the rigid wall hypothesis of computational fluid dynamics, the influence of arterial wall deformation was ignored in these cases. To better capture the features of ruptured aneurysms, fluid-structure interaction (FSI) was used, because it can solve this problem very well and make the simulation more realistic. METHOD 8 ruptured IAs and 4 unruptured IAs at the middle cerebral artery (MCA) bifurcation are studied based on FSI, the goal is to better identify the characteristics of ruptured IA. We studied the differences of hemodynamic parameters such as flow pattern, wall shear stress (WSS), oscillatory shear index(OSI)and displacement and deformation of the arterial wall. RESULTS Ruptured IAs had a larger proportion of low wall shear stress area, and more complex, concentrated and unstable flow, OSI was higher. At the same time, there is a more concentrated and larger displacement deformation area at the ruptured IA. CONCLUSIONS Large AR and HW, complex, unstable and concentrated flow patterns with small impact areas, large low WSS region proportion and WSS fluctuation, high OSI and large displacement of aneurysm dome may be risk factors associated with aneurysm rupture If similar cases are encountered when the numerical simulation is used in clinic, priority should be given to diagnosis and treatment.
Collapse
Affiliation(s)
- Hongchang Ding
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology.
| | - Bei Gao
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology
| | - Yande Ren
- The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China.
| | - Di Bai
- The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Zeyu Wu
- The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| |
Collapse
|
3
|
Hanigk M, Burgstaller E, Latus H, Shehu N, Zimmermann J, Martinoff S, Hennemuth A, Ewert P, Stern H, Meierhofer C. Aortic wall shear stress in bicuspid aortic valve disease-10-year follow-up. Cardiovasc Diagn Ther 2023; 13:38-50. [PMID: 36864959 PMCID: PMC9971286 DOI: 10.21037/cdt-22-477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/19/2022] [Indexed: 02/21/2023]
Abstract
Background Bicuspid aortic valve (BAV) disease leads to deviant helical flow patterns especially in the mid-ascending aorta (AAo), potentially causing wall alterations such as aortic dilation and dissection. Among others, wall shear stress (WSS) could contribute to the prediction of long-term outcome of patients with BAV. 4D flow in cardiovascular magnetic resonance (CMR) has been established as a valid method for flow visualization and WSS estimation. The aim of this study is to reevaluate flow patterns and WSS in patients with BAV 10 years after the initial evaluation. Methods Fifteen patients (median age 34.0 years) with BAV were re-evaluated 10 years after the initial study from 2008/2009 using 4D flow by CMR. Our particular patient cohort met the same inclusion criteria as in 2008/2009, all without enlargement of the aorta or valvular impairment at that time. Flow patterns, aortic diameters, WSS and distensibility were calculated in different aortic regions of interest (ROI) with dedicated software tools. Results Indexed aortic diameters in the descending aorta (DAo), but especially in the AAo did not change in the 10-year period. Median difference 0.05 cm/m2 (95% CI: 0.01 to 0.22; P=0.06) for AAo and median difference -0.08 cm/m2 (95% CI: -0.12 to 0.01; P=0.07) for DAo. WSS values were lower in 2018/2019 at all measured levels. Aortic distensibility decreased by median 25.6% in the AAo, while stiffness increased concordantly (median +23.6%). Conclusions After a ten years' follow-up of patients with isolated BAV disease, indexed aortic diameters did not change in this patient cohort. WSS was lower compared to values generated 10 years earlier. Possibly a drop of WSS in BAV could serve as a marker for a benign long-term course and implementation of more conservative treatment strategies.
Collapse
Affiliation(s)
- Michael Hanigk
- Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Elisabeth Burgstaller
- Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Heiner Latus
- Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Nerejda Shehu
- Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Judith Zimmermann
- Department of Computer Science, Technical University of Munich, Munich, Germany
| | - Stefan Martinoff
- Radiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Anja Hennemuth
- Institute for Computational and Imaging Science in Cardiovascular Medicine, Charité Universitätsmedizin, Berlin, Germany;,Fraunhofer MEVIS Institute for Digital Medicine, Bremen, Germany
| | - Peter Ewert
- Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Heiko Stern
- Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Christian Meierhofer
- Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| |
Collapse
|
4
|
Qiu YJ, Cheng J, Zhang Q, Yang DH, Zuo D, Mao F, Liu LX, Dong Y, Cao SQ, Wang WP. Clinical Application of High-Frame-Rate Vector Flow Imaging in Evaluation of Carotid Atherosclerotic Stenosis. Diagnostics (Basel) 2023; 13:diagnostics13030519. [PMID: 36766624 PMCID: PMC9914914 DOI: 10.3390/diagnostics13030519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/16/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE This study seeks to evaluate the value of the high-frame-rate vector flow imaging technique in assessing the hemodynamic changes of carotid atherosclerotic stenosis in aging people (>60 years old). METHODS Aging patients diagnosed with carotid atherosclerotic stenosis who underwent carotid high-frame-rate vector flow imaging examination were prospectively enrolled. A Mindray Resona7s ultrasound machine equipped with high-frame-rate vector flow function was used for ultrasound evaluation. First, B mode ultrasound and color Doppler flow imaging were used to evaluate carotid stenosis. Then, the vector arrows and flow streamline detected by V Flow were analyzed and the wall shear stress values (Pa) at the carotid stenosis site were measured. All patients were divided into symptomatic and asymptomatic groups according to whether they had acute/subacute stroke or other clinical symptoms within 2 weeks before ultrasound examination. The results of digital subtraction angiography or computed tomography angiography were used as the gold standard. The stenosis rate was calcified, according to North American Symptomatic Carotid Endarterectomy Trial criteria. The diagnostic values of wall shear stress, conventional ultrasound, and the combined diagnosis in carotid atherosclerotic stenosis were compared. RESULTS Finally, 88 patients with carotid atherosclerotic plaque were enrolled (71 males (80.7%), mean age 67.6 ± 5.4 years). The success rate of high-frame-rate vector flow imaging was 96.7% (88/91). The WSS value of symptomatic carotid stenosis (1.4 ± 0.15 Pa) was significantly higher than that of asymptomatic carotid stenosis (0.80 ± 0.08 Pa) (p < 0.05). Taking the wall shear stress value > 0.78 Pa as the diagnostic criteria for symptomatic carotid atherosclerotic plaque, the area under receiver operating characteristic curves was 0.79 with 87.1% sensitivity and 69.6% specificity. The area under receiver operating characteristic curves of the combined diagnosis (0.966) for differentiating severe carotid atherosclerotic stenosis was significantly higher than that of conventional ultrasound and WSS value, with 89.7% sensitivity and 93.2% specificity (p < 0.05). CONCLUSION As a non-invasive imaging method, the high-frame-rate vector flow imaging technique showed potential value in the preoperative assessment of the symptomatic carotid atherosclerotic stenosis and diagnosing carotid atherosclerotic stenosis in aging patients.
Collapse
Affiliation(s)
- Yi-Jie Qiu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Juan Cheng
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - Qi Zhang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Dao-Hui Yang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Dan Zuo
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Feng Mao
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Ling-Xiao Liu
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- Correspondence: (L.-X.L.); (Y.D.); Tel.: +86-(0)21-6404-1990 (ext. 2474) (L.-X.L.); +86-(0)21-2507-6104 (Y.D.); Fax: +86-(0)21-6422-0319 (L.-X.L.); +86-(0)21-2507-7258 (Y.D.)
| | - Yi Dong
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
- Correspondence: (L.-X.L.); (Y.D.); Tel.: +86-(0)21-6404-1990 (ext. 2474) (L.-X.L.); +86-(0)21-2507-6104 (Y.D.); Fax: +86-(0)21-6422-0319 (L.-X.L.); +86-(0)21-2507-7258 (Y.D.)
| | - Si-Qi Cao
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - Wen-Ping Wang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| |
Collapse
|
5
|
Liu H, Liu Y, Ip BYM, Ma SH, Abrigo J, Soo YOY, Leung TW, Leng X. Effects of stent shape on focal hemodynamics in intracranial atherosclerotic stenosis: A simulation study with computational fluid dynamics modeling. Front Neurol 2022; 13:1067566. [PMID: 36582612 PMCID: PMC9792661 DOI: 10.3389/fneur.2022.1067566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022] Open
Abstract
Background and aims The shape of a stent could influence focal hemodynamics and subsequently plaque growth or in-stent restenosis in intracranial atherosclerotic stenosis (ICAS). In this preliminary study, we aim to investigate the associations between stent shapes and focal hemodynamics in ICAS, using computational fluid dynamics (CFD) simulations with manually manipulated stents of different shapes. Methods We built an idealized artery model, and reconstructed four patient-specific models of ICAS. In each model, three variations of stent geometry (i.e., enlarged, inner-narrowed, and outer-narrowed) were developed. We performed static CFD simulation on the idealized model and three patient-specific models, and transient CFD simulation of three cardiac cycles on one patient-specific model. Pressure, wall shear stress (WSS), and low-density lipoprotein (LDL) filtration rate were quantified in the CFD models, and compared between models with an inner- or outer-narrowed stent vs. an enlarged stent. The absolute difference in each hemodynamic parameter was obtained by subtracting values from two models; a normalized difference (ND) was calculated as the ratio of the absolute difference and the value in the enlarged stent model, both area-averaged throughout the arterial wall. Results The differences in focal pressure in models with different stent geometry were negligible (ND<1% for all cases). However, there were significant differences in the WSS and LDL filtration rate with different stent geometry, with ND >20% in a static model. Observable differences in WSS and LDL filtration rate mainly appeared in area adjacent to and immediately distal to the stent. In the transient simulation, the LDL filtration rate had milder temporal fluctuations than WSS. Conclusions The stent geometry might influence the focal WSS and LDL filtration rate in ICAS, with negligible effect on pressure. Future studies are warranted to verify the relevance of the changes in these hemodynamic parameters in governing plaque growth and possibly in-stent restenosis in ICAS.
Collapse
Affiliation(s)
- Haipeng Liu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Yu Liu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Bonaventure Y. M. Ip
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sze Ho Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jill Abrigo
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yannie O. Y. Soo
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Thomas W. Leung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Xinyi Leng
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,*Correspondence: Xinyi Leng
| |
Collapse
|
6
|
Veeturi SS, Patel TR, Baig AA, Chien A, Monteiro A, Waqas M, Snyder KV, Siddiqui AH, Tutino VM. Hemodynamic Analysis Shows High Wall Shear Stress Is Associated with Intraoperatively Observed Thin Wall Regions of Intracranial Aneurysms. J Cardiovasc Dev Dis 2022; 9. [PMID: 36547421 DOI: 10.3390/jcdd9120424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/23/2022] [Accepted: 11/26/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Studying the relationship between hemodynamics and local intracranial aneurysm (IA) pathobiology can help us understand the natural history of IA. We characterized the relationship between the IA wall appearance, using intraoperative imaging, and the hemodynamics from CFD simulations. METHODS Three-dimensional geometries of 15 IAs were constructed and used for CFD. Two-dimensional intraoperative images were subjected to wall classification using a machine learning approach, after which the wall type was mapped onto the 3D surface. IA wall regions included thick (white), normal (purple-crimson), and thin/translucent (red) regions. IA-wide and local statistical analyses were performed to assess the relationship between hemodynamics and wall type. RESULTS Thin regions of the IA sac had significantly higher WSS, Normalized WSS, WSS Divergence and Transverse WSS, compared to both normal and thick regions. Thicker regions tended to co-locate with significantly higher RRT than thin regions. These trends were observed on a local scale as well. Regression analysis showed a significant positive correlation between WSS and thin regions and a significant negative correlation between WSSD and thick regions. CONCLUSION Hemodynamic simulation results were associated with the intraoperatively observed IA wall type. We consistently found that elevated WSS and WSSNorm were associated with thin regions of the IA wall rather than thick and normal regions.
Collapse
|
7
|
Song D, Liu M, Dong Y, Hong S, Chen M, Du Y, Li S, Xu J, Gao W, Dong F. Investigation on the differences of hemodynamics in normal common carotid, subclavian, and common femoral arteries using the vector flow technique. Front Cardiovasc Med 2022; 9:956023. [PMID: 36465451 PMCID: PMC9712999 DOI: 10.3389/fcvm.2022.956023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 10/31/2022] [Indexed: 10/16/2023] Open
Abstract
OBJECTIVES To investigate the feasibility of the vector flow imaging (V Flow) technique to measure peripheral arterial hemodynamic parameters, including wall shear stress (WSS) and turbulence index (Tur) in healthy adults, and compare the results in different arteries. MATERIALS AND METHODS Fifty-two healthy adult volunteers were recruited in this study. The maximum and mean values of WSS, and the Tur values at early-systole, mid-systole, late-systole, and early diastole for total 156 normal peripheral arteries [common carotid arteries (CCA), subclavian arteries (SCA), and common femoral arteries (CFA)] were assessed using the V Flow technique. RESULTS The mean WSS values for CCA, SCA, and CFA were (1.66 ± 0.68) Pa, (0.62 ± 0.30) Pa, and (0.56 ± 0.27) Pa, respectively. The mean Tur values for CCA, SCA, and CFA were (0.46 ± 1.09%), (20.7 ± 9.06%), and (24.63 ± 17.66%), respectively. The CCA and SCA, as well as the CCA and CFA, showed statistically significant differences in the mean WSS and the mean Tur (P < 0.01). The mean Tur values had a negative correlation with the mean WSS; the correlation coefficient between log(Tur) and WSS is -0.69 (P < 0.05). CONCLUSION V Flow technique is a simple, practical, and feasible quantitative imaging approach for assessing WSS and Tur in peripheral arteries. It has the potential to be a useful tool for evaluating atherosclerotic plaques in peripheral arteries. The results provide a new quantitative foundation for future investigations into diverse arterial hemodynamic parameters.
Collapse
Affiliation(s)
- Di Song
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
| | - Mengmeng Liu
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
| | - Yinghui Dong
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
| | - Shaofu Hong
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
| | - Ming Chen
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
| | - Yigang Du
- Shenzhen Mindray Bio-Medical Electronics Co., Ltd., Shenzhen, Guangdong, China
| | - Shuangshuang Li
- Shenzhen Mindray Bio-Medical Electronics Co., Ltd., Shenzhen, Guangdong, China
| | - Jinfeng Xu
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
| | - Wenjing Gao
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
| | - Fajin Dong
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
| |
Collapse
|
8
|
Hong J, Zhang Y, Wang Y, Zhang T, Wang X, Xu D. Influence of a single hemodialysis on left ventricular energy loss and wall shear stress in patients with uremic cardiomyopathy assessed with vector flow mapping. Quant Imaging Med Surg 2022; 12:4059-4068. [PMID: 35919051 PMCID: PMC9338362 DOI: 10.21037/qims-21-1083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 05/30/2022] [Indexed: 11/06/2022]
Abstract
Background The influence of hemodialysis (HD) on hydromechanics of the left ventricle has not been reported. This study evaluated the left ventricular summation of energy loss (EL-SUM), average energy loss (EL-AVE), and wall shear stress (WSS) before and after HD using vector flow mapping (VFM) in patients with end-stage renal disease (ESRD). Methods We prospectively recruited 40 patients receiving long-term HD and excluded those with structural cardiac disease. Echocardiography was performed before and within 24 hours after HD. Conventional echocardiographic parameters, summation, and average energy loss (EL-SUM, EL-AVE, EL-base, EL-mid and EL-apex), and WSS in each segment were compared. Results A total of 40 patients with uremia were recruited. After HD, left ventricular EL-AVE-total, and EL-SUM-total decreased significantly in the early diastolic [29.43 (18.76 to 46.28) vs. 17.70 (10.76 to 95.60) N/(m2·s) and 12 (6 to 17) vs. 5 (3 to 11) e−2 J; P<0.001, respectively], mid-diastolic [17.07 (10.38 to 24.35) vs. 10.29 (5.86 to 16.30) N/(m2·s) and 7 (3 to 10) vs. 4 (2 to 6) e−2 J; P<0.001, respectively], and early systolic [17.82 (12.79 to 24.77) vs.14.90 (10.23 to 19.05) N/(m2·s) P=0.011 and 8 (5 to 11) vs. 5 (4 to 8) e−2 J, P=0.002, respectively] phases. It was revealed that HD did not change EL-AVE-total and EL-SUM-total in the late diastolic and late systolic phases. The EL-AVE decreased after HD in the left ventricular (LV) basal [50.70 (24.19 to 77.92) vs. 26.00 (11.50 to 47.68) N/(m2·s); P<0.001] and mid [15.52 (8.88 to 20.90) vs. 9.47 (6.41 to 14.21) N/(m2·s); P=0.001] segments during the early diastolic phase; in the LV basal [18.64 (10.33 to 29.80) vs. 10.25 (6.98 to 19.43) N/(m2·s); P<0.001), mid (15.70 (9.93 to 23.08) vs. 9.99 (6.03 to 16.25) N/(m2·s); P<0.001), and apical [9.78 (4.06 to 15.77) vs. 4.52 (3.14 to 10.36) N/(m2·s); P=0.001) segments during the mid-diastolic phase; in the LV mid [14.34 (8.34 to 23.88) vs. 9.36 (6.48 to 17.05) N/(m2·s); P=0.013] and apex [11.25 (6.37 to 21.88) vs. 6.60 (5.33 to 12.17) N/(m2·s); P=0.016] segments during the late diastolic phase; and in the apical [10.28 (6.05 to 17.01) vs. 7.59 (3.73 to 13.20) N/(m2·s) P=0.025] segment during the early systolic phase. After HD, WSS significantly reduced in the mid-diastolic [0.51 (0.32 to 0.69) vs. 0.38 (0.30 to 0.46) Pa, P=0.001] and early systolic [0.60 (0.45 to 0.81) vs. 0.57 (0.42 to 0.68) Pa, P=0.029] phases. There was no change in WSS during the early diastolic, late diastolic, and late systolic phases. Conclusions After HD, EL and WSS of LV decrease during the systolic and diastolic phases. The VFM can reflect the LV hemodynamics in patients undergoing HD under different fluid loads.
Collapse
Affiliation(s)
- Jian Hong
- Department of Geriatrics, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yanjuan Zhang
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yingying Wang
- Department of Geriatrics, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Tao Zhang
- Department of Geriatrics, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoyan Wang
- Department of Geriatrics, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Di Xu
- Department of Geriatrics, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| |
Collapse
|
9
|
Faraji A, Sahebi M, SalavatiDezfouli S. Numerical investigation of different viscosity models on pulsatile blood flow of thoracic aortic aneurysm (TAA) in a patient-specific model. Comput Methods Biomech Biomed Engin 2022; 26:986-998. [PMID: 35882063 DOI: 10.1080/10255842.2022.2102423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Aortic aneurysm is one of the most common aortic diseases that can lead to unfortunate consequences. Numerical simulations have an important role in the prediction of the aftereffects of vascular diseases including aneurysm. In this research, numerical simulation of pulsatile blood flow is performed for a 3-dimensional patient-specific model of a thoracic aortic aneurysm (TAA). Since the choice of blood viscosity model may have a significant impact on the simulation results, the effects of four non-Newtonian models of blood viscosity namely Carreau, Casson, Herschel-Bulkley, power low, and the Newtonian model on the wall shear stress (WSS) distribution, shear rate, and oscillatory shear index (OSI) have been analyzed. Simulation results showed that all the non-Newtonian and Newtonian models generally, predict similar patterns for blood flow and shear rate. At high flow rates in the cardiac cycle, the WSS value for all the models are similar to each other except for the power-law model due to the shear thinning behavior. All models predict high values of OSI on the inner wall of the ascending aorta and broad areas of the inner wall of the aneurysm sac. However, the Newtonian model predicts the OSI less than the non-Newtonian models in some areas of the aneurysm sac. Results indicated that the Newtonian model generally can predict the hemodynamic parameters of the blood flow similar to the non-Newtonian but for more precise analysis and to predict the regions prone to rupture and atherosclerosis, choosing a proper non-Newtonian model is recommended.
Collapse
Affiliation(s)
- Amir Faraji
- Department of Mechanical Engineering, Qom University of Technology, Qom, Iran
| | - Mahdi Sahebi
- Department of Mechanical Engineering, Qom University of Technology, Qom, Iran
| | | |
Collapse
|
10
|
Wang H, Balzani D, Vedula V, Uhlmann K, Varnik F. On the Potential Self-Amplification of Aneurysms Due to Tissue Degradation and Blood Flow Revealed From FSI Simulations. Front Physiol 2021; 12:785780. [PMID: 34955893 PMCID: PMC8709128 DOI: 10.3389/fphys.2021.785780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/09/2021] [Indexed: 11/13/2022] Open
Abstract
Tissue degradation plays a crucial role in the formation and rupture of aneurysms. Using numerical computer simulations, we study the combined effects of blood flow and tissue degradation on intra-aneurysm hemodynamics. Our computational analysis reveals that the degradation-induced changes of the time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI) within the aneurysm dome are inversely correlated. Importantly, their correlation is enhanced in the process of tissue degradation. Regions with a low TAWSS and a high OSI experience still lower TAWSS and higher OSI during degradation. Furthermore, we observed that degradation leads to an increase of the endothelial cell activation potential index, in particular, at places experiencing low wall shear stress. These findings are robust and occur for different geometries, degradation intensities, heart rates and pressures. We interpret these findings in the context of recent literature and argue that the degradation-induced hemodynamic changes may lead to a self-amplification of the flow-induced progressive damage of the aneurysmal wall.
Collapse
Affiliation(s)
- Haifeng Wang
- Theory and Simulation of Complex Fluids, Department of Scale-Bridging Thermodynamic and Kinetic Simulation, Interdisciplinary Center for Advanced Materials Simulation (ICAMS), Ruhr-Universität Bochum, Bochum, Germany
| | - Daniel Balzani
- Department of Civil and Environmental Engineering, Chair of Continuum Mechanics, Ruhr-Universität Bochum, Bochum, Germany
| | - Vijay Vedula
- Department of Mechanical Engineering, Columbia University in the City of New York, New York, NY, United States
| | - Klemens Uhlmann
- Department of Civil and Environmental Engineering, Chair of Continuum Mechanics, Ruhr-Universität Bochum, Bochum, Germany
| | - Fathollah Varnik
- Theory and Simulation of Complex Fluids, Department of Scale-Bridging Thermodynamic and Kinetic Simulation, Interdisciplinary Center for Advanced Materials Simulation (ICAMS), Ruhr-Universität Bochum, Bochum, Germany
| |
Collapse
|
11
|
Erratum: Exploring the Relationships Between Hemodynamic Stresses in the Carotid Arteries. Front Cardiovasc Med 2021; 8:669888. [PMID: 33791352 PMCID: PMC8006346 DOI: 10.3389/fcvm.2021.669888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 02/19/2021] [Indexed: 11/22/2022] Open
|
12
|
Ziegler M, Alfraeus J, Good E, Engvall J, de Muinck E, Dyverfeldt P. Exploring the Relationships Between Hemodynamic Stresses in the Carotid Arteries. Front Cardiovasc Med 2021; 7:617755. [PMID: 33614742 PMCID: PMC7886794 DOI: 10.3389/fcvm.2020.617755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/31/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Atherosclerosis manifests as a focal disease, often affecting areas with complex hemodynamics such as the carotid bifurcation. The magnitude and regularity of the hemodynamic shear stresses acting on the vessel wall are thought to generate risk patterns unique to each patient and play a role in the pathogenesis of atherosclerosis. The involvement of different expressions of shear stress in the pathogenesis of carotid atherosclerosis highlights the need to characterize and compare the differential impact of the various expressions of shear stress in the atherosclerotic carotid bifurcation. Therefore, the aim of this study is to characterize and compare hemodynamic wall shear stresses (WSS) in the carotid arteries of subjects with asymptomatic atherosclerotic plaques. Shear stresses were also compared against vessel diameter and bifurcation angle to examine the relationships with the geometry of the carotid bifurcation. Methods: 4D Flow MRI and contrast-enhanced MRA data were acquired for 245 subjects with atherosclerotic plaques of at least 2.7 mm in conjunction with the Swedish CArdioPulmonary bioImage Study (SCAPIS). Following automatic segmentation and geometric analysis, time-resolved WSS and near-wall turbulent kinetic energy (nwTKE) were derived from the 4D Flow data. Whole-cycle parameters including time-averaged WSS and nwTKE, and the oscillatory shear index (OSI) were calculated. Pairwise Spearman rank-correlation analyses were used to investigate relationships among the hemodynamic as well as geometric parameters. Results: One hundred and seventy nine subjects were successfully segmented using automated tools and subsequently geometric and hemodynamic analyses were performed. Temporally resolved WSS and nwTKE were strongly correlated, ρ = 0.64. Cycle-averaged WSS and nwTKE were moderately correlated, ρ = 0.57. Cycle-average nwTKE was weakly correlated to OSI (ρ = -0.273), revealing that nwTKE provides information about disturbed flow on the vessel wall that OSI does not. In this cohort, there was large inter-individual variation for both WSS and nwTKE. Both WSS and nwTKE varied most within the external carotid artery. WSS, nwTKE, and OSI were weakly correlated to vessel diameter and bifurcation angle. Conclusion: The turbulent and mean component of WSS were examined together in vivo for the first time, and a strong correlation was found between them. nwTKE presents the opportunity to quantify turbulent wall stresses in vivo and gain insight into the effects of disturbed flow on the vessel wall. Neither vessel diameter nor bifurcation angle were found to be strongly correlated to the turbulent or mean component of WSS in this cohort.
Collapse
Affiliation(s)
- Magnus Ziegler
- Division of Cardiovascular Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Jesper Alfraeus
- Division of Cardiovascular Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Elin Good
- Division of Cardiovascular Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Cardiology, Linköping University, Linköping, Sweden
| | - Jan Engvall
- Division of Cardiovascular Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Ebo de Muinck
- Division of Cardiovascular Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Cardiology, Linköping University, Linköping, Sweden
| | - Petter Dyverfeldt
- Division of Cardiovascular Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| |
Collapse
|
13
|
Qiu Y, Yang D, Zhang Q, Chen K, Dong Y, Wang WP. V Flow technology in measurement of wall shear stress of common carotid arteries in healthy adults: Feasibility and normal values. Clin Hemorheol Microcirc 2020; 74:453-462. [PMID: 31683473 DOI: 10.3233/ch-190719] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To evaluate the feasibility of vector flow imaging technique (V Flow) in measurement of wall shear stress (WSS) of common carotid arteries (CCA) in healthy adults and to provide the normal WSS values assessed by V Flow. METHODS & MATERIALS This prospective study was approved by the Ethics Committee of our University. Eighty healthy adult volunteers were included (mean age 43.3 y, 47 females, 33 males). The volunteers were classified into three groups according to their age: group I (age 20 - 39 y), group II (age 40 - 59 y) and group III (age 60 - 80 y). Mindray Resona 8 ultrasound machine and a linear array transducer (3-9 MHz) was used, equipped with the updated V Flow function. Common carotid arteries of both sides were evaluated in three segments (initial segment, middle segment and near bifurcation segment). The WSS values of CCA were measured by two independent radiologists. The intraclass correlation coefficient (ICC) of observer reliability in WSS measurement was calculated. Inter-observer reproducibility was also evaluated with the 95% Bland-Altman limits of agreement (LOA). RESULTS V Flow measurements were performed successfully in 79 volunteers (98.8 %, 79/80). The mean value of WSS in right CCA was (0.66±0.24) Pa, in left CCA was (0.66±0.18) Pa (P > 0.05). Mean WSS value had a moderately negative correlation with age group (P < 0.05). The mean WSS value of group I(mean±SD, 0.75±0.25 Pa) is larger than group II (mean±SD, 0.62±0.13 Pa) and group III (mean±SD, 0.49±0.11 Pa) (P < 0.05). The ICC of observer reliability of group I, II and III was 0.96 (95% confidence interval (95% CI) 0.92-0.98), 0.94 (95% CI 0.88-0.97), 0.93 (95% CI 0.76-0.98) respectively. The Bland-Altman plots showed that the 95% LOA were -0.17-0.12 (Pa) for group I, -0.09-0.13 (Pa) for group II and -0.08-0.10 (Pa) for group III. CONCLUSION V Flow measurement is a simple, rapid and feasible imaging method for the WSS assessment of CCA in healthy volunteers, which will probably be an important tool for assessing CCA function.
Collapse
Affiliation(s)
- Yijie Qiu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Daohui Yang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qi Zhang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Kailing Chen
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wen-Ping Wang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
14
|
Dai Y, Lv P, Javadzadegan A, Tang X, Qian Y, Lin J. Hemodynamic analysis of carotid artery after endarterectomy: a preliminary and quantitative imaging study based on computational fluid dynamics and magnetic resonance angiography. Quant Imaging Med Surg 2018; 8:399-409. [PMID: 29928605 DOI: 10.21037/qims.2018.05.02] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The carotid blood flow following carotid endarterectomy (CEA) is not fully understood. Computational fluid dynamics (CFD) is a promising method to study blood flow. This study is to investigate local hemodynamic characteristics after CEA via the use of unenhanced magnetic resonance angiography (MRA) and CFD. Methods Eight carotid arteries with atherosclerosis and sixteen normal carotid arteries were included in this study. Time-of-flight (TOF) and phase contrast (PC) MRA were applied for the measurement of three-dimensional artery geometries and velocity profile under CFD simulation. The hemodynamic parameters of the proximal internal carotid artery (ICA) including velocity, ICA/common carotid artery (CCA) velocity ratio, mean, maximum, minimum and gradient of wall shear stress (WSSmean, WSSmax, WSSmin and WSSG) were calculated before and after CEA. Morphologic characteristics of the carotid including bifurcation angle, tortuosity and planarity were also analyzed. Results Compared with pre-CEA, there was a significant reduction in post-CEA velocity, WSSmax, WSSmean, and WSSG, by 87.24%±13.38%, 86.86%±14.97%, 57.32%±56.71% and 69.74%±37.03% respectively, whereas WSSmin was almost unchanged. ICA/ CCA velocity ratios increased significantly after CEA. We also found that the post-CEA flow conditions were positively remodelled to approximate the conditions in normal arteries. The correlation between PC-MRA and CFD was excellent for the measurement of maximum velocity at the external carotid artery (r=0.846). Conclusions Our preliminary results indicated that major flow dynamics were restored shortly following CEA, and CFD based on MRA measurements could be useful for quantitative evaluation of hemodynamic outcomes after CEA.
Collapse
Affiliation(s)
- Yuanyuan Dai
- Department of Radiology, Zhongshan Hospital of Fudan University and Shanghai Institute of Medical Imaging, Shanghai 200032, China.,Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Peng Lv
- Department of Radiology, Zhongshan Hospital of Fudan University and Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - Ashkan Javadzadegan
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Xiao Tang
- Department of Vascular Surgery, Zhongshan Hospital of Fudan University, Shanghai 200032, China
| | - Yi Qian
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Jiang Lin
- Department of Radiology, Zhongshan Hospital of Fudan University and Shanghai Institute of Medical Imaging, Shanghai 200032, China
| |
Collapse
|
15
|
Nakai Y, Hamada H, Kittaka D, Noda C, Sato H, Kato K. [Standardization of Analysis Conditions and Prediction of Increase Prediction Using Blood Flow Analysis Software for Cerebral Aneurysms: Phantom Study and Clinical Study]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2018; 74:1275-1285. [PMID: 30464095 DOI: 10.6009/jjrt.2018_jsrt_74.11.1275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In recent years, reports have been made that predict the state of aneurysm by performing computational fluid dynamics (CFD) analysis using cerebral aneurysm blood flow analysis software. However, analysis results are not constant and there are various opinions, and it is conceivable that the image quality and analysis conditions of medical images used for CFD analysis are not standardized. In this study, CFD analysis of cerebral aneurysm phantom was performed, and image quality and analysis conditions were standardized. Then, we investigated whether increase of cerebral aneurysm and prediction of rupture are possible. From this study, stable results of wall shear stress analysis were obtained under slice thickness 1.0 mm or less, CT value 400 HU or more, reconstruction function as soft part function, image SD under 10 HU. In addition, as the size of the cerebral aneurysm became larger, wall shear stress tended to be lower, and the same tendency was shown also in clinical cases. Although CFD analysis using software dedicated to blood flow analysis did not reach the prediction of rupture, it can be evaluated based on the quantitative values for the aneurysm increase at the preceding stage and plays an important role in prediction there is a possibility.
Collapse
Affiliation(s)
- Yuichi Nakai
- Department of Radiological Technology, Showa University Northern Yokohama Hospital
| | - Hiroki Hamada
- Department of Radiological Technology, Showa University Hospital
| | - Daisuke Kittaka
- Department of Radiological Technology, Showa University Hospital
| | - Chikara Noda
- Department of Radiological Technology, Showa University Northern Yokohama Hospital
- Graduate School of Health Sciences, Showa University
| | - Hisaya Sato
- Department of Radiological Technology, Showa University Hospital
- Graduate School of Health Sciences, Showa University
| | - Kyoichi Kato
- Graduate School of Health Sciences, Showa University
- Department of Unification Radiological Technology, Showa University
| |
Collapse
|
16
|
Mahalingam A, Gawandalkar UU, Kini G, Buradi A, Araki T, Ikeda N, Nicolaides A, Laird JR, Saba L, Suri JS. Numerical analysis of the effect of turbulence transition on the hemodynamic parameters in human coronary arteries. Cardiovasc Diagn Ther 2016; 6:208-20. [PMID: 27280084 DOI: 10.21037/cdt.2016.03.08] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Local hemodynamics plays an important role in atherogenesis and the progression of coronary atherosclerosis disease (CAD). The primary biological effect due to blood turbulence is the change in wall shear stress (WSS) on the endothelial cell membrane, while the local oscillatory nature of the blood flow affects the physiological changes in the coronary artery. In coronary arteries, the blood flow Reynolds number ranges from few tens to several hundreds and hence it is generally assumed to be laminar while calculating the WSS calculations. However, the pulsatile blood flow through coronary arteries under stenotic condition could result in transition from laminar to turbulent flow condition. METHODS In the present work, the onset of turbulent transition during pulsatile flow through coronary arteries for varying degree of stenosis (i.e., 0%, 30%, 50% and 70%) is quantitatively analyzed by calculating the turbulent parameters distal to the stenosis. Also, the effect of turbulence transition on hemodynamic parameters such as WSS and oscillatory shear index (OSI) for varying degree of stenosis is quantified. The validated transitional shear stress transport (SST) k-ω model used in the present investigation is the best suited Reynolds averaged Navier-Stokes turbulence model to capture the turbulent transition. The arterial wall is assumed to be rigid and the dynamic curvature effect due to myocardial contraction on the blood flow has been neglected. RESULTS Our observations shows that for stenosis 50% and above, the WSSavg, WSSmax and OSI calculated using turbulence model deviates from laminar by more than 10% and the flow disturbances seems to significantly increase only after 70% stenosis. Our model shows reliability and completely validated. CONCLUSIONS Blood flow through stenosed coronary arteries seems to be turbulent in nature for area stenosis above 70% and the transition to turbulent flow begins from 50% stenosis.
Collapse
Affiliation(s)
- Arun Mahalingam
- 1 Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, Mangalore, India ; 2 Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan ; 3 Division of Cardiovascular Medicine, National Center for Global Health and Medicine (NCGM), Tokyo, Japan ; 4 Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus ; 5 Division of Cardiology, University of Davis, Sacramento, California, USA ; 6 Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy ; 7 Diagnostic and Monitoring Division, AtheroPoint, Roseville, California, USA ; 8 Department of Electrical Engineering (Affl.), Idaho State University, Pocatello, ID, USA
| | - Udhav Ulhas Gawandalkar
- 1 Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, Mangalore, India ; 2 Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan ; 3 Division of Cardiovascular Medicine, National Center for Global Health and Medicine (NCGM), Tokyo, Japan ; 4 Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus ; 5 Division of Cardiology, University of Davis, Sacramento, California, USA ; 6 Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy ; 7 Diagnostic and Monitoring Division, AtheroPoint, Roseville, California, USA ; 8 Department of Electrical Engineering (Affl.), Idaho State University, Pocatello, ID, USA
| | - Girish Kini
- 1 Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, Mangalore, India ; 2 Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan ; 3 Division of Cardiovascular Medicine, National Center for Global Health and Medicine (NCGM), Tokyo, Japan ; 4 Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus ; 5 Division of Cardiology, University of Davis, Sacramento, California, USA ; 6 Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy ; 7 Diagnostic and Monitoring Division, AtheroPoint, Roseville, California, USA ; 8 Department of Electrical Engineering (Affl.), Idaho State University, Pocatello, ID, USA
| | - Abdulrajak Buradi
- 1 Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, Mangalore, India ; 2 Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan ; 3 Division of Cardiovascular Medicine, National Center for Global Health and Medicine (NCGM), Tokyo, Japan ; 4 Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus ; 5 Division of Cardiology, University of Davis, Sacramento, California, USA ; 6 Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy ; 7 Diagnostic and Monitoring Division, AtheroPoint, Roseville, California, USA ; 8 Department of Electrical Engineering (Affl.), Idaho State University, Pocatello, ID, USA
| | - Tadashi Araki
- 1 Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, Mangalore, India ; 2 Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan ; 3 Division of Cardiovascular Medicine, National Center for Global Health and Medicine (NCGM), Tokyo, Japan ; 4 Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus ; 5 Division of Cardiology, University of Davis, Sacramento, California, USA ; 6 Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy ; 7 Diagnostic and Monitoring Division, AtheroPoint, Roseville, California, USA ; 8 Department of Electrical Engineering (Affl.), Idaho State University, Pocatello, ID, USA
| | - Nobutaka Ikeda
- 1 Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, Mangalore, India ; 2 Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan ; 3 Division of Cardiovascular Medicine, National Center for Global Health and Medicine (NCGM), Tokyo, Japan ; 4 Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus ; 5 Division of Cardiology, University of Davis, Sacramento, California, USA ; 6 Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy ; 7 Diagnostic and Monitoring Division, AtheroPoint, Roseville, California, USA ; 8 Department of Electrical Engineering (Affl.), Idaho State University, Pocatello, ID, USA
| | - Andrew Nicolaides
- 1 Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, Mangalore, India ; 2 Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan ; 3 Division of Cardiovascular Medicine, National Center for Global Health and Medicine (NCGM), Tokyo, Japan ; 4 Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus ; 5 Division of Cardiology, University of Davis, Sacramento, California, USA ; 6 Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy ; 7 Diagnostic and Monitoring Division, AtheroPoint, Roseville, California, USA ; 8 Department of Electrical Engineering (Affl.), Idaho State University, Pocatello, ID, USA
| | - John R Laird
- 1 Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, Mangalore, India ; 2 Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan ; 3 Division of Cardiovascular Medicine, National Center for Global Health and Medicine (NCGM), Tokyo, Japan ; 4 Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus ; 5 Division of Cardiology, University of Davis, Sacramento, California, USA ; 6 Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy ; 7 Diagnostic and Monitoring Division, AtheroPoint, Roseville, California, USA ; 8 Department of Electrical Engineering (Affl.), Idaho State University, Pocatello, ID, USA
| | - Luca Saba
- 1 Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, Mangalore, India ; 2 Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan ; 3 Division of Cardiovascular Medicine, National Center for Global Health and Medicine (NCGM), Tokyo, Japan ; 4 Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus ; 5 Division of Cardiology, University of Davis, Sacramento, California, USA ; 6 Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy ; 7 Diagnostic and Monitoring Division, AtheroPoint, Roseville, California, USA ; 8 Department of Electrical Engineering (Affl.), Idaho State University, Pocatello, ID, USA
| | - Jasjit S Suri
- 1 Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, Mangalore, India ; 2 Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan ; 3 Division of Cardiovascular Medicine, National Center for Global Health and Medicine (NCGM), Tokyo, Japan ; 4 Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus ; 5 Division of Cardiology, University of Davis, Sacramento, California, USA ; 6 Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy ; 7 Diagnostic and Monitoring Division, AtheroPoint, Roseville, California, USA ; 8 Department of Electrical Engineering (Affl.), Idaho State University, Pocatello, ID, USA
| |
Collapse
|
17
|
Rivera J, van der Graaf GB, Escudero JR, Bellmunt S, van de Vosse F. A computational fluid dynamics study on hemodynamics for different locations of the distal anastomosis of a bypass nearby a collateral vessel in the femoropopliteal area. Int J Numer Method Biomed Eng 2014; 30:1263-1277. [PMID: 24916477 DOI: 10.1002/cnm.2656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 05/23/2014] [Accepted: 05/27/2014] [Indexed: 06/03/2023]
Abstract
Revascularization of the femoropopliteal sector is often performed by the placement of a bypass. In this paper, we have studied the effects of hemodynamics on patency of the bypass for different positions of the distal anastomosis close to a collateral artery. Computational fluid dynamics (CFD) are used for this study. The cardiac cycle-averaged wall shear stress (WSS) and oscillation index (OSI) have been analyzed. Low WSS and high OSI may increase the risk of intimal hyperplasia (IH), which may reduce bypass patency. From the CFD simulations, spots of low WSS and high OSI are found within and near the entrance of the collateral artery, near the suture line, at the floor, toe, and heel. We regarded flow ratios of 20:80 and of 35:65. It is found that for the high flow ratio anastomosis located proximal to the collateral artery is clearly more advantageous. However for the low flow ratio anastomosis located distal to the collateral artery seems to be slightly more advantageous, the results are less conclusive. One of the studied flow geometries has been validated by in vitro experiments using a time resolved particle image velocimetry technique. Velocity fields from these experiments are in good agreement with the CFD results.
Collapse
Affiliation(s)
- J Rivera
- Departament de Resistència de Materials i Estructures a l'Enginyeria, Universitat Politècnica de Catalunya, Avda. Bases de Manresa 61-73, 08242 Manresa, Spain
| | | | | | | | | |
Collapse
|
18
|
Boileau E, Bevan RLT, Sazonov I, Rees MI, Nithiarasu P. Flow-induced ATP release in patient-specific arterial geometries--a comparative study of computational models. Int J Numer Method Biomed Eng 2013; 29:1038-1056. [PMID: 23894050 DOI: 10.1002/cnm.2581] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 06/24/2013] [Accepted: 06/25/2013] [Indexed: 06/02/2023]
Abstract
The importance of the endothelium in the local regulation of blood flow is reflected by its influence on vascular tone by means of vasodilatory responses to many physiological stimuli. Regulatory pathways are affected by mass transport and wall shear stress (WSS), via mechanotransduction mechanisms. In the present work, we review the most relevant computational models that have been proposed to date, and introduce a general framework for modelling the responses of the endothelium to alteration in the flow, with a view to understanding the biomechanical processes involved in the pathways to endothelial dysfunction. Simulations are performed on two different patient-specific stenosed carotid artery geometries to investigate the influence of WSS and mass transport phenomena upon the agonist coupling response at the endothelium. In particular, results presented for two different models of WSS-dependent adenosine-5'-triphosphate (ATP) release reveal that existing paradigms may not account for the conditions encountered in vivo and may therefore not be adequate to model the kinetics of ATP at the endothelium.
Collapse
Affiliation(s)
- E Boileau
- College of Engineering, Swansea University, Swansea, SA2 8PP, UK
| | | | | | | | | |
Collapse
|