Assessment of Wall Elasticity Variations on Intraluminal Haemodynamics in Descending Aortic Dissections Using a Lumped-Parameter Model
Assessment of Wall Elasticity Variations on Intraluminal Haemodynamics in Descending Aortic Dissections Using a Lumped-Parameter Model
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DOI：
10.1371/journal.pone.0124011
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发表时间：
2015-04-16
期刊：
影响因子：
3.7
通讯作者：
Evangelista, Arturo
中科院分区：
文献类型：
--
作者：
Rudenick, Paula A.;Bijnens, Bart H.;Evangelista, Arturo
降主动脉夹层（DAD）与高发病率和死亡率相关。主动脉壁僵硬度是DAD患者中经常改变的变量，并可能涉及长期结局。然而，其相关性仍然大多未知。为了更详细地了解壁弹性（顺应性）如何影响DAD中的管腔内血流动力学，基于脉动液压回路的实验数据开发了一个集总参数模型，并在8种临床情况下进行了验证。接下来，管腔内压力和流量的变化被评估为壁弹性的函数。与壁最硬的情况相比，弹性增加到生理值与收缩压下降和舒张压增加相关，分别高达33%和63%，随后压力波振幅下降高达86%。此外，这与多方向腔内血流增加以及2条平行血管向带侧腔血管的行为转变有关。该模型支持壁弹性作为DAD的腔内压力和流动模式的决定因素的极其重要的作用，因此，在疾病的临床评估和计算建模期间考虑它的相关性。
Descending aortic dissection (DAD) is associated with high morbidity and mortality rates. Aortic wall stiffness is a variable often altered in DAD patients and potentially involved in long-term outcome. However, its relevance is still mostly unknown. To gain more detailed knowledge of how wall elasticity (compliance) might influence intraluminal haemodynamics in DAD, a lumped-parameter model was developed based on experimental data from a pulsatile hydraulic circuit and validated for 8 clinical scenarios. Next, the variations of intraluminal pressures and flows were assessed as a function of wall elasticity. In comparison with the most rigid-wall case, an increase in elasticity to physiological values was associated with a decrease in systolic and increase in diastolic pressures of up to 33% and 63% respectively, with a subsequent decrease in the pressure wave amplitude of up to 86%. Moreover, it was related to an increase in multidirectional intraluminal flows and transition of behaviour as 2 parallel vessels towards a vessel with a side-chamber. The model supports the extremely important role of wall elasticity as determinant of intraluminal pressures and flow patterns for DAD, and thus, the relevance of considering it during clinical assessment and computational modelling of the disease.