Computational simulations demonstrate altered wall shear stress in aortic coarctation patients treated by resection with end-to-end anastomosis.
Computational simulations demonstrate altered wall shear stress in aortic coarctation patients treated by resection with end-to-end anastomosis.
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DOI：
10.1111/j.1747-0803.2011.00553.x
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发表时间：
2011-09
影响因子：
0.3
通讯作者：
Feinstein JA
中科院分区：
文献类型：
--
作者：
LaDisa JF Jr;Dholakia RJ;Figueroa CA;Vignon-Clementel IE;Chan FP;Samyn MM;Cava JR;Taylor CA;Feinstein JA
正常人胸降主动脉粥样硬化斑块（dAo）与血管壁切应力（WSS）改变有关。端端吻合切除术（RWEA）是主动脉缩窄（CoA）修复的金标准，但可能导致WSS指数改变，从而导致发病率。根据对照受试者和接受RWEA治疗的年龄和性别匹配的CoA患者（4例男性，2例女性，15±8岁）的成像和血压数据创建计算流体动力学（CFD）模型。计算流体动力学分析包括下游血管阻力和顺应性，以生成血流速度、时间平均WSS（TAWSS）和振荡剪切指数（OSI）结果。这些指标在dAo中纵向和周向量化，并使用几种可视化方法突出显示潜在血流动力学敏感性区域。暴露于低于正常TAWSS和OSI的总dAo面积在组间相似，但显示了几个统计学显著的局部差异。对照组受试者经历了左手旋转模式的TAWSS和OSI下来的dAo。在CoA患者中，TAWSS在残余翼部位附近升高，OSI在远端升高，特别是沿沿着dAo壁升高。组间WSS指数的差异可以忽略不计超过5 dAo直径远端的主动脉弓。局部差异WSS指数内的dAo的CoA患者接受RWEA治疗表明，斑块可能形成在独特的位置受手术修复。这些区域可以以熟悉和直观的方式可视化，使临床医生能够在纵向研究中跟踪其对发病率的贡献。
Atherosclerotic plaque in the descending thoracic aorta (dAo) is related to altered wall shear stress (WSS) for normal patients. Resection with end-to-end anastomosis (RWEA) is the gold standard for coarctation of the aorta (CoA) repair, but may lead to altered WSS indices that contribute to morbidity. Computational fluid dynamics (CFD) models were created from imaging and blood pressure data for control subjects and age- and gender-matched CoA patients treated by RWEA (4 male, 2 female, 15±8 years). CFD analysis incorporated downstream vascular resistance and compliance to generate blood flow velocity, time-averaged WSS (TAWSS) and oscillatory shear index (OSI) results. These indices were quantified longitudinally and circumferentially in the dAo, and several visualization methods were used to highlight regions of potential hemodynamic susceptibility. The total dAo area exposed to subnormal TAWSS and OSI was similar between groups, but several statistically significant local differences were revealed. Control subjects experienced left-handed rotating patterns of TAWSS and OSI down the dAo. TAWSS was elevated in CoA patients near the site of residual narrowings and OSI was elevated distally, particularly along the left dAo wall. Differences in WSS indices between groups were negligible more than 5 dAo diameters distal to the aortic arch. Localized differences in WSS indices within the dAo of CoA patients treated by RWEA suggest that plaque may form in unique locations influenced by the surgical repair. These regions can be visualized in familiar and intuitive ways allowing clinicians to track their contribution to morbidity in longitudinal studies.
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影响因子：
2.4
作者：
STERGIOPULOS, N;YOUNG, DF;ROGGE, TR
通讯作者：
ROGGE, TR
影响因子：
37.8
作者：
KILNER, PJ;YANG, GZ;LONGMORE, DB
通讯作者：
LONGMORE, DB
DOI：
10.1016/j.cma.2005.11.011
发表时间：
2006-01-01
影响因子：
7.2
作者：
Figueroa, C. Alberto;Vignon-Clementel, Irene E.;Taylor, Charles A.
通讯作者：
Taylor, Charles A.
影响因子：
6.1
作者：
Sindhu, RK;Roberts, CK;Vaziri, ND
通讯作者：
Vaziri, ND
影响因子：
24
作者：
Wentzel, JJ;Corti, R;Badimon, JJ
通讯作者：
Badimon, JJ