Computational simulation-derived hemodynamic and biomechanical properties of the pulmonary arterial tree early in the course of ventricular septal defects.
Computational simulation-derived hemodynamic and biomechanical properties of the pulmonary arterial tree early in the course of ventricular septal defects.
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DOI：
10.1007/s10237-021-01519-4
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发表时间：
2021-12
影响因子：
3.5
通讯作者：
Marsden, Alison L.
中科院分区：
文献类型：
--
作者：
Dong, Melody L.;Lan, Ingrid S.;Yang, Weiguang;Rabinovitch, Marlene;Feinstein, Jeffrey A.;Marsden, Alison L.
关键词：
未经治疗的室间隔缺损(VSD)可导致以肺动脉压(PA)升高和血管重构为特征的肺动脉高压(PAH)，称为PAH合并先天性心脏病(PAH-CHD)。尽管以前的研究已经研究了晚期PAH的血流动力学对血管力学生物学的影响，但导致PAH-CHD发病的血流动力学还没有完全量化。我们假设VSD早期从左向右分流的血流动力学异常会影响PA的生物力学特性，从而导致PAH的发生。为了在血管重塑开始之前模拟健康、小型、中等和大型VSD状态下的PA血流动力学，使用健康1岁儿童近端PA的3D有限元模型和体表面积尺度的0D PA远端树进行了计算流体动力学模拟。用肺血流增加来模拟室间隔缺损的情况，以表示从左向右分流的程度。在PAS近端，压力、流量、应变和壁切应力(WSS)随着VSD直径的增大而增加；在较大的PA血管中，振荡剪切指数随着VSD直径的增大而减小。WSS在直径较小的血管中较高，并随室缺大小而增加，较大的VSD条件下表现出WSS>；100dyn/cm2，远高于用于研究PAH中功能障碍的机械转导通路的典型数值。这项研究首次评估了导致PAH启动的VSD严重程度的整个儿科PA树的血流动力学和生物力学指标，并对未来评估在PAH-CHD启动和进展过程中发生的异常机械刺激对内皮细胞和血管壁力学的影响具有指导意义。
Untreated ventricular septal defects (VSDs) can lead to pulmonary arterial hypertension (PAH) characterized by elevated pulmonary artery (PA) pressure and vascular remodeling, known as PAH associated with congenital heart disease (PAH-CHD). Though previous studies have investigated hemodynamic effects on vascular mechanobiology in late-stage PAH, hemodynamics leading to PAH-CHD initiation have not been fully quantified. We hypothesize that abnormal hemodynamics from left-to-right shunting in early stage VSDs affects PA biomechanical properties leading to PAH initiation. To model PA hemodynamics in healthy, small, moderate, and large VSD conditions prior to the onset of vascular remodeling, computational fluid dynamics simulations were performed using a 3D finite element model of a healthy 1-year-old’s proximal PAs and a body-surface-area-scaled 0D distal PA tree. VSD conditions were modeled with increased pulmonary blood flow to represent degrees of left-to-right shunting. In the proximal PAs, pressure, flow, strain, and wall shear stress (WSS) increased with increasing VSD size; oscillatory shear index decreased with increasing VSD size in the larger PA vessels. WSS was higher in smaller diameter vessels and increased with VSD size, with the large VSD condition exhibiting WSS >100 dyn/cm2, well above values typically used to study dysfunctional mechanotransduction pathways in PAH. This study is the first to estimate hemodynamic and biomechanical metrics in the entire pediatric PA tree with VSD severity at the stage leading to PAH initiation and has implications for future studies assessing effects of abnormal mechanical stimuli on endothelial cells and vascular wall mechanics that occur during PAH-CHD initiation and progression.
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DOI：
10.1115/1.2895545
发表时间：
1993-11-01
影响因子：
1.7
作者：
GIDDENS, DP;ZARINS, CK;GLAGOV, S
通讯作者：
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10.1016/j.cma.2005.11.011
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