Computer simulation of three-dimensional plaque formation and progression in the carotid artery
Computer simulation of three-dimensional plaque formation and progression in the carotid artery
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DOI：
10.1007/s11517-012-1031-4
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发表时间：
2013-06-01
影响因子：
3.2
通讯作者：
Parodi, Oberdan
中科院分区：
文献类型：
--
作者：
Filipovic, Nenad;Teng, Zhongzhao;Parodi, Oberdan
动脉粥样硬化正在成为全球头号死因。本研究建立了人颈动脉斑块形成和发展的三维计算机模型。三维血流由Navier-Stokes方程和连续性方程描述。血液管腔内和通过动脉壁的质量传递与血流耦合，并通过对流扩散方程建模。低密度脂蛋白在血管腔内和通过血管组织的转运由Kedem-Katchalsky方程耦合。使用三个额外的反应扩散偏微分方程模拟炎症过程。流体-结构相互作用被用来估计有效壁应力分析。斑块体积增长函数与切应力和有效壁应力分布相关。我们从MRI研究中选择了两名具有显著斑块进展的特定患者。使用基线、3个月和12个月随访的三个时间点拟合斑块体积进展。我们的斑块定位结果对应于低剪切应力区，我们拟合我们的模型参数，使用非线性最小二乘法。确定斑块的位置和组成，并对特定患者的进展进行计算机模拟，显示出预测疾病进展的潜在益处。三维计算机建模在动脉粥样硬化斑块负荷评估中的有效性证明可能使MRI的临床信息从形态学评估转向功能工具。了解和预测动脉粥样硬化斑块演变为易损斑块或稳定斑块是医学界的主要任务。
Atherosclerosis is becoming the number one cause of death worldwide. In this study, three-dimensional computer model of plaque formation and development for human carotid artery is developed. The three-dimensional blood flow is described by the Navier-Stokes equation, together with the continuity equation. Mass transfer within the blood lumen and through the arterial wall is coupled with the blood flow and is modeled by a convection-diffusion equation. The low-density lipoproteins transports in lumen of the vessel and through the vessel tissue are coupled by Kedem-Katchalsky equations. The inflammatory process is modeled using three additional reaction-diffusion partial differential equations. Fluid-structure interaction is used to estimate effective wall stress analysis. Plaque growth functions for volume progression are correlated with shear stress and effective wall stress distribution. We choose two specific patients from MRI study with significant plaque progression. Plaque volume progression using three time points for baseline, 3- and 12-month follow up is fitted. Our results for plaque localization correspond to low shear stress zone and we fitted parameters from our model using nonlinear least-square method. Determination of plaque location and composition, and computer simulation of progression in time for a specific patient shows a potential benefit for the prediction of disease progression. The proof of validity of three-dimensional computer modeling in the evaluation of atherosclerotic plaque burden may shift the clinical information of MRI from morphological assessment toward a functional tool. Understanding and prediction of the evolution of atherosclerotic plaques either into vulnerable or stable plaques are major tasks for the medical community.