A multiscale modelling approach to understand atherosclerosis formation: A patient-specific case study in the aortic bifurcation.
A multiscale modelling approach to understand atherosclerosis formation: A patient-specific case study in the aortic bifurcation.
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DOI：
10.1177/0954411917697356
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发表时间：
2017-05
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影响因子：
--
通讯作者：
Díaz-Zuccarini V
中科院分区：
文献类型：
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作者：
Alimohammadi M;Pichardo-Almarza C;Agu O;Díaz-Zuccarini V
动脉粥样硬化，即血管壁中斑块的形成，是由于血管壁中的脂质积累（低密度脂蛋白胆固醇）而开始的。这种积累与内皮机械转导的位点、内皮对机械刺激的反应和血液动力学有关，其决定调节血管壁渗透性的生化过程。生物力学和生物化学现象之间的这种相互作用是复杂的，跨越不同的生物尺度，并且是患者特异性的，需要能够在统一的框架中捕获这种数学和生物学复杂性的工具。数学模型通过考虑多因素和多尺度过程和机制，提供了一种优雅而有效的方法，以捕捉个体患者斑块形成的基本原理。在这项研究中，提出了一个数学模型来了解斑块和钙化的位置：该模型通过多尺度，复杂的指数或度量（低密度脂蛋白胆固醇的渗透部位，表示为体积流量）提供了强大的可解释性和物理意义。主动脉分叉和髂动脉的计算机断层扫描进行了分析，并与多因素模型的结果进行了比较。结果表明，该模型显示出预测大多数斑块位置的潜力，也不能预测斑块不存在的区域。该病例研究的有希望的结果提供了可应用于更大患者人群的概念证明。
Atherogenesis, the formation of plaques in the wall of blood vessels, starts as a result of lipid accumulation (low-density lipoprotein cholesterol) in the vessel wall. Such accumulation is related to the site of endothelial mechanotransduction, the endothelial response to mechanical stimuli and haemodynamics, which determines biochemical processes regulating the vessel wall permeability. This interaction between biomechanical and biochemical phenomena is complex, spanning different biological scales and is patient-specific, requiring tools able to capture such mathematical and biological complexity in a unified framework. Mathematical models offer an elegant and efficient way of doing this, by taking into account multifactorial and multiscale processes and mechanisms, in order to capture the fundamentals of plaque formation in individual patients. In this study, a mathematical model to understand plaque and calcification locations is presented: this model provides a strong interpretability and physical meaning through a multiscale, complex index or metric (the penetration site of low-density lipoprotein cholesterol, expressed as volumetric flux). Computed tomography scans of the aortic bifurcation and iliac arteries are analysed and compared with the results of the multifactorial model. The results indicate that the model shows potential to predict the majority of the plaque locations, also not predicting regions where plaques are absent. The promising results from this case study provide a proof of concept that can be applied to a larger patient population.