Development of a Patient-Specific Multi-Scale Model to Understand Atherosclerosis and Calcification Locations: Comparison with In vivo Data in an Aortic Dissection.
Development of a Patient-Specific Multi-Scale Model to Understand Atherosclerosis and Calcification Locations: Comparison with In vivo Data in an Aortic Dissection.
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DOI：
10.3389/fphys.2016.00238
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发表时间：
2016
影响因子：
4
通讯作者：
Díaz-Zuccarini V
中科院分区：
文献类型：
--
作者：
Alimohammadi M;Pichardo-Almarza C;Agu O;Díaz-Zuccarini V
血管钙化导致主动脉硬化，并与高血压和动脉粥样硬化有关。动脉粥样硬化是一个复杂的、多因素的系统性过程；许多因素的结果，每个因素在几个空间和时间尺度上同时起作用。预测动脉粥样硬化发生部位的能力将对临床医生有很大的帮助，以改善诊断和治疗计划。在本文中，我们提出了一个数学模型作为工具来理解为什么动脉粥样硬化斑块和钙化发生在特定位置。然后，该模型被用于分析主动脉夹层患者的血管钙化和动脉粥样硬化区域，使用机制，多尺度建模方法，将患者特异性，流固相互作用模拟与内皮机械转导模型相结合。基于最新文献的许多血流动力学因素被用作内皮通透性模型的输入，以研究斑块和钙化分布，并将其与临床影像学数据进行比较。与广泛使用的血流动力学指标相比，通过使用包含平均和振荡剪切分量的剪切指数（HOLMES）和非牛顿粘度模型作为输入，可以显著改善水力电导率或体积通量升高与钙化和斑块存在之间的相关性。所提出的方法显示了作为预测工具的希望。结合生物力学/生化建模方法获得的改进突出了机械建模作为理解复杂现象的强大工具的好处，并提供了对关键血流动力学参数相对重要性的见解。
Vascular calcification results in stiffening of the aorta and is associated with hypertension and atherosclerosis. Atherogenesis is a complex, multifactorial, and systemic process; the result of a number of factors, each operating simultaneously at several spatial and temporal scales. The ability to predict sites of atherogenesis would be of great use to clinicians in order to improve diagnostic and treatment planning. In this paper, we present a mathematical model as a tool to understand why atherosclerotic plaque and calcifications occur in specific locations. This model is then used to analyze vascular calcification and atherosclerotic areas in an aortic dissection patient using a mechanistic, multi-scale modeling approach, coupling patient-specific, fluid-structure interaction simulations with a model of endothelial mechanotransduction. A number of hemodynamic factors based on state-of-the-art literature are used as inputs to the endothelial permeability model, in order to investigate plaque and calcification distributions, which are compared with clinical imaging data. A significantly improved correlation between elevated hydraulic conductivity or volume flux and the presence of calcification and plaques was achieved by using a shear index comprising both mean and oscillatory shear components (HOLMES) and a non-Newtonian viscosity model as inputs, as compared to widely used hemodynamic indicators. The proposed approach shows promise as a predictive tool. The improvements obtained using the combined biomechanical/biochemical modeling approach highlight the benefits of mechanistic modeling as a powerful tool to understand complex phenomena and provides insight into the relative importance of key hemodynamic parameters.