Abnormal flow pattern of low wall shear stress and high oscillatory shear index in spontaneous vertebral artery dissection with vertebral artery hypoplasia.
Abnormal flow pattern of low wall shear stress and high oscillatory shear index in spontaneous vertebral artery dissection with vertebral artery hypoplasia.
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DOI：
10.3389/fnins.2023.1179963
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发表时间：
2023
影响因子：
4.3
通讯作者：
He, Li
中科院分区：
文献类型：
--
作者：
Bao, Jiajia;Gan, Xinling;Feng, Wentao;Li, Yanbo;Qiu, Yue;Zhou, Muke;Guo, Jian;He, Li
关键词：
自发性椎动脉夹层（sVAD）可能倾向于在椎动脉发育不良（VAH）伴血流动力学功能障碍时发生，评估sVAD伴VAH的血流动力学对研究这一假设至关重要。这项回顾性研究旨在量化sVAD伴VAH患者的血流动力学参数。本回顾性研究入组了因VAH的sVAD而发生缺血性卒中的患者。使用Mimics和Geomagic Studio软件从CT血管造影（CTA）中重建14例患者（28条血管）的几何形状。利用ANSYS ICEM和ANSYS FLUENT进行网格生成、设置边界条件、求解控制方程并进行数值模拟。在每个VA的上游区域、夹层或中游区域和下游区域获得切片。通过瞬时流线和收缩峰期及舒张晚期的压力显示血流模式。血流动力学参数包括压力、流速、时均血流量、时均壁面切应力（TAWSS）、振荡剪切指数（OSI）、内皮细胞动作电位（ECAP）、相对停留时间（RRT）和时均一氧化氮产生率（TARNO）。与其他非夹层区域相比，狭窄闭塞性sVAD伴VAH的夹层区域中存在显著的局灶性流速增加（0.910 m/s vs. 0.449 vs. 0.566，p < 0.001），而根据流速流线，在狭窄闭塞性sVAD伴VAH的夹层区域中观察到局灶性流速缓慢。狭窄闭塞性sVAD伴VAH动脉的时间平均血流量较低（0.499 cm 3/s vs. 2.268，p < 0.001），TAWSS较低（1.115 Pa vs. 2.437，p = 0.001），OSI更高（0.248 vs. 0.173，p = 0.006），ECAP更高（0.328 Pa−1 vs. 0.094，p = 0.002），RRT（3.519 Pa−1 vs. 1.044，p = 0.001）更高，TARNO（104.014 nM/s vs. 158.195，p < 0.001）比对侧VA减少。狭窄闭塞性sVAD合并VAH患者存在局灶性流速增加、时间平均血流降低、TAWSS降低、OSI升高、ECAP升高、RRT升高和TARNO降低的异常血流模式。这些结果为进一步研究sVAD的血流动力学提供了良好的基础，并支持CFD方法在检验sVAD的血流动力学假设中的适用性。将来需要更详细的sVAD不同阶段的血流动力学条件。
Spontaneous vertebral artery dissection (sVAD) might tend to develop in vertebral artery hypoplasia (VAH) with hemodynamic dysfunction and it is crucial to assess hemodynamics in sVAD with VAH to investigate this hypothesis. This retrospective study aimed to quantify hemodynamic parameters in patients with sVAD with VAH. Patients who had suffered ischemic stroke due to an sVAD of VAH were enrolled in this retrospective study. The geometries of 14 patients (28 vessels) were reconstructed using Mimics and Geomagic Studio software from CT angiography (CTA). ANSYS ICEM and ANSYS FLUENT were utilized for mesh generation, set boundary conditions, solve governing equations, and perform numerical simulations. Slices were obtained at the upstream area, dissection or midstream area and downstream area of each VA. The blood flow patterns were visualized through instantaneous streamline and pressure at peak systole and late diastole. The hemodynamic parameters included pressure, velocity, time-averaged blood flow, time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), endothelial cell action potential (ECAP), relative residence time (RRT) and time-averaged nitric oxide production rate (TARNO). Significant focal increased velocity was present in the dissection area of steno-occlusive sVAD with VAH compared to other nondissected areas (0.910 m/s vs. 0.449 vs. 0.566, p < 0.001), while focal slow flow velocity was observed in the dissection area of aneurysmal dilatative sVAD with VAH according to velocity streamlines. Steno-occlusive sVAD with VAH arteries had a lower time-averaged blood flow (0.499 cm3/s vs. 2.268, p < 0.001), lower TAWSS (1.115 Pa vs. 2.437, p = 0.001), higher OSI (0.248 vs. 0.173, p = 0.006), higher ECAP (0.328 Pa−1 vs. 0.094, p = 0.002), higher RRT (3.519 Pa−1 vs. 1.044, p = 0.001) and deceased TARNO (104.014 nM/s vs. 158.195, p < 0.001) than the contralateral VAs. Steno-occlusive sVAD with VAH patients had abnormal blood flow patterns of focal increased velocity, low time-averaged blood flow, low TAWSS, high OSI, high ECAP, high RRT and decreased TARNO. These results provide a good basis for further investigation of sVAD hemodynamics and support the applicability of the CFD method in testing the hemodynamic hypothesis of sVAD. More detailed hemodynamic conditions with different stages of sVAD are warranted in the future.
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DOI：
10.1016/j.niox.2010.08.003
发表时间：
2010-12-15
期刊：
Nitric oxide : biology and chemistry
影响因子：
--
作者：
Andrews AM;Jaron D;Buerk DG;Kirby PL;Barbee KA
通讯作者：
Barbee KA
影响因子：
2.4
作者：
Gunther, Albrecht;Witte, Otto W.;Drescher, Robert
通讯作者：
Drescher, Robert
影响因子：
2.1
作者：
BROWNLEE, RD;LANGILLE, BL
通讯作者：
LANGILLE, BL
影响因子：
4.8
作者：
Hwang, J;Saha, A;Jo, H
通讯作者：
Jo, H
影响因子：
2.4
作者：
Jozwik, Krzysztof;Obidowski, Damian
通讯作者：
Obidowski, Damian