Hemodynamics and AAA disease: Uncovering the Hidden Connections

描述（由申请人提供）：大量证据表明，血流力学（血液动力学）在腹主动脉瘤（AAA）疾病的发生和进展中起主导作用。相应地，假设由于运动而增加的通过AAA的血流量可以提供减缓或停止疾病进展的有效手段。缺乏对真实AAA血流动力学的准确理解。本项目的目标是使用创新的计算动力系统方法进行流体流动结构分析，以了解血液如何通过AAA运输的特定性质，并使用此框架评估流动条件如何从休息到运动的变化。提出了与位于斯坦福大学Simbios的国家生物医学计算中心的协同合作，该合作利用了伊利诺伊理工学院（IIT）的专业知识，利用血流模拟能力和斯坦福大学生成的前所未有的AAA血流动力学数据来表征和分析复杂的运输现象。Simbios将向IIT的研究人员提供小型和中型AAA患者的AAA血流模拟数据以及重现模拟结果的必要数据，IIT将使用这些数据应用计算动力学系统方法来更精确地表征动脉瘤中的运输条件。对于每例患者，将在静息和运动条件下比较动力系统计算得出的详细血流结构信息，以评价急性运动对AAA血流动力学的生物力学受益。这些信息将与每个动脉瘤进展的随访图像相结合，以建立前瞻性临床相关性，以确定我们发现的相关性，并潜在地揭示AAA进展的生物力学机制。 公共卫生相关性：腹主动脉瘤（AAA）是一种常见的病态疾病，很少引起公众的关注。证据表明腹主动脉中血流的性质在很大程度上是AAA发生和进展的原因。我们的目标是使用新的计算技术来研究AAA中的血流模式。我们对AAA病理学的机制了解得越多，我们就能更好地预防、诊断和微创治疗这种毁灭性疾病。

DESCRIPTION (provided by applicant): Substantial and mounting evidence suggest that blood flow mechanics (hemodynamics) play a leading role in the development and progression of abdominal aortic aneurysm (AAA) disease. Correspondingly, it is hypoth- esized that increased blood flow through AAA due to exercise may provide an effective means to slow or halt disease progression. Precise understandings of realistic AAA hemodynamics are lacking. The objective of this project is to use innovative computational dynamical systems methods for fluid flow structure analysis to under- stand the specific nature of how blood is transported through AAA, and furthermore, to use this framework to evaluate how flow conditions change from rest to exercise. A synergistic collaboration with the National Center for Biomedical Computing at Stanford, Simbios, is proposed, which leverages expertise at the Illinois Institute of Technology (IIT) in the characterization and analysis of complex transport phenomena with the blood flow simula- tion capabilities and unprecedented wealth of AAA hemodynamics data being generated at Stanford. Simbios will provide AAA blood flow simulation data for patients with small and intermediate sized AAA, and necessary data to reproduce the simulation results, to investigators at IIT, who will use the data to apply computational dynamical systems methods to more precisely characterize transport conditions in the aneurysm. For each patient, the detailed flow structure information resulting from the dynamical systems computations will be compared between rest and exercise conditions to evaluate the biomechanical benefits of acute exercise on AAA hemodynamics. This information will be combined with follow-up images of each aneurysm's progression for prospective clinical correlation to establish the relevance of our findings, and to potentially uncover the biomechanical mechanisms underlying AAA progression. PUBLIC HEALTH RELEVANCE: Abdominal aortic aneurysm (AAA) is a common and morbid disease that garners little public attention. Evi- dence suggests that the nature of blood flow in the abdominal aorta is largely responsible for AAA initiation and progression. We aim to use novel computational techniques to study blood flow patterns in AAA. The more we learn about the mechanisms underlying AAA pathology, the better equipped we will be to prevent, diagnose and less-invasively treat this devastating disease.