Mathematical modelling of atheroma plaque formation and development in coronary arteries
Mathematical modelling of atheroma plaque formation and development in coronary arteries
复制标题
DOI：
10.1098/rsif.2013.0866
复制
发表时间：
2014-01-06
影响因子：
3.9
通讯作者：
Martinez, Miguel A.
中科院分区：
文献类型：
--
作者：
Cilla, Myriam;Pena, Estefania;Martinez, Miguel A.
动脉粥样硬化是一种由动脉壁炎症引起的血管疾病，导致炎症部位低密度脂蛋白（LDL）胆固醇、单核细胞、巨噬细胞和富含脂肪的泡沫细胞积聚。该过程通常称为斑块形成。动脉粥样硬化疾病的演变，特别是壁剪切应力对动脉粥样硬化斑块生长的影响，仍然是一个知之甚少的现象。这项工作提出了一个数学模型来重现冠状动脉中粥样斑块的生长。该模型使用纳维-斯托克斯方程和达西定律进行流体动力学，使用对流扩散反应方程来模拟管腔和内膜中的质量平衡，并使用 Kedem-Katchalsky 方程来模拟膜（即内皮）的界面耦合。流体和多孔域之间界面上的体积通量和溶质通量由三孔模型控制。模型中考虑了在早期动脉粥样硬化发展中起作用的主要种类和物质，即LDL、氧化LDL、单核细胞、巨噬细胞、泡沫细胞、平滑肌细胞、细胞因子和胶原蛋白。此外，已使用从文献中获取的实验数据来从生理学角度确定模型参数。该数学模型已在代表性的轴对称几何冠状动脉模型中实现。结果表明，该数学模型能够定性地捕获内膜层中观察到的粥样斑块的发展。
Atherosclerosis is a vascular disease caused by inflammation of the arterial wall, which results in the accumulation of low-density lipoprotein (LDL) cholesterol, monocytes, macrophages and fat-laden foam cells at the place of the inflammation. This process is commonly referred to as plaque formation. The evolution of the atherosclerosis disease, and in particular the influence of wall shear stress on the growth of atherosclerotic plaques, is still a poorly understood phenomenon. This work presents a mathematical model to reproduce atheroma plaque growth in coronary arteries. This model uses the Navier-Stokes equations and Darcy's law for fluid dynamics, convection-diffusion-reaction equations for modelling the mass balance in the lumen and intima, and the Kedem-Katchalsky equations for the interfacial coupling at membranes, i.e. endothelium. The volume flux and the solute flux across the interface between the fluid and the porous domains are governed by a three-pore model. The main species and substances which play a role in early atherosclerosis development have been considered in the model, i.e. LDL, oxidized LDL, monocytes, macrophages, foam cells, smooth muscle cells, cytokines and collagen. Furthermore, experimental data taken from the literature have been used in order to physiologically determine model parameters. The mathematical model has been implemented in a representative axisymmetric geometrical coronary artery model. The results show that the mathematical model is able to qualitatively capture the atheroma plaque development observed in the intima layer.