Hemodynamics and AAA disease: Uncovering the Hidden Connections

描述(由申请人提供)：大量和越来越多的证据表明，血液流动力学(血流动力学)在腹主动脉瘤(AAA)疾病的发生和发展中起主导作用。据此推测，运动引起的AAA血流量增加可能是延缓或阻止疾病进展的有效手段。对实际的AAA血流动力学缺乏准确的理解。该项目的目标是使用创新的计算动力学系统方法进行流体流动结构分析，以了解血液如何通过AAA运输的具体性质，并进一步使用该框架来评估从休息到运动的流动状况如何变化。建议与斯坦福国家生物医学计算中心Simbios进行协同合作，利用伊利诺伊理工学院(IIT)在表征和分析复杂运输现象方面的专业知识，以及斯坦福大学正在生成的血流模拟能力和前所未有的丰富的AAA血流动力学数据。SIMBIOS将向IIT的研究人员提供中小型AAA患者的AAA血流模拟数据，以及复制模拟结果所需的数据，他们将使用这些数据应用计算动力学系统方法来更准确地描述动脉瘤中的运输条件。对于每个患者，动力系统计算得到的详细流动结构信息将在休息和运动条件下进行比较，以评估急性运动对AAA血流动力学的生物力学好处。这些信息将与每个动脉瘤进展的后续图像相结合，用于前瞻性的临床相关性，以确定我们的发现的相关性，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)是一种常见且病态的疾病，很少引起公众的关注。有证据表明腹主动脉血流的性质是AAA发生和发展的主要原因。我们的目标是使用新的计算技术来研究AAA的血流模式。我们对AAA病理基础的机制了解得越多，我们就越有能力预防、诊断和减少这种破坏性疾病的治疗。

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.