Patient-Specific Computational Analysis of Hemodynamics and Wall Mechanics and Their Interactions in Pulmonary Arterial Hypertension.

Autor: Zambrano BA; J. Mike Walker '66 Department of Mechanical Engineering, Texas A&M University, College Station, TX, United States., McLean N; Department of Mechanical Engineering, Michigan State University, East Lansing, MI, United States., Zhao X; National Heart Centre Singapore, Singapore, Singapore., Tan JL; National Heart Centre Singapore, Singapore, Singapore., Zhong L; National Heart Centre Singapore, Singapore, Singapore.; Duke-National University of Singapore, Singapore, Singapore., Figueroa CA; Departments of Biomedical Engineering and Surgery, University of Michigan, Ann Arbor, MI, United States., Lee LC; Department of Mechanical Engineering, Michigan State University, East Lansing, MI, United States., Baek S; Department of Mechanical Engineering, Michigan State University, East Lansing, MI, United States.
Jazyk: angličtina
Zdroj: Frontiers in bioengineering and biotechnology [Front Bioeng Biotechnol] 2021 Jan 28; Vol. 8, pp. 611149. Date of Electronic Publication: 2021 Jan 28 (Print Publication: 2020).
DOI: 10.3389/fbioe.2020.611149
Abstrakt: Vascular wall stiffness and hemodynamic parameters are potential biomechanical markers for detecting pulmonary arterial hypertension (PAH). Previous computational analyses, however, have not considered the interaction between blood flow and wall deformation. Here, we applied an established computational framework that utilizes patient-specific measurements of hemodynamics and wall deformation to analyze the coupled fluid-vessel wall interaction in the proximal pulmonary arteries (PA) of six PAH patients and five control subjects. Specifically, we quantified the linearized stiffness ( E ), relative area change (RAC), diastolic diameter ( D ), regurgitant flow, and time-averaged wall shear stress (TAWSS) of the proximal PA, as well as the total arterial resistance ( R t ) and compliance ( C t ) at the distal pulmonary vasculature. Results found that the average proximal PA was stiffer [median: 297 kPa, interquartile range (IQR): 202 kPa vs. median: 75 kPa, IQR: 5 kPa; P = 0.007] with a larger diameter (median: 32 mm, IQR: 5.25 mm vs. median: 25 mm, IQR: 2 mm; P = 0.015) and a reduced RAC (median: 0.22, IQR: 0.10 vs. median: 0.42, IQR: 0.04; P = 0.004) in PAH compared to our control group. Also, higher total resistance ( R t ; median: 6.89 mmHg × min/l, IQR: 2.16 mmHg × min/l vs. median: 3.99 mmHg × min/l, IQR: 1.15 mmHg × min/l; P = 0.002) and lower total compliance ( C t ; median: 0.13 ml/mmHg, IQR: 0.15 ml/mmHg vs. median: 0.85 ml/mmHg, IQR: 0.51 ml/mmHg; P = 0.041) were observed in the PAH group. Furthermore, lower TAWSS values were seen at the main PA arteries (MPAs) of PAH patients (median: 0.81 Pa, IQR: 0.47 Pa vs. median: 1.56 Pa, IQR: 0.89 Pa; P = 0.026) compared to controls. Correlation analysis within the PAH group found that E was directly correlated to the PA regurgitant flow ( r = 0.84, P = 0.018) and inversely related to TAWSS ( r = -0.72, P = 0.051). Results suggest that the estimated elastic modulus E may be closely related to PAH hemodynamic changes in pulmonary arteries.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2021 Zambrano, McLean, Zhao, Tan, Zhong, Figueroa, Lee and Baek.)
Databáze: MEDLINE
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