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Berggren CC, Jiang D, Jack Wang YF, Bergquist JA, Rupp LC, Liu Z, MacLeod RS, Narayan A, Timmins LH. Influence of material parameter variability on the predicted coronary artery biomechanical environment via uncertainty quantification. Biomech Model Mechanobiol 2024; 23:927-940. [PMID: 38361087 PMCID: PMC11102342 DOI: 10.1007/s10237-023-01814-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 12/30/2023] [Indexed: 02/17/2024]
Abstract
Central to the clinical adoption of patient-specific modeling strategies is demonstrating that simulation results are reliable and safe. Indeed, simulation frameworks must be robust to uncertainty in model input(s), and levels of confidence should accompany results. In this study, we applied a coupled uncertainty quantification-finite element (FE) framework to understand the impact of uncertainty in vascular material properties on variability in predicted stresses. Univariate probability distributions were fit to material parameters derived from layer-specific mechanical behavior testing of human coronary tissue. Parameters were assumed to be probabilistically independent, allowing for efficient parameter ensemble sampling. In an idealized coronary artery geometry, a forward FE model for each parameter ensemble was created to predict tissue stresses under physiologic loading. An emulator was constructed within the UncertainSCI software using polynomial chaos techniques, and statistics and sensitivities were directly computed. Results demonstrated that material parameter uncertainty propagates to variability in predicted stresses across the vessel wall, with the largest dispersions in stress within the adventitial layer. Variability in stress was most sensitive to uncertainties in the anisotropic component of the strain energy function. Moreover, unary and binary interactions within the adventitial layer were the main contributors to stress variance, and the leading factor in stress variability was uncertainty in the stress-like material parameter that describes the contribution of the embedded fibers to the overall artery stiffness. Results from a patient-specific coronary model confirmed many of these findings. Collectively, these data highlight the impact of material property variation on uncertainty in predicted artery stresses and present a pipeline to explore and characterize forward model uncertainty in computational biomechanics.
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Affiliation(s)
- Caleb C Berggren
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
| | - David Jiang
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
| | - Y F Jack Wang
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
| | - Jake A Bergquist
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
- Nora Eccles Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, UT, USA
| | - Lindsay C Rupp
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
- Nora Eccles Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, UT, USA
| | - Zexin Liu
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
- Department of Mathematics, University of Utah, Salt Lake City, UT, USA
| | - Rob S MacLeod
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
- Nora Eccles Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, UT, USA
| | - Akil Narayan
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
- Department of Mathematics, University of Utah, Salt Lake City, UT, USA
| | - Lucas H Timmins
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA.
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA.
- School of Engineering Medicine, Texas A&M University, 1020 Holcombe Blvd., Houston, TX, USA.
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA.
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2
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De Ornelas B, Sucato V, Vadalà G, Buono A, Galassi AR. Myocardial Bridge and Atherosclerosis, an Intimal Relationship. Curr Atheroscler Rep 2024:10.1007/s11883-024-01219-1. [PMID: 38822987 DOI: 10.1007/s11883-024-01219-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2024] [Indexed: 06/03/2024]
Abstract
PURPOSE OF REVIEW This review investigates the relationship between myocardial bridges (MBs), intimal thickening in coronary arteries, and Atherosclerotic cardiovascular disease. It focuses on the role of mechanical forces, such as circumferential strain, in arterial wall remodeling and aims to clarify how MBs affect coronary artery pathology. REVIEW FINDINGS MBs have been identified as influential in modulating coronary artery intimal thickness, demonstrating a protective effect against thickening within the MB segment and an increase in thickness proximal to the MB. This is attributed to changes in mechanical stress and hemodynamics. Research involving arterial hypertension models and vein graft disease has underscored the importance of circumferential strain in vascular remodeling and intimal hyperplasia. Understanding the complex dynamics between MBs, mechanical strain, and vascular remodeling is crucial for advancing our knowledge of coronary artery disease mechanisms. This could lead to improved management strategies for cardiovascular diseases, highlighting the need for further research into MB-related vascular changes.
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Affiliation(s)
- Benjamin De Ornelas
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
| | - Vincenzo Sucato
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Giuseppe Vadalà
- Division of Cardiology, University Hospital "P. Giaccone", Palermo, Italy
| | - Andrea Buono
- Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Institute, Brescia, Italy
| | - Alfredo Ruggero Galassi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
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3
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Frolov A, Lobov A, Kabilov M, Zainullina B, Tupikin A, Shishkova D, Markova V, Sinitskaya A, Grigoriev E, Markova Y, Kutikhin A. Multi-Omics Profiling of Human Endothelial Cells from the Coronary Artery and Internal Thoracic Artery Reveals Molecular but Not Functional Heterogeneity. Int J Mol Sci 2023; 24:15032. [PMID: 37834480 PMCID: PMC10573276 DOI: 10.3390/ijms241915032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/02/2023] [Accepted: 10/08/2023] [Indexed: 10/15/2023] Open
Abstract
Major adverse cardiovascular events occurring upon coronary artery bypass graft surgery are typically accompanied by endothelial dysfunction. Total arterial revascularisation, which employs both left and right internal thoracic arteries instead of the saphenous vein to create a bypass, is associated with better mid- and long-term outcomes. We suggested that molecular profiles of human coronary artery endothelial cells (HCAECs) and human internal mammary artery endothelial cells (HITAECs) are coherent in terms of transcriptomic and proteomic signatures, which were then investigated by RNA sequencing and ultra-high performance liquid chromatography-mass spectrometry, respectively. Both HCAECs and HITAECs overexpressed molecules responsible for the synthesis of extracellular matrix (ECM) components, basement membrane assembly, cell-ECM adhesion, organisation of intercellular junctions, and secretion of extracellular vesicles. HCAECs were characterised by higher enrichment with molecular signatures of basement membrane construction, collagen biosynthesis and folding, and formation of intercellular junctions, whilst HITAECs were notable for augmented pro-inflammatory signaling, intensive synthesis of proteins and nitrogen compounds, and enhanced ribosome biogenesis. Despite HCAECs and HITAECs showing a certain degree of molecular heterogeneity, no specific markers at the protein level have been identified. Coherence of differentially expressed molecular categories in HCAECs and HITAECs suggests synergistic interactions between these ECs in a bypass surgery scenario.
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Affiliation(s)
- Alexey Frolov
- Department of Experimental Medicine, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Boulevard, Kemerovo 650002, Russia; (A.F.); (D.S.); (V.M.); (A.S.); (E.G.); (Y.M.)
| | - Arseniy Lobov
- Laboratory for Regenerative Biomedicine, Research Institute of Cytology of the Russian Academy of Sciences, 4 Tikhoretskiy Prospekt, St. Petersburg 194064, Russia;
| | - Marsel Kabilov
- SB RAS Genomics Core Facility, Institute of Chemical Biology and Fundamental Medicine of the Siberian Branch of the Russian Academy of Sciences, 8 Prospekt Akademika Lavrentieva, Novosibirsk 630090, Russia; (M.K.); (A.T.)
| | - Bozhana Zainullina
- Centre for Molecular and Cell Technologies, Research Park, Saint Petersburg State University, 7/9 Universitetskaya Embankment, St. Petersburg 199034, Russia;
| | - Alexey Tupikin
- SB RAS Genomics Core Facility, Institute of Chemical Biology and Fundamental Medicine of the Siberian Branch of the Russian Academy of Sciences, 8 Prospekt Akademika Lavrentieva, Novosibirsk 630090, Russia; (M.K.); (A.T.)
| | - Daria Shishkova
- Department of Experimental Medicine, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Boulevard, Kemerovo 650002, Russia; (A.F.); (D.S.); (V.M.); (A.S.); (E.G.); (Y.M.)
| | - Victoria Markova
- Department of Experimental Medicine, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Boulevard, Kemerovo 650002, Russia; (A.F.); (D.S.); (V.M.); (A.S.); (E.G.); (Y.M.)
| | - Anna Sinitskaya
- Department of Experimental Medicine, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Boulevard, Kemerovo 650002, Russia; (A.F.); (D.S.); (V.M.); (A.S.); (E.G.); (Y.M.)
| | - Evgeny Grigoriev
- Department of Experimental Medicine, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Boulevard, Kemerovo 650002, Russia; (A.F.); (D.S.); (V.M.); (A.S.); (E.G.); (Y.M.)
| | - Yulia Markova
- Department of Experimental Medicine, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Boulevard, Kemerovo 650002, Russia; (A.F.); (D.S.); (V.M.); (A.S.); (E.G.); (Y.M.)
| | - Anton Kutikhin
- Department of Experimental Medicine, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Boulevard, Kemerovo 650002, Russia; (A.F.); (D.S.); (V.M.); (A.S.); (E.G.); (Y.M.)
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4
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Messina Alvarez AA, Bilal MA, Damlakhy AR, Manasrah N, Chaudhary A. Spontaneous Coronary Artery Dissection: A Literature Review. Cureus 2023; 15:e45868. [PMID: 37885493 PMCID: PMC10597803 DOI: 10.7759/cureus.45868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2023] [Indexed: 10/28/2023] Open
Abstract
Spontaneous coronary artery dissection is a medical condition characterized by the rupture of the coronary artery wall, occurring without any external trauma. This ailment has been linked to various inflammatory, rheumatologic, and connective tissue disorders, as well as pregnancy-related changes. Despite being a less familiar cause of acute coronary syndrome, it has a considerable mortality rate, with incidence rates reaching up to 4%. This review will discuss the occurrence, pathophysiology, categorization, risk factors, diagnostic techniques, and treatment approaches related to spontaneous coronary artery dissection.
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Affiliation(s)
| | - Mohammad A Bilal
- Internal Medicine, Detroit Medical Center/Sinai-Grace Hospital, Detroit, USA
| | - Ahmad R Damlakhy
- Internal Medicine, Detroit Medical Center/Sinai-Grace Hospital, Detroit, USA
| | - Nouraldeen Manasrah
- Internal Medicine, Detroit Medical Center/Sinai-Grace Hospital, Detroit, USA
| | - Ahmed Chaudhary
- Internal Medicine, Detroit Medical Center/Sinai-Grace Hospital, Detroit, USA
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5
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Schultz J, van den Hoogen IJ, Kuneman JH, de Graaf MA, Kamperidis V, Broersen A, Jukema JW, Sakellarios A, Nikopoulos S, Tsarapatsani K, Naka K, Michalis L, Fotiadis DI, Maaniitty T, Saraste A, Bax JJ, Knuuti J. Coronary computed tomography angiography-based endothelial wall shear stress in normal coronary arteries. Int J Cardiovasc Imaging 2023; 39:441-450. [PMID: 36255544 PMCID: PMC9870961 DOI: 10.1007/s10554-022-02739-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/27/2022] [Indexed: 01/27/2023]
Abstract
Endothelial wall shear stress (ESS) is a biomechanical force which plays a role in the formation and evolution of atherosclerotic lesions. The purpose of this study is to evaluate coronary computed tomography angiography (CCTA)-based ESS in coronary arteries without atherosclerosis, and to assess factors affecting ESS values. CCTA images from patients with suspected coronary artery disease were analyzed to identify coronary arteries without atherosclerosis. Minimal and maximal ESS values were calculated for 3-mm segments. Factors potentially affecting ESS values were examined, including sex, lumen diameter and distance from the ostium. Segments were categorized according to lumen diameter tertiles into small (< 2.6 mm), intermediate (2.6-3.2 mm) or large (≥ 3.2 mm) segments. A total of 349 normal vessels from 168 patients (mean age 59 ± 9 years, 39% men) were included. ESS was highest in the left anterior descending artery compared to the left circumflex artery and right coronary artery (minimal ESS 2.3 Pa vs. 1.9 Pa vs. 1.6 Pa, p < 0.001 and maximal ESS 3.7 Pa vs. 3.0 Pa vs. 2.5 Pa, p < 0.001). Men had lower ESS values than women, also after adjusting for lumen diameter (p < 0.001). ESS values were highest in small segments compared to intermediate or large segments (minimal ESS 3.8 Pa vs. 1.7 Pa vs. 1.2 Pa, p < 0.001 and maximal ESS 6.0 Pa vs. 2.6 Pa vs. 2.0 Pa, p < 0.001). A weak to strong correlation was found between ESS and distance from the ostium (ρ = 0.22-0.62, p < 0.001). CCTA-based ESS values increase rapidly and become widely scattered with decreasing lumen diameter. This needs to be taken into account when assessing the added value of ESS beyond lumen diameter in highly stenotic lesions.
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Affiliation(s)
- Jussi Schultz
- grid.410552.70000 0004 0628 215XTurku PET Centre, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - Inge J. van den Hoogen
- grid.10419.3d0000000089452978Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jurrien H. Kuneman
- grid.10419.3d0000000089452978Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michiel A. de Graaf
- grid.10419.3d0000000089452978Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Vasileios Kamperidis
- Department of Cardiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexander Broersen
- grid.10419.3d0000000089452978Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands
| | - J. Wouter Jukema
- grid.10419.3d0000000089452978Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands ,grid.411737.7Netherlands Heart Institute, Utrecht, The Netherlands
| | - Antonis Sakellarios
- Department of Biomedical Research, FORTH-IMBB, Ioannina, Greece ,grid.9594.10000 0001 2108 7481Department of Materials Science and Engineering, Unit of Medical Technology and Intelligent Information Systems, University of Ioannina, Ioannina, Greece
| | - Sotirios Nikopoulos
- grid.9594.10000 0001 2108 7481Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Konstantina Tsarapatsani
- Department of Biomedical Research, FORTH-IMBB, Ioannina, Greece ,grid.9594.10000 0001 2108 7481Department of Materials Science and Engineering, Unit of Medical Technology and Intelligent Information Systems, University of Ioannina, Ioannina, Greece
| | - Katerina Naka
- grid.9594.10000 0001 2108 7481Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Lampros Michalis
- grid.9594.10000 0001 2108 7481Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Dimitrios I. Fotiadis
- Department of Biomedical Research, FORTH-IMBB, Ioannina, Greece ,grid.9594.10000 0001 2108 7481Department of Materials Science and Engineering, Unit of Medical Technology and Intelligent Information Systems, University of Ioannina, Ioannina, Greece
| | - Teemu Maaniitty
- grid.410552.70000 0004 0628 215XTurku PET Centre, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - Antti Saraste
- grid.410552.70000 0004 0628 215XTurku PET Centre, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, 20520 Turku, Finland ,grid.410552.70000 0004 0628 215XHeart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Jeroen J. Bax
- grid.10419.3d0000000089452978Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands ,grid.410552.70000 0004 0628 215XHeart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Juhani Knuuti
- grid.410552.70000 0004 0628 215XTurku PET Centre, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, 20520 Turku, Finland ,grid.10419.3d0000000089452978Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
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Moniripiri M, Hassani Soukht Abandani M, Firoozabadi B. Simulation of LDL permeation into multilayer wall of a coronary bifurcation using WSS-dependent model: effects of hemorheology. Biomech Model Mechanobiol 2022; 22:711-727. [PMID: 36525181 DOI: 10.1007/s10237-022-01676-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022]
Abstract
Atherosclerosis, due to the permeation of low-density lipoprotein (LDL) particles into the arterial wall, is one of the most common and deadly diseases in today's world. Due to its importance, numerous studies have been conducted on the factors affecting this disease. In this study, using numerical simulation, the effects of Wall Shear Stress (WSS), non-Newtonian behavior of blood, different values of hematocrit and blood pressure on LDL permeation into the arterial wall layers are investigated in a 4-layer wall model of a coronary bifurcation. To obtain the velocity and concentration fields in the fluid domain, the Navier-Stokes, Brinkman, and mass transfer equations are numerically solved in the lumen and wall layers. Results show that it is important to consider the effects of WSS on transport properties of endothelium layer in bifurcations and this leads to completely different concentration profiles compared to the constant properties model. Our computations show that a giant accumulation of LDL in the intima layer of the outer wall of the left anterior descending artery, especially in low WSS regions, may lead to atherosclerosis. It is also, necessary to consider the non-Newtonian behavior of blood in bifurcations due to its direct effect on WSS. A pressure-induced increase in the half-width of leaky junctions may be responsible for the higher risk of atherosclerosis in hypertension. In addition, it is shown that the dominant mechanism in LDL permeation into the wall is convection, and also, hypertension increases the effect of mass transfer by convection mechanism more than the diffusion mechanism. Furthermore, our results are consistent with various clinical studies.
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Affiliation(s)
- Mohammad Moniripiri
- Center of Excellence in Energy Conversion, School of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | | | - Bahar Firoozabadi
- Center of Excellence in Energy Conversion, School of Mechanical Engineering, Sharif University of Technology, Tehran, Iran.
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7
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Giannokostas K, Dimakopoulos Y, Tsamopoulos J. Shear stress and intravascular pressure effects on vascular dynamics: two-phase blood flow in elastic microvessels accounting for the passive stresses. Biomech Model Mechanobiol 2022; 21:1659-1684. [PMID: 35962247 DOI: 10.1007/s10237-022-01612-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/07/2022] [Indexed: 11/02/2022]
Abstract
We study the steady hemodynamics in physiological elastic microvessels proposing an advanced fluid-structure interaction model. The arteriolar tissue is modeled as a two-layer fiber-reinforced hyperelastic material representing its Media and Adventitia layers. The constitutive model employed (Holzapfel et al. in J Elast 61:1-48, 2000) is parametrized via available data on stress-strain experiments for arterioles. The model is completed by simulating the blood/plasma flow in the lumen, using the thixotropic elasto-viscoplastic model in its core, and the linear Phan-Thien and Tanner viscoelastic model in its annular part. The Cell-Free Layer (CFL) and the Fåhraeus and Fåhraeus-Lindqvist effects are considered via analytical expressions based on experimental data (Giannokostas et al. in Materials (Basel) 14:367, 2021b). The coupling between tissue deformation and blood flow is achieved through the experimentally verified pressure-shear hypothesis (Pries et al. Circ Res 77:1017-1023, 1995). Our calculations confirm that the increase in the reference inner radius produces larger expansion. Also, by increasing the intraluminal pressure, the thinning of the walls is more pronounced and it may reach 40% of the initial thickness. Comparing our predictions with those in rigid-wall microtubes, we conclude that apart from the vital importance of vasodilation, there is an up to 25% reduction in wall shear stress. The passive vasodilation contributes to the decrease in the tissue stress fields and affects the hemodynamic features such as the CFL thickness, reducing the plasma layer when blood flows in vessels with elastic walls, in quantitative agreement with previous experiments. Our calculations verify the correctness of the pressure-shear hypothesis but not that of the Laplace law.
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Affiliation(s)
- K Giannokostas
- Laboratory of Fluid Mechanics and Rheology, Department of Chemical Engineering, University of Patras, Patras, Greece
| | - Y Dimakopoulos
- Laboratory of Fluid Mechanics and Rheology, Department of Chemical Engineering, University of Patras, Patras, Greece.
| | - J Tsamopoulos
- Laboratory of Fluid Mechanics and Rheology, Department of Chemical Engineering, University of Patras, Patras, Greece
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8
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Mattesini A, Demola P, Shlofmitz R, Shlofmitz E, Waksman R, Jaffer FA, Di Mario C. Optical Coherence Tomography, Near‐Infrared Spectroscopy, and Near‐Infrared Fluorescence Molecular Imaging. Interv Cardiol 2022. [DOI: 10.1002/9781119697367.ch9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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9
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Rickel AP, Deng X, Engebretson D, Hong Z. Electrospun nanofiber scaffold for vascular tissue engineering. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 129:112373. [PMID: 34579892 DOI: 10.1016/j.msec.2021.112373] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/28/2021] [Accepted: 08/10/2021] [Indexed: 12/16/2022]
Abstract
Due to the prevalence of cardiovascular diseases, there is a large need for small diameter vascular grafts that cannot be fulfilled using autologous vessels. Although medium to large diameter synthetic vessels are in use, no suitable small diameter vascular graft has been developed due to the unique dynamic environment that exists in small vessels. To achieve long term patency, a successful tissue engineered vascular graft would need to closely match the mechanical properties of native tissue, be non-thrombotic and non-immunogenic, and elicit the proper healing response and undergo remodeling to incorporate into the native vasculature. Electrospinning presents a promising approach to the development of a suitable tissue engineered vascular graft. This review provides a comprehensive overview of the different polymers, techniques, and functionalization approaches that have been used to develop an electrospun tissue engineered vascular graft.
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Affiliation(s)
- Alex P Rickel
- The Department of Biomedical Engineering, The University of South Dakota, Sioux Falls, SD 57107, United States of America
| | - Xiajun Deng
- The Department of Biomedical Engineering, The University of South Dakota, Sioux Falls, SD 57107, United States of America
| | - Daniel Engebretson
- The Department of Biomedical Engineering, The University of South Dakota, Sioux Falls, SD 57107, United States of America
| | - Zhongkui Hong
- The Department of Biomedical Engineering, The University of South Dakota, Sioux Falls, SD 57107, United States of America.
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10
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Das L, Kumari TK, Renuka K, Rajeev R, Raju N. Microanatomy of Left Internal Thoracic Artery and Left Anterior Descending Artery: A Comparative Study. NATIONAL JOURNAL OF CLINICAL ANATOMY 2021. [DOI: 10.4103/njca.njca_30_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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11
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Lund T, Svindland A, Bay D, Sundhagen JO, Hisdal J, Flørenes T. Histological Analysis of a Long Term Patent Subintimal Canal in the Superficial Femoral Artery. EJVES Vasc Forum 2020; 50:19-23. [PMID: 33511376 PMCID: PMC7815991 DOI: 10.1016/j.ejvsvf.2020.12.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 12/01/2020] [Accepted: 12/22/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction Subintimal angioplasty (SIA) was introduced in the late 1980s and is a supplement to bypass surgery. Adaptation of the technique has been hampered by high rates of early intervention to maintain patency, but the long term assisted patency is good. Report The superficial femoral and popliteal artery containing a patent subintimal canal were explanted from a patient who died in the authors' ward. Histological analysis indicated that the lumen was created in the medial layer of the vessel wall. A collagen rich neointima and fragmented internal elastic lamina were observed, presumably as a result of activated smooth muscle cells. The luminal surface was partly covered by a single layer of CD31, von Willebrand factor, and partly CD144 positive cells. An early atherosclerotic lesion was observed distally in the subintimal canal. Discussion Remodelling and neo-cellularisation of the vascular wall after SIA are described. Notably, hallmarks of early and late stage atherosclerotic disease were evident throughout the subintimal canal. These observations require confirmation in a larger number of specimens but underscore the need for surveillance after SIA.
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Affiliation(s)
- Tormod Lund
- Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway
| | - Aud Svindland
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Dag Bay
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Jon O Sundhagen
- Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway
| | - Jonny Hisdal
- Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Tor Flørenes
- Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway
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12
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Ibdah RK, Alrabadi N, Rawashdeh SI, Al-Ksassbeh A, Habib A, hijazi E. A 44 years-old male patient surviving total occlusion of the left main coronary artery (STEMI) accompanied with cardiogenic shock. Ann Med Surg (Lond) 2020; 60:610-613. [PMID: 33304573 PMCID: PMC7711079 DOI: 10.1016/j.amsu.2020.11.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 11/21/2020] [Accepted: 11/24/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction Thrombus occlusion of the left main coronary artery (LMCA) is a poorly prognostic condition that is commonly associated with mortality especially when complicated with cardiogenic shock. Presentation of case In this report, we presented a case for 44 years-old male patient who is not known to have ischemic heart disease. He was transferred from a peripheral hospital for emergency percutaneous coronary intervention (PCI) after presenting with anterior ST-elevation myocardial infarction (STEMI) complicated with cardiogenic shock. Discussion The PCI revealed complete occlusion of the LMCA with a thrombus which was stented and the patient regain his cardiovascular stability. The patient survived this complete occlusion that was complicated with cardiogenic shock giving the quick intervention with the PCI and the use of the circulatory support devices. Conclusion The PCI procedure with the intra-aortic balloon pump should be available and offered early for patients with STEMI complicated with cardiogenic shock. This could be very critical in increasing the survival rates for those patients. A case of a patient who survived a complete LMCA occlusion. Total LM occlusion often associated with lifethretining arrhythmia. A Primary Percutaneous Coronary Intervention with intra-aortic balloon pump should be available and offered early for patients with cardiogenic shock.
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Affiliation(s)
- Rasheed K. Ibdah
- Division of Cardiology, Department of Internal Medicine, Jordan University for Science and Technology, Irbid, 22110, Jordan
- Corresponding author.
| | - Nasr Alrabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University for Science and Technology, Irbid, 22110, Jordan
- Corresponding author. Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan.
| | - Sukaina I. Rawashdeh
- Division of Cardiology, Department of Internal Medicine, Jordan University for Science and Technology, Irbid, 22110, Jordan
| | - Abdullah Al-Ksassbeh
- Division of Cardiology, Department of Internal Medicine, Jordan University for Science and Technology, Irbid, 22110, Jordan
| | - Amjad Habib
- Division of Cardiology, Department of Internal Medicine, Jordan University for Science and Technology, Irbid, 22110, Jordan
| | - Emad hijazi
- Department of Surgery, Faculty of Medicine, Jordan University for Science and Technology, Irbid, 22110, Jordan
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Co-Culture of Primary Human Coronary Artery and Internal Thoracic Artery Endothelial Cells Results in Mutually Beneficial Paracrine Interactions. Int J Mol Sci 2020; 21:ijms21218032. [PMID: 33126651 PMCID: PMC7663246 DOI: 10.3390/ijms21218032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/21/2020] [Accepted: 10/27/2020] [Indexed: 12/12/2022] Open
Abstract
Although saphenous veins (SVs) are commonly used as conduits for coronary artery bypass grafting (CABG), internal thoracic artery (ITA) grafts have significantly higher long-term patency. As SVs and ITA endothelial cells (ECs) have a considerable level of heterogeneity, we suggested that synergistic paracrine interactions between CA and ITA ECs (HCAECs and HITAECs, respectively) may explain the increased resistance of ITA grafts and adjacent CAs to atherosclerosis and restenosis. In this study, we measured the gene and protein expression of the molecules responsible for endothelial homeostasis, pro-inflammatory response, and endothelial-to-mesenchymal transition in HCAECs co-cultured with either HITAECs or SV ECs (HSaVECs) for an ascending duration. Upon the co-culture, HCAECs and HITAECs showed augmented expression of endothelial nitric oxide synthase (eNOS) and reduced expression of endothelial-to-mesenchymal transition transcription factors Snail and Slug when compared to the HCAEC–HSaVEC model. HCAECs co-cultured with HITAECs demonstrated an upregulation of HES1, a master regulator of arterial specification, of which the expression was also exclusively induced in HSaVECs co-cultured with HCAECs, suggestive of their arterialisation. In addition, co-culture of HCAECs and HITAECs promoted the release of pro-angiogenic molecules. To conclude, co-culture of HCAECs and HITAECs results in reciprocal and beneficial paracrine interactions that might contribute to the better performance of ITA grafts upon CABG.
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Olender ML, Athanasiou LS, Michalis LK, Fotiadis DI, Edelman ER. A Domain Enriched Deep Learning Approach to Classify Atherosclerosis using Intravascular Ultrasound Imaging. IEEE JOURNAL OF SELECTED TOPICS IN SIGNAL PROCESSING 2020; 14:1210-1220. [PMID: 33520048 PMCID: PMC7845913 DOI: 10.1109/jstsp.2020.3002385] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Intravascular ultrasound (IVUS) imaging is widely used for diagnostic imaging in interventional cardiology. The detection and quantification of atherosclerosis from acquired images is typically performed manually by medical experts or by virtual histology IVUS (VH-IVUS) software. VH-IVUS analyzes backscattered radio frequency (RF) signals to provide a color-coded tissue map, and is the method of choice for assessing atherosclerotic plaque in situ. However, a significant amount of tissue cannot be analyzed in reasonable time because the method can be applied just once per cardiac cycle. Furthermore, only hardware and software compatible with RF signal acquisition and processing may be used. We present an image-based tissue characterization method that can be applied to entire acquisition sequences post hoc for the assessment of diseased vessels. The pixel-based method utilizes domain knowledge of arterial pathology and physiology, and leverages technological advances of convolutional neural networks to segment diseased vessel walls into the same tissue classes as virtual histology using only grayscale IVUS images. The method was trained and tested on patches extracted from VH-IVUS images acquired from several patients, and achieved overall accuracy of 93.5% for all segmented tissue. Imposing physically-relevant spatial constraints driven by domain knowledge was key to achieving such strong performance. This enriched approach offers capabilities akin to VH-IVUS without the constraints of RF signals or limited once-per-cycle analysis, offering superior potential information acquisition speed, reduced hardware and software requirements, and more widespread applicability. Such an approach may well yield promise for future clinical and research applications.
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Affiliation(s)
- Max L Olender
- Department of Mechanical Engineering and the Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139 USA
| | - Lambros S Athanasiou
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139 USA; Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115 USA
| | - Lampros K Michalis
- Faculty of Medicine, School of Health Sciences, University of Ioannina and the 2nd Department of Cardiology, University Hospital of Ioannina, Ioannina, 45500 Greece
| | - Dimitris I Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, 45110 Greece; Department of Biomedical Research, Institute of Molecular Biology and Biotechnology - FORTH, Ioannina, 45110 Greece
| | - Elazer R Edelman
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139 USA; Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115 USA
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Intracoronary Delivery of Mitochondria to Prevent Ischemia-Reperfusion Injury: Challenging Pathway From Bench to Bedside. JACC Basic Transl Sci 2020; 5:208. [PMID: 32140626 PMCID: PMC7046498 DOI: 10.1016/j.jacbts.2020.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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16
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Milutinović A, Šuput D, Zorc-Pleskovič R. Pathogenesis of atherosclerosis in the tunica intima, media, and adventitia of coronary arteries: An updated review. Bosn J Basic Med Sci 2020; 20:21-30. [PMID: 31465719 PMCID: PMC7029210 DOI: 10.17305/bjbms.2019.4320] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 07/31/2019] [Indexed: 02/07/2023] Open
Abstract
Atherosclerosis is a chronic inflammatory disease of arteries and it affects the structure and function of all three layers of the coronary artery wall. Current theories suggest that the dysfunction of endothelial cells is one of the initial steps in the development of atherosclerosis. The view that the tunica intima normally consists of a single layer of endothelial cells attached to the subendothelial layer and internal elastic membrane has been questioned in recent years. The structure of intima changes with age and it becomes multilayered due to migration of smooth muscle cells from the media to intima. At this stage, the migration and proliferation of smooth muscle cells do not cause pathological changes in the intima. The multilayering of intima is classically considered to be an important stage in the development of atherosclerosis, but in fact atherosclerotic plaques develop only focally due to the interplay of various processes that involve the resident and invading inflammatory cells. The tunica media consists of multiple layers of smooth muscle cells that produce the extracellular matrix, and this layer normally does not contain microvessels. During the development of atherosclerosis, the microvessels from the tunica adventitia or from the lumen may penetrate thickened media to provide nutrition and oxygenation. According to some theories, the endothelial dysfunction of these nutritive vessels may significantly contribute to the atherosclerosis of coronary arteries. The adventitia contains fibroblasts, progenitor cells, immune cells, microvessels, and adrenergic nerves. The degree of inflammatory cell infiltration into the adventitia, which can lead to the formation of tertiary lymphoid organs, correlates with the severity of atherosclerotic plaques. Coronary arteries are surrounded by perivascular adipose tissue that also participates in the atherosclerotic process.
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Affiliation(s)
- Aleksandra Milutinović
- Institute of Histology and Embryology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| | - Dušan Šuput
- Institute of Pathophysiology, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
| | - Ruda Zorc-Pleskovič
- Institute of Histology and Embryology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; International Center for Cardiovascular Diseases MC Medicor d.d., Izola, Slovenia.
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17
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Patil BS, Kanthe PS, Reddy CR, Das KK. Emblica officinalis (Amla) Ameliorates High-Fat Diet Induced Alteration of Cardiovascular Pathophysiology. Cardiovasc Hematol Agents Med Chem 2019; 17:52-63. [PMID: 30963985 PMCID: PMC6864597 DOI: 10.2174/1871525717666190409120018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 04/01/2019] [Accepted: 04/03/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Dietary high fat possibly causes oxidative stress. Also, it alters the pathophysiology of metabolically active myocardial tissues and vascular architecture. Emblica officinalis contains a potential antioxidant that counteracts oxidative stress and possibly maintains vascular integrity. OBJECTIVES To assess the effect of ethanolic extract of Emblica officinalis (EEO) on High Fat Diet (HFD) induced changes in vascular chemistry and histopathology of the cardiovascular system in male albino rats. MATERIALS AND METHODS Ethanolic extract of Emblica officinalis (EEO) was prepared and phytochemical analysis was done. Rats were divided into four groups, having six rats in each group as follows: group 1- Control (20% fat); group 2 (20% fat+ EEO 100 mg/kg/b w); group 3 (30% fat) and group 4 (30% fat + EEO 100 mg/kg/b w). Dietary and EEO supplementation was continued for 21 days. Gravimetric and oxidative stress markers like MDA, NO, antioxidants like Vitamin C and E, and molecular marker (NOS3) were evaluated. Histopathological analysis was done on the myocardium and elastic artery along with measurement of coronary arterial wall thickness and lumen diameter. One way ANOVA was done for analysis of data. RESULTS High fat diet showed a significant increase in MDA, decrease of NO with unaltered NOS3 protein in rats fed with high fat diet, which indicate possible alteration of vascular pathophysiology. Supplementation of EEO showed an ameliorating effect on high fat diet induced oxidative stress. These results were further corroborated with findings of a histopathological study on the myocardium, elastic artery and coronary arterial architecture. CONCLUSION Ethanolic extract of Emblica officinalis (EEO) indicates its cardioprotective efficacy against rats fed with high fat diet.
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Affiliation(s)
- Bheemshetty S Patil
- Department of Anatomy, Shri B.M. Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur-586103, Karnataka, India
| | - Pallavi S Kanthe
- Laboratory of Vascular Physiology and Medicine, Department of Physiology, Shri B. M. Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur- 586103, Karnataka, India
| | - Chandramouli R Reddy
- Laboratory of Vascular Physiology and Medicine, Department of Physiology, Shri B. M. Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur- 586103, Karnataka, India
| | - Kusal K Das
- Laboratory of Vascular Physiology and Medicine, Department of Physiology, Shri B. M. Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur- 586103, Karnataka, India
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18
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Phospholipid packing defects and oxysterols in atherosclerosis: Dietary prevention and the French paradox. Biochimie 2019; 167:145-151. [PMID: 31586653 DOI: 10.1016/j.biochi.2019.09.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 09/29/2019] [Indexed: 02/06/2023]
Abstract
The research literature on atherosclerosis includes findings investigating the atherosclerotic effect of oxysterols, which are the oxidation products of cholesterol; and the literature on oxysterols refers to mechanisms by which oxysterols cause phospholipid packing defects in cell membranes. This review synthesizes these two bodies of research findings to describe how oxysterols cause phospholipid packing defects within the membranes of vascular endothelial cells, potentially increasing cell permeability of low-density lipoprotein cholesterol which may lead to atheroma formation. Exogenous sources of oxysterols are provided by dietary intake of animal-based foods that contain cholesterol oxidation products. This review proposes an explanation for the anti-atherosclerotic effect of plant-based dietary patterns, which is attributed to restriction or avoidance of dietary oxysterol intake from animal-based foods. Furthermore, raw-milk cheeses play an important role in the traditional French diet-low oxysterol content in these unheated foods may contribute to the French paradox, in which reduced coronary heart disease is associated with a diet high in saturated fat and cholesterol.
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19
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Kilany MS, El Sayed SA, Salem HF, Beheiry RR. Histological and ultrastructural studies on the coronary artery of adult domestic dog (Canis familiaris). Anat Histol Embryol 2019; 49:80-89. [PMID: 31508860 DOI: 10.1111/ahe.12488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 07/09/2019] [Accepted: 08/10/2019] [Indexed: 11/29/2022]
Abstract
The objective of this work was to study the histological structure of the dog's coronary artery by light and transmission electron microscope (TEM). The coronary artery consisted of three tunics: tunica intima, tunica media and tunica adventitia. The tunica intima consisted of endothelium rested directly on internal elastic lamina without the subendothelial connective tissue layer. The tunica media were composed of smooth muscle fibres interspersed with few elastic and collagen fibres. The tunica adventitia consisted of collagen and elastic fibres intermingled with fibroblast cells; it had vasa vasorum and nervi vasorum. Some histomorphometric measurements were performed and compared statistically. The ultrastructural study showed that the endothelial cells were communicated through complex junctions and characterised by filiform cytoplasmic processes passed through the opening of the underlying internal elastic membrane. The smooth muscle fibres of tunica media communicated with each other through cytoplasmic processes. The tunica adventitia showed minute non-myelinated nerve. This work revealed that the dog's coronary arteries are typical muscular arteries, which show little structural variations from that of other mammals.
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Affiliation(s)
- Maha S Kilany
- Department of Histology and Cytology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Shafika A El Sayed
- Department of Histology and Cytology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Hoda F Salem
- Department of Histology and Cytology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Rasha R Beheiry
- Department of Histology and Cytology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
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20
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Elsayed Y, Lekakou C, Tomlins P. Modeling, simulations, and optimization of smooth muscle cell tissue engineering for the production of vascular grafts. Biotechnol Bioeng 2019; 116:1509-1522. [PMID: 30737955 DOI: 10.1002/bit.26955] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 02/01/2019] [Accepted: 02/06/2019] [Indexed: 12/20/2022]
Abstract
The paper presents a transient, continuum, two-phase model of the tissue engineering in fibrous scaffolds, including transport equations for the flowing culture medium, nutrient and cell concentration with transverse and in-plane diffusion and cell migration, a novel feature of local in-plane transport across a phenomenological pore and innovative layer-by-layer cell filling approach. The model is successfully validated for the smooth muscle cell tissue engineering of a vascular graft using crosslinked, electrospun gelatin fiber scaffolds for both static and dynamic cell culture, the latter in a dynamic bioreactor with a rotating shaft on which the tubular scaffold is attached. Parametric studies evaluate the impact of the scaffold microstructure, cell dynamics, oxygen transport, and static or dynamic conditions on the rate and extent of cell proliferation and depth of oxygen accessibility. An optimized scaffold of 75% dry porosity is proposed that can be tissue engineered into a viable and still fully oxygenated graft of the tunica media of the coronary artery within 2 days in the dynamic bioreactor. Such scaffold also matches the mechanical properties of the tunica media of the human coronary artery and the suture retention strength of a saphenous vein, often used as a coronary artery graft.
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Affiliation(s)
- Yahya Elsayed
- Department of Mechanical Engineering Sciences, Engineering Materials Centre, University of Surrey, Guildford, Surrey, UK.,Department of Mechanical Engineering Sciences, Centre of Biomedical Engineering, University of Surrey, Guildford, Surrey, UK
| | - Constantina Lekakou
- Department of Mechanical Engineering Sciences, Engineering Materials Centre, University of Surrey, Guildford, Surrey, UK
| | - Paul Tomlins
- National Physical Laboratory, Teddington, Middlesex, UK
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21
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Ardila DC, Liou JJ, Maestas D, Slepian MJ, Badowski M, Wagner WR, Harris D, Vande Geest JP. Surface Modification of Electrospun Scaffolds for Endothelialization of Tissue-Engineered Vascular Grafts Using Human Cord Blood-Derived Endothelial Cells. J Clin Med 2019; 8:E185. [PMID: 30720769 PMCID: PMC6416564 DOI: 10.3390/jcm8020185] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/22/2019] [Accepted: 02/01/2019] [Indexed: 01/09/2023] Open
Abstract
Tissue engineering has gained attention as an alternative approach for developing small diameter tissue-engineered vascular grafts intended for bypass surgery, as an option to treat coronary heart disease. To promote the formation of a healthy endothelial cell monolayer in the lumen of the graft, polycaprolactone/gelatin/fibrinogen scaffolds were developed, and the surface was modified using thermoforming and coating with collagen IV and fibronectin. Human cord blood-derived endothelial cells (hCB-ECs) were seeded onto the scaffolds and the important characteristics of a healthy endothelial cell layer were evaluated under static conditions using human umbilical vein endothelial cells as a control. We found that polycaprolactone/gelatin/fibrinogen scaffolds that were thermoformed and coated are the most suitable for endothelial cell growth. hCB-ECs can proliferate, produce endothelial nitric oxide synthase, respond to interleukin 1 beta, and reduce platelet deposition.
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Affiliation(s)
| | - Jr-Jiun Liou
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA.
| | - David Maestas
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21231, USA.
| | - Marvin J Slepian
- Sarver Heart Center, The University of Arizona, Tucson, AZ 85721, USA.
- The Arizona Center for Accelerated BioMedical Innovation, University of Arizona, Tucson, AZ 85721, USA.
- BIO5 Institute for Biocollaborative Research, The University of Arizona, Tucson, AZ 85721, USA.
- Interventional Cardiology, University of Arizona, Tucson, AZ 85721, USA.
| | - Michael Badowski
- Arizona Health Science Center Biorepository, University of Arizona, Tucson, AZ 85724, USA.
| | - William R. Wagner
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA.
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA.
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15219, USA.
| | - David Harris
- Arizona Health Science Center Biorepository, University of Arizona, Tucson, AZ 85724, USA.
- Department of Immunobiology, Arizona Health Science Center Biorepository, University of Arizona, Tucson, AZ 85724, USA.
| | - Jonathan P Vande Geest
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA.
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA.
- Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA 15219, USA.
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Carbon nanotube scaffolds as emerging nanoplatform for myocardial tissue regeneration: A review of recent developments and therapeutic implications. Biomed Pharmacother 2018; 104:496-508. [DOI: 10.1016/j.biopha.2018.05.066] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 05/14/2018] [Accepted: 05/14/2018] [Indexed: 01/19/2023] Open
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Tohno Y, Tohno S, Quiggins R, Minami T, Mahakkanukrauh P. Scarce Occurrence of Calcification in Human Sinoatrial Nodal Arteries in Old Age. Biol Trace Elem Res 2018; 184:24-32. [PMID: 28986768 DOI: 10.1007/s12011-017-1173-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 09/27/2017] [Indexed: 10/18/2022]
Abstract
To elucidate age-related changes of the sinoatrial (sinuatrial) nodal (SAN) artery, the authors investigated age-related changes of elements in the SAN artery by direct chemical analysis. In addition, the effects of different arterial origins, arterial sizes, and genders on element accumulation were investigated in the SAN artery. Fifty-nine formalin-fixed adult Thai hearts were dissected, and the following three types of the SAN artery were found: The first type was a single SAN artery arising from the right coronary artery (RCA). The second type was a single SAN artery arising from the proximal segment of the left circumflex artery (LCX). The third type was dual SAN artery arising from both the RCA and the LCX. For element analysis, both 41 single SAN arteries arising from the RCA and the LCX and 18 larger branches of dual SAN artery were used. After the arteries were incinerated with nitric acid and perchloric acid, element contents were determined by inductively coupled plasma-atomic emission spectrometry. It was found that seven element contents such as Ca, P, S, Mg, Zn, Fe, and Na did not change significantly in the SAN arteries with aging. Regarding the relationships among seven elements in the SAN arteries, extremely significant direct correlations were found among P, S, Mg, and Fe contents with one exception. However, no significant correlations were found between Ca and either P or Mg contents in the SAN arteries. To examine an effect of the different arterial origins on element accumulation, the SAN arteries were separated into the RCA and the LCX groups by the arterial origin and age-related changes of element contents were compared between two groups. It was found that there were no significant differences between the RCA and the LCX groups in age-related changes of Ca and P contents. No gender differences were found in age-related changes of Ca and P contents in the SAN arteries. To elucidate whether calcification occurred in the SAN arteries in old age, both the mass ratios of Ca/P and Mg/Ca were estimated in the SAN arteries. The mass ratio of Ca/P increased progressively in the SAN arteries with Ca increase, being not constant. The mass ratio of Mg/Ca decreased gradually in the SAN arteries with Ca increase, but the average mass ratio of Mg/Ca was very high, being 49.4 ± 16.5%. These results indicated that calcification scarcely occurred in the SAN arteries in old age, independently of the arterial origin and gender.
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Affiliation(s)
- Yoshiyuki Tohno
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Setsuko Tohno
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Ranida Quiggins
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Takeshi Minami
- Laboratory of Environmental Biology, Department of Life Science, Faculty of Science and Technology, Kinki University, Higashi-Osaka, Osaka, 577-8502, Japan
| | - Pasuk Mahakkanukrauh
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
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Jewkes R, Burton HE, Espino DM. Towards Additive Manufacture of Functional, Spline-Based Morphometric Models of Healthy and Diseased Coronary Arteries: In Vitro Proof-of-Concept Using a Porcine Template. J Funct Biomater 2018; 9:E15. [PMID: 29393899 PMCID: PMC5872101 DOI: 10.3390/jfb9010015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 01/26/2018] [Accepted: 01/31/2018] [Indexed: 12/21/2022] Open
Abstract
The aim of this study is to assess the additive manufacture of morphometric models of healthy and diseased coronary arteries. Using a dissected porcine coronary artery, a model was developed with the use of computer aided engineering, with splines used to design arteries in health and disease. The model was altered to demonstrate four cases of stenosis displaying varying severity, based on published morphometric data available. Both an Objet Eden 250 printer and a Solidscape 3Z Pro printer were used in this analysis. A wax printed model was set into a flexible thermoplastic and was valuable for experimental testing with helical flow patterns observed in healthy models, dominating the distal LAD (left anterior descending) and left circumflex arteries. Recirculation zones were detected in all models, but were visibly larger in the stenosed cases. Resin models provide useful analytical tools for understanding the spatial relationships of blood vessels, and could be applied to preoperative planning techniques, but were not suitable for physical testing. In conclusion, it is feasible to develop blood vessel models enabling experimental work; further, through additive manufacture of bio-compatible materials, there is the possibility of manufacturing customized replacement arteries.
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Affiliation(s)
- Rachel Jewkes
- Department of Mechanical Engineering, University of Birmingham, Birmingham B15 2TT, UK.
| | - Hanna E Burton
- Department of Mechanical Engineering, University of Birmingham, Birmingham B15 2TT, UK.
| | - Daniel M Espino
- Department of Mechanical Engineering, University of Birmingham, Birmingham B15 2TT, UK.
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25
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Ormiston JA, Kassab G, Finet G, Chatzizisis YS, Foin N, Mickley TJ, Chiastra C, Murasato Y, Hikichi Y, Wentzel JJ, Darremont O, Iwasaki K, Lefèvre T, Louvard Y, Beier S, Hojeibane H, Netravali A, Wooton J, Cowan B, Webster MW, Medrano-Gracia P, Stankovic G. Bench testing and coronary artery bifurcations: a consensus document from the European Bifurcation Club. EUROINTERVENTION 2018; 13:e1794-e1803. [PMID: 29131803 DOI: 10.4244/eij-d-17-00270] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This is a consensus document from the European Bifurcation Club concerning bench testing in coronary artery bifurcations. It is intended to provide guidelines for bench assessment of stents and other strategies in coronary bifurcation treatment where the United States Food and Drug Administration (FDA) or International Organization for Standardization (ISO) guidelines are limited or absent. These recommendations provide guidelines rather than a step-by-step manual. We provide data on the anatomy of bifurcations and elastic response of coronary arteries to aid model construction. We discuss testing apparatus, bench testing endpoints and bifurcation nomenclature.
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Harbron RW, Ainsbury EA, Bouffler SD, Tanner RJ, Pearce MS, Eakins JS. The impact of iodinated contrast media on intravascular and extravascular absorbed doses in X-ray imaging: A microdosimetric analysis. Phys Med 2018; 46:140-147. [PMID: 29519400 DOI: 10.1016/j.ejmp.2018.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/22/2017] [Accepted: 02/01/2018] [Indexed: 12/27/2022] Open
Abstract
Studies suggest iodinated contrast media (ICM) may increase organ dose and blood cell DNA damage for a given X-ray exposure. The impact of ICM on dose/damage to extravascular cells and cancer risks is unclear. METHODS We used Monte Carlo modelling to investigate the microscopic distribution of absorbed dose outside the lumen of arteries, capillaries and interstitial fluids containing blood and various concentrations of iodine. Models were irradiated with four X-ray spectra representing clinical procedures. RESULTS For the artery model, The average dose enhancement factors (DEF) to blood were 1.70, 2.38, 7.38, and 12.34 for mass concentrations of iodine in blood (ρiI) of 5, 10, 50 and 100 mg/ml, respectively, compared to 0 mg/ml. Average DEFs were reduced to 1.26, 1.51, 3.48 and 5.56, respectively, in the first micrometre of the vessel wall, falling to 1.01, 1.02, 1.06 and 1.09 at 40-50 μm from the lumen edge. For the capillary models, DEF for extravascular tissues was on average 48% lower than DEF for the whole model, including capillaries. A similar situation was observed for the interstitial model, with DEF to the cell nucleus being 35% lower than DEF for the whole model. CONCLUSIONS While ICM may modify the absorbed doses from diagnostic X-ray examinations, the effect is smaller than suggested by assays of circulating blood cells or blood dose enhancement. Conversely, the potentially large increase in dose to the endothelium of blood vessels means that macroscopic organ doses may underestimate the risk of radiation induced cardiovascular disease for ICM-enhanced exposures.
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Affiliation(s)
- Richard W Harbron
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne NE1 4LP, UK; NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Newcastle University, UK.
| | - Elizabeth A Ainsbury
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot OX11 0RQ, UK
| | - Simon D Bouffler
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot OX11 0RQ, UK
| | - Rick J Tanner
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot OX11 0RQ, UK
| | - Mark S Pearce
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne NE1 4LP, UK; NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Newcastle University, UK
| | - Jonathan S Eakins
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot OX11 0RQ, UK
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Yang WJ, Wong KS, Chen XY. Intracranial Atherosclerosis: From Microscopy to High-Resolution Magnetic Resonance Imaging. J Stroke 2017; 19:249-260. [PMID: 28877564 PMCID: PMC5647638 DOI: 10.5853/jos.2016.01956] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 02/26/2017] [Accepted: 03/31/2017] [Indexed: 12/22/2022] Open
Abstract
Intracranial atherosclerosis is one of the leading causes of ischemic stroke and occurs more commonly in patients of Asian, African or Hispanic origin than in Caucasians. Although the histopathology of intracranial atherosclerotic disease resembles extracranial atherosclerosis, there are some notable differences in the onset and severity of atherosclerosis. Current understanding of intracranial atherosclerotic disease has been advanced by the high-resolution magnetic resonance imaging (HRMRI), a novel emerging imaging technique that can directly visualize the vessel wall pathology. However, the pathological validation of HRMRI signal characteristics remains a key step to depict the plaque components and vulnerability in intracranial atherosclerotic lesions. The purpose of this review is to describe the histological features of intracranial atherosclerosis and to state current evidences regarding the validation of MR vessel wall imaging with histopathology.
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Affiliation(s)
- Wen-Jie Yang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong
| | - Ka-Sing Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong
| | - Xiang-Yan Chen
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong
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Bulant CA, Blanco PJ, Lima TP, Assunção AN, Liberato G, Parga JR, Ávila LFR, Pereira AC, Feijóo RA, Lemos PA. A computational framework to characterize and compare the geometry of coronary networks. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2017; 33:e02800. [PMID: 27169829 DOI: 10.1002/cnm.2800] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 04/08/2016] [Accepted: 04/26/2016] [Indexed: 06/05/2023]
Abstract
This work presents a computational framework to perform a systematic and comprehensive assessment of the morphometry of coronary arteries from in vivo medical images. The methodology embraces image segmentation, arterial vessel representation, characterization and comparison, data storage, and finally analysis. Validation is performed using a sample of 48 patients. Data mining of morphometric information of several coronary arteries is presented. Results agree to medical reports in terms of basic geometric and anatomical variables. Concerning geometric descriptors, inter-artery and intra-artery correlations are studied. Data reported here can be useful for the construction and setup of blood flow models of the coronary circulation. Finally, as an application example, similarity criterion to assess vasculature likelihood based on geometric features is presented and used to test geometric similarity among sibling patients. Results indicate that likelihood, measured through geometric descriptors, is stronger between siblings compared with non-relative patients. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- C A Bulant
- National Laboratory for Scientific Computing, LNCC/MCTI, Av. Getúlio Vargas 333, Quitandinha, Petrópolis, 25651-075, Brazil
- National Institute of Science and Technology in Medicine Assisted by Scientific Computing, INCT-MACC, Petrópolis, Brazil
| | - P J Blanco
- National Laboratory for Scientific Computing, LNCC/MCTI, Av. Getúlio Vargas 333, Quitandinha, Petrópolis, 25651-075, Brazil
- National Institute of Science and Technology in Medicine Assisted by Scientific Computing, INCT-MACC, Petrópolis, Brazil
| | - T P Lima
- Heart Institute, University of São Paulo Medical School, INCOR-FM-USP, Av. Dr. Eneas de Carvalho Aguiar, 44, 3rd floor, São Paulo-SP, 05403-000, Brazil
| | - A N Assunção
- Heart Institute, University of São Paulo Medical School, INCOR-FM-USP, Av. Dr. Eneas de Carvalho Aguiar, 44, 3rd floor, São Paulo-SP, 05403-000, Brazil
| | - G Liberato
- Heart Institute, University of São Paulo Medical School, INCOR-FM-USP, Av. Dr. Eneas de Carvalho Aguiar, 44, 3rd floor, São Paulo-SP, 05403-000, Brazil
| | - J R Parga
- Heart Institute, University of São Paulo Medical School, INCOR-FM-USP, Av. Dr. Eneas de Carvalho Aguiar, 44, 3rd floor, São Paulo-SP, 05403-000, Brazil
| | - L F R Ávila
- Heart Institute, University of São Paulo Medical School, INCOR-FM-USP, Av. Dr. Eneas de Carvalho Aguiar, 44, 3rd floor, São Paulo-SP, 05403-000, Brazil
| | - A C Pereira
- Heart Institute, University of São Paulo Medical School, INCOR-FM-USP, Av. Dr. Eneas de Carvalho Aguiar, 44, 3rd floor, São Paulo-SP, 05403-000, Brazil
| | - R A Feijóo
- National Laboratory for Scientific Computing, LNCC/MCTI, Av. Getúlio Vargas 333, Quitandinha, Petrópolis, 25651-075, Brazil
- National Institute of Science and Technology in Medicine Assisted by Scientific Computing, INCT-MACC, Petrópolis, Brazil
| | - P A Lemos
- Heart Institute, University of São Paulo Medical School, INCOR-FM-USP, Av. Dr. Eneas de Carvalho Aguiar, 44, 3rd floor, São Paulo-SP, 05403-000, Brazil
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Kilic ID, Serdoz R, Fabris E, Jaffer FA, Di Mario C. Optical Coherence Tomography, Near-Infrared Spectroscopy, and Near-Infrared Fluorescence Molecular Imaging. Interv Cardiol 2016. [DOI: 10.1002/9781118983652.ch8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Ismail Dogu Kilic
- Department of Cardiology; Pamukkale University Hospitals; Denizli Turkey
- National Institute of Health Research (NIHR); Royal Brompton & Harefield NHS Foundation Trust; London
- NHLI Imperial College; London UK
| | - Roberta Serdoz
- National Institute of Health Research (NIHR); Royal Brompton & Harefield NHS Foundation Trust; London
- NHLI Imperial College; London UK
| | - Enrico Fabris
- National Institute of Health Research (NIHR); Royal Brompton & Harefield NHS Foundation Trust; London
- NHLI Imperial College; London UK
- Cardiovascular Department; Ospedali Riuniti and University of Trieste; Trieste Italy
| | - Farouc Amin Jaffer
- Cardiology Division, Massachusetts General Hospital; Harvard Medical School; Boston MA USA
| | - Carlo Di Mario
- National Institute of Health Research (NIHR); Royal Brompton & Harefield NHS Foundation Trust; London
- NHLI Imperial College; London UK
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Schiavazzi DE, Hsia TY, Marsden AL. On a sparse pressure-flow rate condensation of rigid circulation models. J Biomech 2016; 49:2174-2186. [PMID: 26671219 DOI: 10.1016/j.jbiomech.2015.11.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 11/11/2015] [Indexed: 11/26/2022]
Abstract
Cardiovascular simulation has shown potential value in clinical decision-making, providing a framework to assess changes in hemodynamics produced by physiological and surgical alterations. State-of-the-art predictions are provided by deterministic multiscale numerical approaches coupling 3D finite element Navier Stokes simulations to lumped parameter circulation models governed by ODEs. Development of next-generation stochastic multiscale models whose parameters can be learned from available clinical data under uncertainty constitutes a research challenge made more difficult by the high computational cost typically associated with the solution of these models. We present a methodology for constructing reduced representations that condense the behavior of 3D anatomical models using outlet pressure-flow polynomial surrogates, based on multiscale model solutions spanning several heart cycles. Relevance vector machine regression is compared with maximum likelihood estimation, showing that sparse pressure/flow rate approximations offer superior performance in producing working surrogate models to be included in lumped circulation networks. Sensitivities of outlets flow rates are also quantified through a Sobol׳ decomposition of their total variance encoded in the orthogonal polynomial expansion. Finally, we show that augmented lumped parameter models including the proposed surrogates accurately reproduce the response of multiscale models they were derived from. In particular, results are presented for models of the coronary circulation with closed loop boundary conditions and the abdominal aorta with open loop boundary conditions.
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Affiliation(s)
- D E Schiavazzi
- Mechanical and Aerospace Engineering Department, University of California, San Diego, USA
| | - T Y Hsia
- Great Ormond Street Hospital for Children and UCL Institute of Cardiovascular Science, London, UK
| | - A L Marsden
- Mechanical and Aerospace Engineering Department, University of California, San Diego, USA
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31
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Optimal boundary detection method and window settings for coronary atherosclerotic plaque volume analysis in coronary computed tomography angiography: comparison with intravascular ultrasound. Eur Radiol 2015; 26:3190-8. [DOI: 10.1007/s00330-015-4121-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 11/13/2015] [Accepted: 11/13/2015] [Indexed: 10/22/2022]
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Loukas M, Andall RG, Khan AZ, Patel K, Muresian H, Spicer DE, Tubbs RS. The clinical anatomy of high take-off coronary arteries. Clin Anat 2015; 29:408-19. [PMID: 26518608 DOI: 10.1002/ca.22664] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 10/27/2015] [Accepted: 10/28/2015] [Indexed: 01/09/2023]
Abstract
A number of criteria are used in the literature to describe high take-off coronary arteries, which can in part, explain the divide in the literature on the pathological significance of this anomaly. This study presents the anatomical variations of high take-off coronary arteries to draw attention to the possible clinical implications they may cause during angiography and other surgical procedures. The English Literature was searched to review high take-off coronary arteries. A high take-off coronary artery arising at least 1 cm in adults or 20% the depth of the sinus in children above the sinutubular junction, is considered of greater clinical relevance and was included in our meta-analysis. High take-off coronaries by other criteria was also included as part of the comprehensive review. Exclusion criteria were reports made in case studies or case reviews. The prevalence of high take-off coronary arteries in our study was 26 of 12,899 (0.202%). High take-off coronary arteries were found to originate up to 5 cm above the sinutubular junction. Right coronary arteries made up 84.46% of high take-off coronary arteries reported in the literature. Three (0.023%) cases that originated more than one centimeter above the sinutubular junction was associated with sudden cardiac death. This is a higher reported association than in studies that used other criteria for classification. It is important for clinicians to recognize the importance of correctly diagnosing high take-off coronary arteries in patients with coexisting cardiac morbidities so that suitable management plans can be developed.
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Affiliation(s)
- Marios Loukas
- Department of Anatomical Sciences, St. George's University, School of Medicine Grenada, West Indies
| | - Rebecca G Andall
- Department of Anatomical Sciences, St. George's University, School of Medicine Grenada, West Indies
| | - Akbar Z Khan
- Department of Anatomical Sciences, St. George's University, School of Medicine Grenada, West Indies
| | - Kush Patel
- Department of Anatomical Sciences, St. George's University, School of Medicine Grenada, West Indies
| | - Horia Muresian
- Department of Cardiovascular Surgery, The University Hospital of Bucharest, Romania
| | - Diane E Spicer
- Department of Pediatrics-Cardiology, University of Florida, Gainesville, Florida and Congenital Heart Institute of Florida, St. Petersburg, Florida
| | - R Shane Tubbs
- Department of Anatomical Sciences, St. George's University, School of Medicine Grenada, West Indies.,Children's Hospital, Pediatric Neurosurgery, Birmingham, Alabama
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Tatsuishi W, Nakano K, Kubota S, Asano R, Kataoka G. Identification of Coronary Artery Orifice to Prevent Coronary Complications in Bioprosthetic and Transcatheter Aortic Valve Replacement. Circ J 2015; 79:2157-61. [PMID: 26227280 DOI: 10.1253/circj.cj-15-0415] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of this study was to identify anatomical variations in coronary artery orifices among high-risk patients with a small aortic root undergoing bioprosthetic aortic valve replacement (BAVR) and transcatheter aortic valve replacement (TAVR) in order to prevent coronary orifice obstruction perioperatively. METHODS AND RESULTS Coronary orifice and root structure were identified in 400 patients using aortic multidetector-row computed tomography (MDCT). We measured the aortic root diameter; intercommissural distances; and distance from coronary orifice to valve annulus, commissure, and sinotubular junction. We examined positional relationships between the coronary orifice and stent post, or sewing cuff of the bioprosthetic valve and leaflet of the transcatheter aortic valve. Most left coronary artery orifices were distributed near the center of the non-left and left-right commissures; right ones were relatively distributed on the non-right commissural side. Thirty-four patients (8.5%) with BAVR (coronary orifice near the commissure: 31, 7.8%; low takeoff: 5, 1.3%; and both: 2) and 39 (9.8%) with TAVR were at risk for coronary orifice obstruction. During BAVR, one-stitch rotation of the stent and one-stitch rotation with intra-annular implantation were used in near-commissure and low takeoff cases, respectively. During TAVR, percutaneous coronary intervention may be required in the height of the coronary orifice was ≤10 mm from the base of the ventricle aortic junction. CONCLUSIONS Potential coronary complications during BAVR and TAVR in high-risk patients for coronary obstruction were identified using preoperative aortic MDCT. Choice of appropriate surgical technique or valve is essential.
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Affiliation(s)
- Wataru Tatsuishi
- Department of Cardiovascular Surgery, Tokyo Women's Medical University, Medical Center East
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d'Errico M, Sammarco P, Vairo G. Analytical modeling of drug dynamics induced by eluting stents in the coronary multi-layered curved domain. Math Biosci 2015; 267:79-96. [PMID: 26162517 DOI: 10.1016/j.mbs.2015.06.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 06/18/2015] [Accepted: 06/19/2015] [Indexed: 11/16/2022]
Abstract
Pharmacokinetics induced by drug eluting stents (DES) in coronary walls is modeled by means of a one-dimensional multi-layered model, accounting for vessel curvature and non-homogeneous properties of the arterial tissues. The model includes diffusion mechanisms, advection effects related to plasma filtration through the walls, and bio-chemical drug reactions. A non-classical Sturm-Liouville problem with discontinuous coefficients is derived, whose closed-form analytical solution is obtained via an eigenfunction expansion. Soundness and consistency of the proposed approach are shown by numerical computations based on possible clinical treatments involving both hydrophilic and hydrophobic drugs. The influence of the main model parameters on drug delivery mechanisms is analyzed, highlighting the effects induced by vessel curvature and yielding comparative indications and useful insights into the concurring mechanisms governing the pharmacokinetics.
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Affiliation(s)
- Michele d'Errico
- Department of Civil Engineering and Computer Science Engineering (DICII), Università degli Studi di Roma "Tor Vergata", via del Politecnico 1, Rome 00133, Italy.
| | - Paolo Sammarco
- Department of Civil Engineering and Computer Science Engineering (DICII), Università degli Studi di Roma "Tor Vergata", via del Politecnico 1, Rome 00133, Italy.
| | - Giuseppe Vairo
- Department of Civil Engineering and Computer Science Engineering (DICII), Università degli Studi di Roma "Tor Vergata", via del Politecnico 1, Rome 00133, Italy.
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He ZF, Zhang WM, Lutter G, Quaden R, Cremer J, Cai XJ. In vitro study of coronary flow occlusion in transcatheter aortic valve implantation. J Thorac Dis 2015; 6:1772-7. [PMID: 25589972 DOI: 10.3978/j.issn.2072-1439.2014.12.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 11/13/2014] [Indexed: 11/14/2022]
Abstract
BACKGROUND Transcatheter aortic valve implantation (TAVI) has been developed recently for patients with high morbidities and who are believed to be not tolerate standard surgical aortic valve replacement. Nevertheless, the TAVI is associated with complications such as potential obstruction of coronary ostia, mitral valve insufficiency, and stent migration although it seems promising. Impairment of the coronary blood flow after TAVI is catastrophic and it was believed to be associated with the close position of the coronary orifice and the aortic leaflets and valve stent. However, few data was available as to the anatomic relationship between valve stent and aortic root anatomic structures including the coronary arterial ostia, aortic leaflets. METHODS The aortic roots were observed in 40 hearts specimens. The width of aortic leaflet, height of aortic sinus annulus to the sinutubular junction (STJ), distance between aortic sinus annulus to its corresponding coronary ostia, and coronary arterial ostia to its corresponding STJ level were measured. Moreover, the relationships of valve stent, aortic leaflets and coronary ostia before/post stent implantation and after the open of aorta were evaluated respectively. RESULTS Approximate three quarters of the coronary ostia were located below the STJ level. The mean distances from left, right and posterior aortic sinus annulus to the related STJ level was comparable, which was 18.5±2.7, 18.9±2.6, 18.7±2.6 mm, respectively. Meanwhile, the height of left and right aortic sinus annulus to its corresponding coronary ostia was 16.6±2.8 and 17.2±3.1 mm for left and right side respectively. CONCLUSIONS Most of the coronary ostia were located below the STJ level and could be covered by the leaflets. This highlights the need of modified stents to prevent occlusion of coronary flow after TAVI.
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Affiliation(s)
- Zheng-Fu He
- 1 Department of Cardiothoracic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China ; 2 Department of Cardiovascular Surgery, School of Medicine, University Of Kiel, Kiel, Germany ; 3 Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Wei-Ming Zhang
- 1 Department of Cardiothoracic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China ; 2 Department of Cardiovascular Surgery, School of Medicine, University Of Kiel, Kiel, Germany ; 3 Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - George Lutter
- 1 Department of Cardiothoracic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China ; 2 Department of Cardiovascular Surgery, School of Medicine, University Of Kiel, Kiel, Germany ; 3 Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Rene Quaden
- 1 Department of Cardiothoracic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China ; 2 Department of Cardiovascular Surgery, School of Medicine, University Of Kiel, Kiel, Germany ; 3 Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Jochen Cremer
- 1 Department of Cardiothoracic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China ; 2 Department of Cardiovascular Surgery, School of Medicine, University Of Kiel, Kiel, Germany ; 3 Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Xiu-Jun Cai
- 1 Department of Cardiothoracic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China ; 2 Department of Cardiovascular Surgery, School of Medicine, University Of Kiel, Kiel, Germany ; 3 Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
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Aparci M, Ozturk C, Balta S, Okutucu S, Isilak Z. Hypercholesterolemia is Accounted for Atherosclerosis at the Proximal Arterial Segments of Myocardial Bridging. Clin Appl Thromb Hemost 2014; 22:297-302. [DOI: 10.1177/1076029614554995] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Arterial shear stress was generally implicated in the development of atherosclerotic plaque (AP). Atherosclerotic plaque may be associated with myocardial bridging (MB). We evaluated the metabolic abnormalities which could determine the localization of AP at the proximal coronary segment of MB. We analyzed the patients with MB, AP&MB, and AP on left anterior descending (LAD) artery who were diagnosed by multislice computed tomography coronary angiography. Serum levels of metabolic parameters were compared among study groups. Patients with MB&AP and AP were significantly older than those in the MB group. Patients with MB&AP had AP and MB at the proximal and middle segments of LAD artery, respectively. Total cholesterol, low-density lipoprotein (LDL) cholesterol and very LDL, and triglyceride levels were significantly higher in patients with MB&AP and AP compared to only MB. Low-density lipoprotein cholesterol was significantly correlated with the type of coronary artery disease in multiple regression analysis. Myocardial bridging may be an anatomical determinant for the localization of AP proximal to itself in the presence of hypercholesterolemia.
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Affiliation(s)
- Mustafa Aparci
- Department of Cardiology, Etimesgut Military Hospital, Ankara, Turkey
| | - Cengiz Ozturk
- Department of Cardiology, Gulhane Military Medical Faculty, Ankara, Turkey
| | - Sevket Balta
- Department of Cardiology, Eskisehir Military Hospital, Ankara, Turkey
| | - Sercan Okutucu
- Department of Cardiology, Etimesgut Military Hospital, Ankara, Turkey
| | - Zafer Isilak
- Department of Cardiology, Haydarpasa Training Medicine, Istanbul, Turkey
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Dick M, Jonak P, Leask RL. Statin therapy influences endothelial cell morphology and F-actin cytoskeleton structure when exposed to static and laminar shear stress conditions. Life Sci 2013; 92:859-65. [DOI: 10.1016/j.lfs.2013.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 02/19/2013] [Accepted: 03/02/2013] [Indexed: 01/09/2023]
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Hoffman JJ, Johnson BL, Holland MR, Fedewa RJ, Nair A, Miller JG. Layer-dependent variation in the anisotropy of apparent integrated backscatter from human coronary arteries. ULTRASOUND IN MEDICINE & BIOLOGY 2011; 37:632-641. [PMID: 21376456 PMCID: PMC3063363 DOI: 10.1016/j.ultrasmedbio.2011.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Revised: 12/29/2010] [Accepted: 01/07/2011] [Indexed: 05/30/2023]
Abstract
Clinical imaging of the coronary arteries in the cardiac catheterization laboratory using intravascular ultrasound (IVUS) is known to display a three-layered appearance, corresponding to the intima/plaque, media and adventitia. It is not known whether ultrasonic anisotropy arising from these tissues may alter this pattern in future IVUS systems that insonify in the forward direction or obliquely. In anticipation of such devices, the current study was carried out by imaging fresh human coronary arteries in two orthogonal directions in vitro. Twenty-six sites from 12 arteries were imaged with a side-looking IVUS system, and with an acoustic microscope both radially and axially. Side-looking IVUS and radial acoustic microscopy scans demonstrated the typical "bright-dark-bright" pattern of the backscatter, with the media being significantly darker than the other two layers. Images obtained in the axial orientation exhibited a markedly different pattern, with the relative brightness of the media significantly larger than that of the intima/plaque.
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Affiliation(s)
- Joseph J Hoffman
- Laboratory for Ultrasonics, Washington University, St. Louis, MO, USA
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Walraevens J, Willaert B, De Win G, Ranftl A, De Schutter J, Sloten JV. Correlation between compression, tensile and tearing tests on healthy and calcified aortic tissues. Med Eng Phys 2008; 30:1098-104. [DOI: 10.1016/j.medengphy.2008.01.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2006] [Revised: 09/12/2007] [Accepted: 01/30/2008] [Indexed: 11/27/2022]
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40
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Schmitt R, Froehner S, Brunn J, Wagner M, Brunner H, Cherevatyy O, Gietzen F, Christopoulos G, Kerber S, Fellner F. Congenital anomalies of the coronary arteries: imaging with contrast-enhanced, multidetector computed tomography. Eur Radiol 2005; 15:1110-21. [PMID: 15756551 DOI: 10.1007/s00330-005-2707-z] [Citation(s) in RCA: 153] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2004] [Revised: 02/01/2005] [Accepted: 02/07/2005] [Indexed: 11/29/2022]
Abstract
The objective of this study is to evaluate multidetector CT (MDCT) in detecting and characterizing anomalous coronary arteries. Forty-four patients with anomalies of the coronaries were selected from a total of 1758 individuals examined with ECG-gated 4- and 16-row MDCT including thinMIP, MPR and VRT post-processing. Twenty-eight patients showed origin and course anomalies of the central coronary segments, and in this subgroup 13 were judged as "malignant" because of interarterial courses between the aortic root and the pulmonary trunk, either of the right coronary artery (n=11) or the left coronary artery (n=2). Twelve non-hemodynamic anomalies were found, affecting the coronary origins only (n=10) or the peripheral vessels courses (n=2). Four arteriovenous fistulas were present, all of them with complex arterial feeders. Regardless of vessel anatomy, coronary opacification was always possible by means of the systemic contrast agent, and the aberrant coronary arteries were visualized synoptically in direct relation to the great mediastinal vessels. In contrast to MDCT, selective cannulation and final diagnosis was possible in only 11 of the 20 catheter angiograms performed (accuracy of 55.0%). In conclusion, its non-invasiveness and precise visualization makes MDCT the standard of reference for evaluating anomalous coronary arteries.
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Affiliation(s)
- Rainer Schmitt
- Department of Radiology, Herz- und Gefaessklinik GmbH, Bad Neustadt an der Saale, Germany.
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41
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Veress AI, Weiss JA, Gullberg GT, Vince DG, Rabbitt RD. Strain measurement in coronary arteries using intravascular ultrasound and deformable images. J Biomech Eng 2002; 124:734-41. [PMID: 12596642 DOI: 10.1115/1.1519279] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Atherosclerotic plaque rupture is responsible for the majority of myocardial infarctions and acute coronary syndromes. Rupture is initiated by mechanical failure of the plaque cap, and thus study of the deformation of the plaque in the artery can elucidate the events that lead to myocardial infarction. Intravascular ultrasound (IVUS) provides high resolution in vitro and in vivo cross-sectional images of blood vessels. To extract the deformation field from sequences of IVUS images, a registration process must be performed to correlate material points between image pairs. The objective of this study was to determine the efficacy of an image registration technique termed Warping to determine strains in plaques and coronary arteries from paired IVUS images representing two different states of deformation. The Warping technique uses pointwise differences in pixel intensities between image pairs to generate a distributed body force that acts to deform a finite element model. The strain distribution estimated by image-based Warping showed excellent agreement with a known forward finite element solution, representing the gold standard, from which the displaced image was created. The Warping technique had a low sensitivity to changes in material parameters or material model and had a low dependency on the noise present in the images. The Warping analysis was also able to produce accurate strain distributions when the constitutive model used for the Warping analysis and the forward analysis was different. The results of this study demonstrate that Warping in conjunction with in vivo IVUS imaging will determine the change in the strain distribution resulting from physiological loading and may be useful as a diagnostic tool for predicting the likelihood of plaque rupture through the determination of the relative stiffness of the plaque constituents.
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Affiliation(s)
- Alexander I Veress
- Department of Bioengineering, Department of Radiology, University of Utah, 50 South Central Campus Drive, Room 2480, Salt Lake City, Utah 84112-9202, USA
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42
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Abstract
We examined the coronary arterial orifices in relation to the aortic valve to determine the range of normality in 23 normal hearts from autopsied adults. We determined the position of the zones of apposition between leaflets, the size of the leaflets, the number, position, and shape of the coronary arterial orifices, and their relation to the sinutubular junction. The aortic valve had three leaflets in all specimens, nearly equally spaced around the aorta. The left coronary artery arose within the left posterior aortic sinus (of Valsalva) in 16 (69%) specimens, above the sinutubular junction in five (22%), and at the level of the junction in two (9%). The distance of the left orifice from the zone of apposition between the left posterior and anterior aortic leaflets was between 13% and 61% of the width of the aortic sinus at the sinutubular junction. The right coronary artery arose within the anterior aortic sinus in 18 (78%) specimens, above the junction in three (13%), and at the level of the junction in two (9%). The distance of the orifice from the zone of apposition between the leaflets hinged from the anterior and right posterior aortic sinuses was between 5% and 62% of the width of the aortic sinus at the sinutubular junction. An accessory coronary orifice was found in the anterior aortic sinus in 17 (74%) specimens, whereas a third orifice in this sinus was found in five hearts. The coronary arterial orifices are usually located within the aortic sinuses below the sinutubular junction, but are rarely centrally located. Accessory coronary arterial orifices are found in the majority of the anterior aortic sinuses.
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Affiliation(s)
- M Muriago
- Department of Pediatrics, Imperial College, School of Medicine, London, United Kingdom
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43
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Waller BF, Fry ET, Hermiller JB, Peters T, Slack JD. Nonatherosclerotic causes of coronary artery narrowing--Part I. Clin Cardiol 1996; 19:509-12. [PMID: 8790958 DOI: 10.1002/clc.4960190613] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Approximately 5% of patients with acute myocardial infarction do not have atherosclerotic coronary artery disease but have other causes for their luminal narrowing. The first part of this three-part review of nonatherosclerotic causes of coronary narrowing focuses on congenital coronary artery anomalies, coronary fistula, and high take-off position of coronary ostia.
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Affiliation(s)
- B F Waller
- St. Vincent Hospital, Indianapolis, Indiana, USA
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