1
|
Azimi-Boulali J, Mahler GJ, Murray BT, Huang P. Multiscale computational modeling of aortic valve calcification. Biomech Model Mechanobiol 2024; 23:581-599. [PMID: 38093148 DOI: 10.1007/s10237-023-01793-4] [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: 06/23/2023] [Accepted: 11/13/2023] [Indexed: 03/26/2024]
Abstract
Calcific aortic valve disease (CAVD) is a common cardiovascular disease that affects millions of people worldwide. The disease is characterized by the formation of calcium nodules on the aortic valve leaflets, which can lead to stenosis and heart failure if left untreated. The pathogenesis of CAVD is still not well understood, but involves several signaling pathways, including the transforming growth factor beta (TGF β ) pathway. In this study, we developed a multiscale computational model for TGF β -stimulated CAVD. The model framework comprises cellular behavior dynamics, subcellular signaling pathways, and tissue-level diffusion fields of pertinent chemical species, where information is shared among different scales. Processes such as endothelial to mesenchymal transition (EndMT), fibrosis, and calcification are incorporated. The results indicate that the majority of myofibroblasts and osteoblast-like cells ultimately die due to lack of nutrients as they become trapped in areas with higher levels of fibrosis or calcification, and they subsequently act as sources for calcium nodules, which contribute to a polydispersed nodule size distribution. Additionally, fibrosis and calcification processes occur more frequently in regions closer to the endothelial layer where the cell activity is higher. Our results provide insights into the mechanisms of CAVD and TGF β signaling and could aid in the development of novel therapeutic approaches for CAVD and other related diseases such as cancer. More broadly, this type of modeling framework can pave the way for unraveling the complexity of biological systems by incorporating several signaling pathways in subcellular models to simulate tissue remodeling in diseases involving cellular mechanobiology.
Collapse
Affiliation(s)
- Javid Azimi-Boulali
- Department of Mechanical Engineering, Binghamton University, Binghamton, NY, 13902, USA
| | - Gretchen J Mahler
- Department of Biomedical Engineering, Binghamton University, Binghamton, NY, 13902, USA
| | - Bruce T Murray
- Department of Mechanical Engineering, Binghamton University, Binghamton, NY, 13902, USA
| | - Peter Huang
- Department of Mechanical Engineering, Binghamton University, Binghamton, NY, 13902, USA.
| |
Collapse
|
2
|
Capelli C, Sauvage E, Giusti G, Bosi GM, Ntsinjana H, Carminati M, Derrick G, Marek J, Khambadkone S, Taylor AM, Schievano S. Patient-specific simulations for planning treatment in congenital heart disease. Interface Focus 2017; 8:20170021. [PMID: 29285347 PMCID: PMC5740223 DOI: 10.1098/rsfs.2017.0021] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Patient-specific computational models have been extensively developed over the last decades and applied to investigate a wide range of cardiovascular problems. However, translation of these technologies into clinical applications, such as planning of medical procedures, has been limited to a few single case reports. Hence, the use of patient-specific models is still far from becoming a standard of care in clinical practice. The aim of this study is to describe our experience with a modelling framework that allows patient-specific simulations to be used for prediction of clinical outcomes. A cohort of 12 patients with congenital heart disease who were referred for percutaneous pulmonary valve implantation, stenting of aortic coarctation and surgical repair of double-outlet right ventricle was included in this study. Image data routinely acquired for clinical assessment were post-processed to set up patient-specific models and test device implantation and surgery. Finite-element and computational fluid dynamics analyses were run to assess feasibility of each intervention and provide some guidance. Results showed good agreement between simulations and clinical decision including feasibility, device choice and fluid-dynamic parameters. The promising results of this pilot study support translation of computer simulations as tools for personalization of cardiovascular treatments.
Collapse
Affiliation(s)
- Claudio Capelli
- UCL Institute of Cardiovascular Science, London, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Emilie Sauvage
- UCL Institute of Cardiovascular Science, London, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Giuliano Giusti
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.,Department of Paediatric Cardiology and Adult Congenital Heart Disease, IRCCS-Policlinico San Donato, San Donato, Milanese, Italy
| | - Giorgia M Bosi
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.,UCL Department of Mechanical Engineering, London, UK
| | - Hopewell Ntsinjana
- CH Baragwanath Hospital University of the Witwatersrand, Johannesburg, South Africa
| | - Mario Carminati
- Department of Paediatric Cardiology and Adult Congenital Heart Disease, IRCCS-Policlinico San Donato, San Donato, Milanese, Italy
| | - Graham Derrick
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Jan Marek
- UCL Institute of Cardiovascular Science, London, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Sachin Khambadkone
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Andrew M Taylor
- UCL Institute of Cardiovascular Science, London, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Silvia Schievano
- UCL Institute of Cardiovascular Science, London, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| |
Collapse
|
3
|
Bakhaty AA, Govindjee S, Mofrad MRK. Consistent trilayer biomechanical modeling of aortic valve leaflet tissue. J Biomech 2017; 61:1-10. [PMID: 28830591 DOI: 10.1016/j.jbiomech.2017.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 05/09/2017] [Accepted: 06/05/2017] [Indexed: 10/19/2022]
Abstract
Aortic valve tissue exhibits highly nonlinear, anisotropic, and heterogeneous material behavior due to its complex microstructure. A thorough understanding of these characteristics permits us to develop numerical models that can shed insight on the function of the aortic valve in health and disease. Herein, we take a closer look at consistently capturing the observed physical response of aortic valve tissue in a continuum mechanics framework. Such a treatment is the first step in developing comprehensive multiscale and multiphysics models. We highlight two important aspects of aortic valve tissue behavior: the role of the collagen fiber microstructure and the native prestressing. We propose a model that captures these two features as well as the heterogeneous layer-scale topology of the tissue. We find the model can reproduce the experimentally observed multiscale mechanical behavior in a manner that provides intuition on the underlying mechanics.
Collapse
Affiliation(s)
- Ahmed A Bakhaty
- Departments of Civil & Environmental Engineering and Electrical Engineering & Computer Science, University of California, Berkeley, United States; Molecular Cell Biomechanics Laboratory, Departments of Bioengineering and Mechanical Engineering, University of California, Berkeley, United States.
| | - Sanjay Govindjee
- Department of Civil & Environmental Engineering, University of California, Berkeley, United States.
| | - Mohammad R K Mofrad
- Molecular Cell Biomechanics Laboratory, Departments of Bioengineering and Mechanical Engineering, University of California, Berkeley, United States.
| |
Collapse
|
4
|
Arzani A, Masters KS, Mofrad MRK. Multiscale Systems Biology Model of Calcific Aortic Valve Disease Progression. ACS Biomater Sci Eng 2017; 3:2922-2933. [DOI: 10.1021/acsbiomaterials.7b00174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Amirhossein Arzani
- Molecular
Cell Biomechanics Laboratory, Departments of Bioengineering and Mechanical
Engineering, University of California, Berkeley, California 94720, United States
| | - Kristyn S. Masters
- Department
of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin 53706, United States
| | - Mohammad R. K. Mofrad
- Molecular
Cell Biomechanics Laboratory, Departments of Bioengineering and Mechanical
Engineering, University of California, Berkeley, California 94720, United States
| |
Collapse
|
5
|
Hasan A, Saliba J, Pezeshgi Modarres H, Bakhaty A, Nasajpour A, Mofrad MRK, Sanati-Nezhad A. Micro and nanotechnologies in heart valve tissue engineering. Biomaterials 2016; 103:278-292. [PMID: 27414719 DOI: 10.1016/j.biomaterials.2016.07.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/26/2016] [Accepted: 07/01/2016] [Indexed: 02/04/2023]
Abstract
Due to the increased morbidity and mortality resulting from heart valve diseases, there is a growing demand for off-the-shelf implantable tissue engineered heart valves (TEHVs). Despite the significant progress in recent years in improving the design and performance of TEHV constructs, viable and functional human implantable TEHV constructs have remained elusive. The recent advances in micro and nanoscale technologies including the microfabrication, nano-microfiber based scaffolds preparation, 3D cell encapsulated hydrogels preparation, microfluidic, micro-bioreactors, nano-microscale biosensors as well as the computational methods and models for simulation of biological tissues have increased the potential for realizing viable, functional and implantable TEHV constructs. In this review, we aim to present an overview of the importance and recent advances in micro and nano-scale technologies for the development of TEHV constructs.
Collapse
Affiliation(s)
- Anwarul Hasan
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, Doha 2713, Qatar; Department of Mechanical Engineering, Faculty of Engineering and Architecture, American University of Beirut, Beirut 1107 2020, Lebanon; Biomaterials Innovation Research Center, Division of Biomedical Engineering, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA 02139, USA.
| | - John Saliba
- Department of Mechanical Engineering, Faculty of Engineering and Architecture, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Hassan Pezeshgi Modarres
- BioMEMS and Bioinspired Microfluidic Laboratory, Department of Mechanical and Manufacturing Engineering, University of Calgary, Calgary, Canada; Center for BioEngineering Research and Education, University of Calgary, Calgary, Canada; Molecular Cell Biomechanics Laboratory, Departments of Bioengineering and Mechanical Engineering, University of California Berkeley, 208A Stanley Hall, Berkeley, CA 94720-1762, USA
| | - Ahmed Bakhaty
- Molecular Cell Biomechanics Laboratory, Departments of Bioengineering and Mechanical Engineering, University of California Berkeley, 208A Stanley Hall, Berkeley, CA 94720-1762, USA
| | - Amir Nasajpour
- Biomaterials Innovation Research Center, Division of Biomedical Engineering, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA 02139, USA
| | - Mohammad R K Mofrad
- Molecular Cell Biomechanics Laboratory, Departments of Bioengineering and Mechanical Engineering, University of California Berkeley, 208A Stanley Hall, Berkeley, CA 94720-1762, USA; Physical Biosciences Division, Lawrence Berkeley National Lab, Berkeley, CA 94720, USA
| | - Amir Sanati-Nezhad
- BioMEMS and Bioinspired Microfluidic Laboratory, Department of Mechanical and Manufacturing Engineering, University of Calgary, Calgary, Canada; Center for BioEngineering Research and Education, University of Calgary, Calgary, Canada.
| |
Collapse
|