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Psiuk-Maksymowicz K, Borys D, Melka B, Gracka M, Adamczyk WP, Rojczyk M, Wasilewski J, Głowacki J, Kruk M, Nowak M, Ostrowski Z, Bialecki RA. Methodology of generation of CFD meshes and 4D shape reconstruction of coronary arteries from patient-specific dynamic CT. Sci Rep 2024; 14:2201. [PMID: 38273032 PMCID: PMC10811335 DOI: 10.1038/s41598-024-52398-5] [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: 10/05/2023] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Due to the difficulties in retrieving both the time-dependent shapes of the vessels and the generation of numerical meshes for such cases, most of the simulations of blood flow in the cardiac arteries use static geometry. The article describes a methodology for generating a sequence of time-dependent 3D shapes based on images of different resolutions and qualities acquired from ECG-gated coronary artery CT angiography. The precision of the shape restoration method has been validated using an independent technique. The original proposed approach also generates for each of the retrieved vessel shapes a numerical mesh of the same topology (connectivity matrix), greatly simplifying the CFD blood flow simulations. This feature is of significant importance in practical CFD simulations, as it gives the possibility of using the mesh-morphing utility, minimizing the computation time and the need of interpolation between boundary meshes at subsequent time instants. The developed technique can be applied to generate numerical meshes in arteries and other organs whose shapes change over time. It is applicable to medical images produced by other than angio-CT modalities.
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Affiliation(s)
- Krzysztof Psiuk-Maksymowicz
- Department of Systems Biology and Engineering, Silesian University of Technology, 44-100, Gliwice, Poland
- Biotechnology Centre, Silesian University of Technology, 44-100, Gliwice, Poland
| | - Damian Borys
- Department of Systems Biology and Engineering, Silesian University of Technology, 44-100, Gliwice, Poland.
- Biotechnology Centre, Silesian University of Technology, 44-100, Gliwice, Poland.
| | - Bartlomiej Melka
- Biomedical Engineering Lab, Department of Thermal Technology, Silesian University of Technology, 44-100, Gliwice, Poland
| | - Maria Gracka
- Biomedical Engineering Lab, Department of Thermal Technology, Silesian University of Technology, 44-100, Gliwice, Poland
| | - Wojciech P Adamczyk
- Biomedical Engineering Lab, Department of Thermal Technology, Silesian University of Technology, 44-100, Gliwice, Poland
| | - Marek Rojczyk
- Biomedical Engineering Lab, Department of Thermal Technology, Silesian University of Technology, 44-100, Gliwice, Poland
| | - Jaroslaw Wasilewski
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800, Zabrze, Poland
- Silesian Centre for Heart Diseases, 41-800, Zabrze, Poland
| | - Jan Głowacki
- Silesian Centre for Heart Diseases, 41-800, Zabrze, Poland
- Department of Radiology and Radiodiagnostics, Medical University of Silesia, 41-800, Zabrze, Poland
| | - Mariusz Kruk
- Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, 04-628, Warsaw, Poland
| | - Marcin Nowak
- Department of Mechanics of Materials and Structures, Gdańsk University of Technology, 80-233, Gdańsk, Poland
| | - Ziemowit Ostrowski
- Biomedical Engineering Lab, Department of Thermal Technology, Silesian University of Technology, 44-100, Gliwice, Poland.
| | - Ryszard A Bialecki
- Biomedical Engineering Lab, Department of Thermal Technology, Silesian University of Technology, 44-100, Gliwice, Poland
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Matta A, Roncalli J, Carrié D. Update review on myocardial bridging: New insights. Trends Cardiovasc Med 2024; 34:10-15. [PMID: 35697237 DOI: 10.1016/j.tcm.2022.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 11/30/2022]
Abstract
Myocardial bridging (MB) is a common congenital abnormality that remains asymptomatic in a large proportion of patients. The peak of clinical manifestation occurs during the third and fourth decades of life. MB provokes myocardial ischemia through different mechanisms including supply-demand mismatch, endothelial dysfunction, coronary microvascular dysfunction and external mechanical compression. The association between MB and atherosclerotic disease is controversial. Recent studies established a significant association of MB with myocardial infarction and non-obstructive coronary artery disease. The first line medical treatment is based on beta-blockers and calcium channel blockers. Ivabradine is used in second line therapy. Invasive approaches involving percutaneous coronary intervention, coronary artery bypass graft and myotomy are performed in patients with symptoms refractory to maximally tolerated medical treatment. The choice of revascularization technique depends on anatomical characteristics, clinical condition and physician experience. Available data derived from anecdotal evidence view the lack of randomized clinical trials.
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Affiliation(s)
- Anthony Matta
- Department of cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France; Department of cardiology, Intercommunal Hospital Centre Castres-Mazamet, Castres, France; Faculty of medicine, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Jerome Roncalli
- Department of cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
| | - Didier Carrié
- Department of cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France.
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Xu XR, Zhang MK, Wu QY, Fan LX, Xue H. Surgical intervention of myocardial bridge combined coronary artery disease: could a combination of supra-arterial myotomy and CABG be a better option? J Cardiothorac Surg 2023; 18:123. [PMID: 37038226 PMCID: PMC10088259 DOI: 10.1186/s13019-023-02251-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 04/03/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND The treatment of coronary artery disease combined with severe atherosclerotic stenosis proximal to a left anterior descending artery myocardial bridge (LAD-MB) is still controversial. This study aimed to analyze the outcomes of surgical intervention in patients with severe atherosclerotic stenosis proximal to a LAD-MB. METHODS We retrospectively reviewed all patients with coronary artery disease combined with severe atherosclerotic stenosis proximal to the LAD-MB. The enrolled criteria were systolic compression of LAD more than or equal to 50% and atherosclerotic stenosis proximal to the LAD-MB more than or equal to 70%. All patients suffered from anginal symptoms refractory to medical therapy. All patients received supra-arterial myotomy and coronary artery bypass grafting (CABG) procedures. Clinical characteristics, intraoperative findings, and postoperative outcomes were evaluated. RESULTS Between 2004 and 2021, sixteen patients underwent supra-arterial myotomy and CABG procedure. The compression and length of LAD-MB were 63 ± 17.9% and 25.9 ± 16.3 mm, respectively. Of the 16 patients, one patient had a LAD-MB and proximal coronary stenosis, and 15 patients had LAD-MBs and multivessel lesions. All patients survived and recovered uneventfully without in-hospital mortality or severe complications. The median transfusion amount of red blood cells in the operation was 2 units, and no patients required unplanned reoperation for bleeding. The average length of intensive care unit stay was 2.74 days. Fifteen patients were followed up for 6-146.1 months (mean 45.3 ± 42.9 months). One patient had a recurrence of angina pectoris one year after surgery, and 14 patients had no symptoms of myocardial ischemia during the follow-up period. Significant improvement in symptoms and quality of life using the Seattle Angina Questionnaire assessment was observed in all five categories after surgery (p < 0.01). CONCLUSIONS Based on the results, supra-arterial myotomy and concomitant bypass surgery may be a better option for the treatment of LAD-MB combined with severe proximal stenosis.
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Affiliation(s)
- Xi-Ruo Xu
- Heart Center, First Hospital of Tsinghua University, No. 6 1st Street, Jiuxianqiao, Chaoyang District, Beijing, 100016, China
| | - Ming-Kui Zhang
- Heart Center, First Hospital of Tsinghua University, No. 6 1st Street, Jiuxianqiao, Chaoyang District, Beijing, 100016, China.
| | - Qing-Yu Wu
- Heart Center, First Hospital of Tsinghua University, No. 6 1st Street, Jiuxianqiao, Chaoyang District, Beijing, 100016, China
| | - Li-Xin Fan
- Heart Center, First Hospital of Tsinghua University, No. 6 1st Street, Jiuxianqiao, Chaoyang District, Beijing, 100016, China
| | - Hui Xue
- Heart Center, First Hospital of Tsinghua University, No. 6 1st Street, Jiuxianqiao, Chaoyang District, Beijing, 100016, China
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Bockus L, Kim F. Coronary endothelial dysfunction: from pathogenesis to clinical implications. Open Heart 2022; 9:e002200. [PMID: 36600608 PMCID: PMC9743399 DOI: 10.1136/openhrt-2022-002200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 11/14/2022] [Indexed: 12/13/2022] Open
Abstract
Endothelial dysfunction (ED) has a substantial role in the pathogenesis of atherosclerosis and other vascular diseases. Multiple risk factors, including smoking, hyperlipiadaemia and diabetes, can have associated ED, which is correlated with cardiac events. Measurement of coronary artery endothelial function requires the use of invasive techniques to assess both epicardial coronary artery and microvascular beds. Peripheral vascular techniques and endothelial biomarkers can be used to indirectly assess coronary ED. In this review of coronary artery ED, we discuss the current state of the field, the techniques used to measure ED and its clinical implications.
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Affiliation(s)
- Lee Bockus
- Deparment of Medicine, University of Washington, Seattle, Washington, USA
| | - Francis Kim
- Deparment of Medicine, University of Washington, Seattle, Washington, USA
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Nie C, Zhu C, Yang Q, Xiao M, Meng Y, Wang S. Myocardial bridging of the left anterior descending coronary artery as a risk factor for atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy: a matched case-control study. BMC Cardiovasc Disord 2021; 21:382. [PMID: 34362314 PMCID: PMC8348797 DOI: 10.1186/s12872-021-02185-1] [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: 08/28/2020] [Accepted: 07/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Myocardial bridging (MB) is associated with various forms of arrhythmia. However, whether MB is a risk factor for atrial fibrillation (AF) in patients with hypertrophic obstructive cardiomyopathy (HOCM) remains unknown. This study aimed to identify the relationship between myocardial bridging of the left anterior descending coronary artery (MB-LAD) and AF in patients with HOCM. METHODS We reviewed the medical records of 1925 patients diagnosed with HOCM at Fuwai Hospital from January 2012 to March 2019. Patients with coronary artery disease, a history of heart surgery, and those who had not been subjected to angiography were excluded. Finally, 105 patients with AF were included in this study. The control group was matched in a ratio of 3:1 based on age and gender. RESULTS Forty-three patients were diagnosed with MB-LAD in this study. The presence of MB was significantly higher in patients with AF than in those without AF (19.0% vs. 7.3%; p = 0.001), although MB compression and MB length did not differ between the two groups. In conditional multivariate logistic analysis, MB (odds ratio [OR] 2.33; 95% confidence interval [CI] 1.08-5.01; p = 0.03), pulmonary arterial hypertension (OR 2.63; 95% CI 1.26-5.47; p = 0.01), hyperlipidemia (OR 1.83; 95% CI 1.12-3.00; p = 0.016), left atrial diameter (OR 1.09; 95% CI 1.05-1.13; p < 0.001), and interventricular septal thickness (OR 1.06; 95% CI 1.003-1.12; p = 0.037) were independent risk factors for AF in patients with HOCM. CONCLUSIONS The presence of MB is an independent risk factor for AF in patients with HOCM. The potential mechanistic link between MB and the development of AF warrants further investigation.
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Affiliation(s)
- Changrong Nie
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road 167, Xicheng District, Beijing, 100037, China
| | - Changsheng Zhu
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road 167, Xicheng District, Beijing, 100037, China
| | - Qiulan Yang
- Department of Intensive Care Unit, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Minghu Xiao
- Department of Ultrasound, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanhai Meng
- Department of Intensive Care Unit, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuiyun Wang
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road 167, Xicheng District, Beijing, 100037, China.
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Montone RA, Gurgoglione FL, Del Buono MG, Rinaldi R, Meucci MC, Iannaccone G, La Vecchia G, Camilli M, D’Amario D, Leone AM, Vergallo R, Aurigemma C, Buffon A, Romagnoli E, Burzotta F, Trani C, Crea F, Niccoli G. Interplay Between Myocardial Bridging and Coronary Spasm in Patients With Myocardial Ischemia and Non-Obstructive Coronary Arteries: Pathogenic and Prognostic Implications. J Am Heart Assoc 2021; 10:e020535. [PMID: 34259010 PMCID: PMC8483499 DOI: 10.1161/jaha.120.020535] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background Myocardial bridging (MB) may represent a cause of myocardial ischemia in patients with non‐obstructive coronary artery disease (NOCAD). Herein, we assessed the interplay between MB and coronary vasomotor disorders, also evaluating their prognostic relevance in patients with myocardial infarction and non‐obstructive coronary arteries (MINOCA) or stable NOCAD. Methods and Results We prospectively enrolled patients with NOCAD undergoing intracoronary acetylcholine provocative test. The incidence of major adverse cardiac events, defined as the composite of cardiac death, non‐fatal myocardial infarction, and rehospitalization for unstable angina, was assessed at follow‐up. We also assessed angina status using Seattle Angina Questionnaires summary score. We enrolled 310 patients (mean age, 60.6±11.9; 136 [43.9%] men; 169 [54.5%] stable NOCAD and 141 [45.5%] MINOCA). MB was found in 53 (17.1%) patients. MB and a positive acetylcholine test coexisted more frequently in patients with MINOCA versus stable NOCAD. MB was an independent predictor of positive acetylcholine test and MINOCA. At follow‐up (median, 22 months; interquartile range, 13–32), patients with MB had a higher rate of major adverse cardiac events, mainly driven by a higher rate of hospitalization attributable to angina, and a lower Seattle Angina Questionnaires summary score (all P<0.001) compared with patients without MB. In particular, the group of patients with MB and a positive acetylcholine test had the worst prognosis. Conclusions Among patients with NOCAD, coronary spasm associated with MB may predict a worse clinical presentation with MINOCA and a higher rate of hospitalization attributable to angina at long‐term follow‐up with a low rate of hard events.
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Affiliation(s)
- Rocco A. Montone
- Department of Cardiovascular MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Filippo Luca Gurgoglione
- Department of Cardiovascular and Pulmonary SciencesCatholic University of the Sacred HeartRomeItaly
| | - Marco Giuseppe Del Buono
- Department of Cardiovascular and Pulmonary SciencesCatholic University of the Sacred HeartRomeItaly
| | - Riccardo Rinaldi
- Department of Cardiovascular and Pulmonary SciencesCatholic University of the Sacred HeartRomeItaly
| | - Maria Chiara Meucci
- Department of Cardiovascular and Pulmonary SciencesCatholic University of the Sacred HeartRomeItaly
| | - Giulia Iannaccone
- Department of Cardiovascular and Pulmonary SciencesCatholic University of the Sacred HeartRomeItaly
| | - Giulia La Vecchia
- Department of Cardiovascular and Pulmonary SciencesCatholic University of the Sacred HeartRomeItaly
| | - Massimiliano Camilli
- Department of Cardiovascular and Pulmonary SciencesCatholic University of the Sacred HeartRomeItaly
| | - Domenico D’Amario
- Department of Cardiovascular MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Antonio Maria Leone
- Department of Cardiovascular MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Rocco Vergallo
- Department of Cardiovascular MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Cristina Aurigemma
- Department of Cardiovascular MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Antonino Buffon
- Department of Cardiovascular MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Department of Cardiovascular and Pulmonary SciencesCatholic University of the Sacred HeartRomeItaly
| | - Enrico Romagnoli
- Department of Cardiovascular MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Francesco Burzotta
- Department of Cardiovascular MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Department of Cardiovascular and Pulmonary SciencesCatholic University of the Sacred HeartRomeItaly
| | - Carlo Trani
- Department of Cardiovascular MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Department of Cardiovascular and Pulmonary SciencesCatholic University of the Sacred HeartRomeItaly
| | - Filippo Crea
- Department of Cardiovascular MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Department of Cardiovascular and Pulmonary SciencesCatholic University of the Sacred HeartRomeItaly
| | - Giampaolo Niccoli
- Department of Cardiovascular MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Department of Cardiovascular and Pulmonary SciencesCatholic University of the Sacred HeartRomeItaly
- Department of Medicine and SurgeryUniversity of ParmaItaly
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Sharzehee M, Chang Y, Song JP, Han HC. Hemodynamic effects of myocardial bridging in patients with hypertrophic cardiomyopathy. Am J Physiol Heart Circ Physiol 2019; 317:H1282-H1291. [PMID: 31674812 DOI: 10.1152/ajpheart.00466.2019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Myocardial bridging (MB) is linked to angina and myocardial ischemia and may lead to sudden cardiac death in patients with hypertrophic cardiomyopathy (HCM). However, it remains unclear how MB affect the coronary blood flow in HCM patients. The aim of this study was to assess the effects of MB on coronary hemodynamics in HCM patients. Fifteen patients with MB (7 HCM and 8 non-HCM controls) in their left anterior descending (LAD) coronary artery were chosen. Transient computational fluid dynamics (CFD) simulations were conducted in anatomically realistic models of diseased (with MB) and virtually healthy (without MB) LAD from these patients, reconstructed from biplane angiograms. Our CFD simulation results demonstrated that dynamic compression of MB led to diastolic flow disturbances and could significantly reduce the coronary flow in HCM patients as compared with non-HCM group (P < 0.01). The pressure drop coefficient was remarkably higher (P < 0.05) in HCM patients. The flow rate change is strongly correlated with both upstream Reynolds number and MB compression ratio, while the MB length has less impact on coronary flow. The hemodynamic results and clinical outcomes revealed that HCM patients with an MB compression ratio higher than 65% required a surgical intervention. In conclusion, the transient MB compression can significantly alter the diastolic flow pattern and wall shear stress distribution in HCM patients. HCM patients with severe MB may need a surgical intervention.NEW & NOTEWORTHY In this study, the hemodynamic significance of myocardial bridging (MB) in patients with hypertrophic cardiomyopathy (HCM) was investigated to provide valuable information for surgical decision-making. Our results illustrated that the transient MB compression led to complex flow patterns, which can significantly alter the diastolic flow and wall shear stress distribution. The hemodynamic results and clinical outcomes demonstrated that patients with HCM and an MB compression ratio higher than 65% required a surgical intervention.
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Affiliation(s)
- Mohammadali Sharzehee
- Department of Mechanical Engineering, The University of Texas at San Antonio, San Antonio, Texas
| | - Yuan Chang
- Department of Cardiac Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China
| | - Jiang-Ping Song
- Department of Cardiac Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China
| | - Hai-Chao Han
- Department of Mechanical Engineering, The University of Texas at San Antonio, San Antonio, Texas
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Gimnich OA, Singh J, Bismuth J, Shah DJ, Brunner G. Magnetic resonance imaging based modeling of microvascular perfusion in patients with peripheral artery disease. J Biomech 2019; 93:147-158. [PMID: 31331663 PMCID: PMC7390497 DOI: 10.1016/j.jbiomech.2019.06.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 11/20/2022]
Abstract
Peripheral artery disease (PAD) is associated with an increased risk of adverse cardiovascular events, impaired lower extremity blood flow and microvascular perfusion abnormalities in the calf muscles which can be determined with contrast-enhanced magnetic resonance imaging (CE-MRI). We developed a computational model of the microvascular perfusion in the calf muscles. We included 20 patients (10 PAD, 10 controls) and utilized the geometry, mean signal intensity and arterial input functions from CE-MRI calf muscle perfusion scans. The model included the microvascular pressure (pv), outflow filtration coefficient (OFC), transfer rate constant (kt), porosity (φ), and the interstitial permeability (Ktissue). Parameters were fitted and the simulations were compared across PAD patients and controls. Intra-observer reproducibility of the simulated mean signal intensities was excellent (intraclass correlation coefficients >0.995). kt and Ktissue were higher in PAD patients compared with controls (4.72 interquartile range (IQR) 3.33, 5.56 vs. 2.47 IQR 2.10, 2.85; p = 0.003; and 3.68 IQR 3.18, 4.41 vs. 1.81 IQR 1.81, 1.81; p < 0.001). Conversely, porosity (φ) was lower in PAD patients compared with controls (0.52 IQR 0.49, 0.54 vs. 0.61 IQR 0.58, 0.64; p = 0.016). Porosity (φ) was correlated with the ankle brachial index (r = 0.64, p = 0.011). The proposed computational microvascular model is robust and reproducible, and essential model parameters differ significantly between PAD patients and controls.
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Affiliation(s)
- Olga A Gimnich
- Cardiovascular Imaging Research and Data Sciences Laboratory, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Jaykrishna Singh
- Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Jean Bismuth
- Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Dipan J Shah
- Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Gerd Brunner
- Cardiovascular Imaging Research and Data Sciences Laboratory, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, USA; Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, USA..
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