3D flow study in a mildly stenotic coronary artery phantom using a whole volume PIV method

Smartphone-based particle tracking velocimetry for the in vitro assessment of coronary flows

The present study adopts a smartphone-based approach for the experimental characterization of coronary flows. Technically, Particle Tracking Velocimetry (PTV) measurements were performed using a smartphone camera and a low-power continuous wave laser in realistic healthy and stenosed phantoms of left anterior descending artery with inflow Reynolds numbers approximately ranging from 20 to 200. A Lagrangian-Eulerian mapping was performed to convert Lagrangian PTV velocity data to a Eulerian grid. Eulerian velocity and vorticity data obtained from smartphone-based PTV measurements were compared with Particle Image Velocimetry (PIV) measurements performed with a smartphone-based setup and with a conventional setup based on a high-power double-pulsed laser and a CMOS camera. Smartphone-based PTV and PIV velocity flow fields substantially agreed with conventional PIV measurements, with the former characterized by lower average percentage differences than the latter. Discrepancies emerged at high flow regimes, especially at the stenosis throat, due to particle image blur generated by smartphone camera shutter speed and image acquisition frequency. In conclusion, the present findings demonstrate the feasibility of PTV measurements using a smartphone camera and a low-power light source for the in vitro characterization of cardiovascular flows for research, industrial and educational purposes, with advantages in terms of costs, safety and usability.

Smartphone-based particle image velocimetry for cardiovascular flows applications: A focus on coronary arteries

An experimental set-up is presented for the in vitro characterization of the fluid dynamics in personalized phantoms of healthy and stenosed coronary arteries. The proposed set-up was fine-tuned with the aim of obtaining a compact, flexible, low-cost test-bench for biomedical applications. Technically, velocity vector fields were measured adopting a so-called smart-PIV approach, consisting of a smartphone camera and a low-power continuous laser (30 mW). Experiments were conducted in realistic healthy and stenosed 3D-printed phantoms of left anterior descending coronary artery reconstructed from angiographic images. Time resolved image acquisition was made possible by the combination of the image acquisition frame rate of last generation commercial smartphones and the flow regimes characterizing coronary hemodynamics (velocities in the order of 10 cm/s). Different flow regimes (Reynolds numbers ranging from 20 to 200) were analyzed. The smart-PIV approach was able to provide both qualitative flow visualizations and quantitative results. A comparison between smart-PIV and conventional PIV (i.e., the gold-standard experimental technique for bioflows characterization) measurements showed a good agreement in the measured velocity vector fields for both the healthy and the stenosed coronary phantoms. Displacement errors and uncertainties, estimated by applying the particle disparity method, confirmed the soundness of the proposed smart-PIV approach, as their values fell within the same range for both smart and conventional PIV measured data (≈5% for the normalized estimated displacement error and below 1.2 pixels for displacement uncertainty). In conclusion, smart-PIV represents an easy-to-implement, low-cost methodology for obtaining an adequately robust experimental characterization of cardiovascular flows. The proposed approach, to be intended as a proof of concept, candidates to become an easy-to-handle test bench suitable for use also outside of research labs, e.g., for educational or industrial purposes, or as first-line investigation to direct and guide subsequent conventional PIV measurements.

Experimental and numerical investigation of pulsed flows in asevere aortic stenosed model

Steady and pulsatile aortic stenotic flows through stenosis tubes were experimentally and numerically investigated. The objective was the understanding of the fluid dynamics in arterial geometries most relevant in the context of atherosclerosis. Axisymmetric phantoms corresponding to significant artery stenosis of 50% in diameter and severe aortic stenosis of 75% were respectively machined from silicon. A water flow circuit was established, a steady flow was provided by gravity and a pulsed flow by a pulsatile pump. At inlet Reynolds numbers in the range of 85 to 1125, flows at the stenosis region were investigated using two-component Particle Image Velocimetry (PIV). For the unsteady flow, three different heartbeats (60, 69 and 90 beats per minute) were considered. The k-ω shear-stress-transport first-order turbulence model in Computational Fluid Dynamics (CFD) commercial software was adopted for simulations. Experimental measurements of the velocity fields show good agreements with CFD for both steady and pulsed flows. Recirculation regions were found near the stenosis in both cases. Reverse flow through the stenosis was also observed in pulsatile flow during the end diastolic phase of the cycle. CFD simulations allowed us to accurately assess wall shear stress in the stenotic region where the optical measurements are very noisy. High values of wall shear stress (with high variations both in space and time), are observed, which are indicators of possible future aortic wall damage.

A Hemodynamic Comparison of Myocardial Bridging and Coronary Atherosclerotic Stenosis: A Computational Model With Experimental Evaluation

Myocardial bridging (MB) and coronary atherosclerotic stenosis can impair coronary blood flow and may cause myocardial ischemia or even heart attack. It remains unclear how MB and stenosis are similar or different regarding their impacts on coronary hemodynamics. The purpose of this study was to compare the hemodynamic effects of coronary stenosis and MB using experimental and computational fluid dynamics (CFD) approaches. For CFD modeling, three MB patients with different levels of lumen obstruction, mild, moderate, and severe were selected. Patient-specific left anterior descending (LAD) coronary artery models were reconstructed from biplane angiograms. For each MB patient, the virtually healthy and stenotic models were also simulated for comparison. In addition, an in vitro flow-loop was developed, and the pressure drop was measured for comparison. The CFD simulations results demonstrated that the difference between MB and stenosis increased with increasing MB/stenosis severity and flowrate. Experimental results showed that increasing the MB length (by 140%) only had significant impact on the pressure drop in the severe MB (39% increase at the exercise), but increasing the stenosis length dramatically increased the pressure drop in both moderate and severe stenoses at all flow rates (31% and 93% increase at the exercise, respectively). Both CFD and experimental results confirmed that the MB had a higher maximum and a lower mean pressure drop in comparison with the stenosis, regardless of the degree of lumen obstruction. A better understanding of MB and atherosclerotic stenosis may improve the therapeutic strategies in coronary disease patients and prevent acute coronary syndromes.

Flow Field Analysis in RF Ablation Based on PIV Experiment

Resistant hypertension (RH) is a major healthcare issue, causing cardiovascular and cerebrovascular diseases. In recent years, radiofrequency (RF) ablation to renal sympathetic denervation (RSD) is a new effective method for the treatment of RH. However, the effect of RSD on renal artery blood flow still need further research. In this study, Particle Image Velocimetry (PIV) experiment and RF ablation experiment were used to observe the blood flow states in three conditions: no ablation with flow, ablation with no flow, and ablation with flow. The results showed that when the blood flow was 1L/min in renal artery without ablation, it was uniform laminar flow. When the blood was static in renal artery with ablation, there was eddy around the ablation catheter. When the blood flow was 1L/min in renal artery with ablation, the eddy disappeared and the blood flow was uniform laminar flow. Therefore, when the renal artery blood flow is 1L/min, there will be no thrombus and hemolysis in the renal artery due to eddy current and large velocity gradient, which preliminarily verified the safety of the RSD. Keyword: Resistant hypertension; Radiofrequency ablation; Flow field; PIVClinical relevance-When the blood flow of renal artery is 1L/min, there will be no thrombus and hemolysis in renal artery due to eddy current and large velocity gradient during the operation of RF ablation to renal sympathetic denervation.

A Systematic Review for the Design of In Vitro Flow Studies of the Carotid Artery Bifurcation

PURPOSE

In vitro blood flow studies in carotid artery bifurcation models may contribute to understanding the influence of hemodynamics on carotid artery disease. However, the design of in vitro blood flow studies involves many steps and selection of imaging techniques, model materials, model design, and flow visualization parameters. Therefore, an overview of the possibilities and guidance for the design process is beneficial for researchers with less experience in flow studies.

METHODS

A systematic search to in vitro flow studies in carotid artery bifurcation models aiming at quantification and detailed flow visualization of blood flow dynamics results in inclusion of 42 articles.

RESULTS

Four categories of imaging techniques are distinguished: MRI, optical particle image velocimetry (PIV), ultrasound and miscellaneous techniques. Parameters for flow visualization are categorized into velocity, flow, shear-related, turbulent/disordered flow and other parameters. Model materials and design characteristics vary between study type.

CONCLUSIONS

A simplified three-step design process is proposed for better fitting and adequate match with the pertinent research question at hand and as guidance for less experienced flow study researchers. The three consecutive selection steps are: flow parameters, image modality, and model materials and designs. Model materials depend on the chosen imaging technique, whereas choice of flow parameters is independent from imaging technique and is therefore only determined by the goal of the study.

PIV investigation of the flow fields in subject-specific vertebro-basilar (VA-BA) junction

Background

As the only arterial structure of which two main arteries merged into one, the vertebro-basilar (VA-BA) system is one of the favorite sites of cerebral atherosclerotic plaques. The aim of this study was to investigate the detailed hemodynamics characteristics in the VA-BA system.

Methods

A scale-up subject-specific flow phantom of VA-BA system was fabricated based on the computed tomography angiography (CTA) scanning images of a healthy adult. Flow fields in eight axial planes and six radial planes were measured and analyzed by using particle image velocimetry (PIV) under steady flow conditions of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${Re}=300$$\end{document}Re=300, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${Re}=500$$\end{document}Re=500. A water–glycerin mixture was used as the working fluid.

Results

The flow in the current model exhibited highly three-dimensional characteristics. The confluence of VAs flow formed bimodal velocity distribution near the confluence apex. Due to the asymmetrical structural configuration, the bimodal velocity profile skewed towards left, and sharper peaks were observed under higher Reynolds condition. Secondary flow characterized by two vortices formed in the radial planes where 10 mm downstream the confluence apex and persists along the BA under both Reynolds numbers. The strength of secondary flow under \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${Re}=500$$\end{document}Re=500 is around 8% higher than that under \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${Re}=300$$\end{document}Re=300, and decayed nonlinearly along the flow direction. In addition, a low momentum recirculation region induced by boundary layer separation was observed near the confluence apex. The wall shear stress (WSS) in the recirculation area was found to be lower than 0.4 Pa. This region coincides well with the preferential site of vascular lesions in the VA-BA system.

Conclusions

This preliminary study verified that the subject-specific in-vitro experiment is capable of reflecting the detailed flow features in the VA-BA system. The findings from this study may help to expand the understanding of the hemodynamics in the VA-BA system, and further clarifying the mechanism that underlying the localization of vascular lesions.

Variations in pulsatile flow around stenosed microchannel depending on viscosity

In studying blood flow in the vessels, the characteristics of non-Newtonian fluid are important, considering the role of viscosity in rheology. Stenosis, which is an abnormal narrowing of the vessel, has an influence on flow behavior. Therefore, analysis of blood flow in stenosed vessels is essential. However, most of them exist as simulation outcomes. In this study, non-Newtonian fluid was observed in stenosed microchannels under the pulsatile flow condition. A polydimethylsiloxane channel with 60% stenosis was fabricated by combining an optic fiber and a petri dish, resembling a mold. Three types of samples were prepared by changing the concentrations of xanthan gum, which induces a shear thinning effect (phosphate buffered saline (PBS) solution as the Newtonian fluid and two non-Newtonian fluids mimicking normal blood and highly viscous blood analog). The viscosity of the samples was measured using a Y-shaped microfluidic viscometer. Thereafter, velocity profiles were analyzed under the pulsatile flow condition using the micro-particle image velocimetry (PIV) method. For the Newtonian fluid, the streamline was skewed more to the wall of the channel. The velocity profile of the non-Newtonian fluid was generally blunter than that of the Newtonian fluid. A highly oscillating wall shear stress (WSS) during the pulsatile phase may be attributed to such a bluntness of flow under the same wall shear rate condition with the Newtonian fluid. In addition, a highly viscous flow contributes to the variation in the WSS after passing through the stenosed structures. A similar tendency was observed in simulation results. Such a variation in the WSS was associated with plaque instability or rupture and damage of the tissue layer. These results, related to the influence on the damage to the endothelium or stenotic lesion, may help clinicians understand relevant mechanisms.

Cardiac Magnetic Resonance Imaging of Mechanical Cavopulmonary Assistance

Mechanical circulatory support (MCS) options are limited for patients with dysfunctional single ventricle physiology. To address this unmet clinical need, we are developing an axial-flow blood pump to provide mechanical assistance to the cavopulmonary circulation. In this study, we investigate the use of high-resolution cardiac magnetic resonance imaging (MRI) to visualize the complex fluid flow conditions of mechanical circulatory assist in two patient-specific Fontan anatomies. A three-bladed axial-flow impeller coupled to a supportive cage with a four-bladed diffuser was positioned in the inferior vena cava (IVC) of each Fontan anatomy. Cardiac magnetic resonance (CMR) imaging and power efficiency studies were conducted at physiologic relevant parameters with cardiac outputs of 2, 3, and 4 L/min with impeller rotational speeds of 2000 and 4000 rpm. The axial-flow impeller was able to generate improved flow in the total cavopulmonary connection (TCPC). The higher rotational speed was able to redistribute flow in the TCPC anastomosis aiding in removing stagnant blood. No retrograde flow was observed or measured in the superior vena cava (SVC). As an extension of the CMR data, a scalar stress analysis was performed on both models and found a maximum scalar stress of approximately 42 Pa for both patient anatomies. The power efficiency experiments demonstrated a maximum energy gain of 8.6 mW for TCPC Anatomy 1 and 12.58 mW for TCPC Anatomy 2 for a flow rate of 4 L/min and at 4000 rpm. These findings support the continued development of axial blood pumps for mechanical cavopulmonary assist.

Characteristics of pulsatile flows in curved stenosed channels

Spatial and temporal variations of the hemodynamic features occur under pulsatile conditions in complex vessel geometry. Wall shear stress affected by the disturbed flow can result in endothelial cell dysfunction, which leads to atherogenesis and thrombosis. Therefore, detailed understanding of the hemodynamic characteristics in a curved stenosed channel is highly important when examining the pathological effects of hemodynamic phenomena on the progression of atherosclerosis. The present study measures the velocity fields of pulsatile flows with three different Reynolds numbers in 3D curved vessel models with stenosis using time-resolved particle image velocimetry (PIV). Three different models were cast in PDMS polymer using models made by a 3D printer with different bend angles of 0°, 10°, and 20° between the longitudinal axes at the upstream and downstream of the stenosis. To investigate the 3D flow structures, a stack of 2D velocity fields was obtained by adjusting the position of the laser sheet along the Z-direction. The structures of flow fields in the stenosed models were analyzed using the distribution of the shearing strain as well as the skewness and full width at half maximum of the velocity profile. To support experiment results, distributions of pressure and 3D vortex in the curved stenosed channels were estimated by conducting the numerical simulation. These results indicate that the curvature of the tube considerably influences the skewness of the flow, and the shear stress is intensified near the outer curvature wall due to centrifugal force. The results would be helpful in understanding the effects of geometrical factors on plaque rupture and severe cardiovascular diseases.

Coronary CT angiography using low concentrated contrast media injected with high flow rates: Feasible in clinical practice

PURPOSE

Aim of this study was to test the hypothesis that peak injection pressures and image quality using low concentrated contrast media (CM) (240 mg/mL) injected with high flow rates will be comparable to a standard injection protocol (CM: 300 mg/mL) in coronary computed tomographic angiography (CCTA).

MATERIAL AND METHODS

One hundred consecutive patients were scanned on a 2nd generation dual-source CT scanner. Group 1 (n=50) received prewarmed Iopromide 240 mg/mL at an injection rate of 9 mL/s, followed by a saline chaser. Group 2 (n=50) received the standard injection protocol: prewarmed Iopromide 300 mg/mL; flow rate: 7.2 mL/s. For both protocols, the iodine delivery rate (IDR, 2.16 gI/s) and the total iodine load (22.5 gI) were kept identical. Injection pressure (psi) was continuously monitored by a data acquisition program. Contrast enhancement was measured in the thoracic aorta and all proximal and distal coronary segments. Subjective and objective image quality was evaluated between both groups.

RESULTS

No significant differences in peak injection pressures were found between both CM groups (121 ± 5.6 psi vs. 120 ± 5.3 psi, p=0.54). Flow rates of 9 mL/s were safely injected without any complications. No significant differences in contrast-to-noise ratio, signal-to-noise ratio and subjective image quality were found (all p>0.05). No significant differences in attenuation levels were found in the thoracic aorta and all segments of the coronary arteries (all p>0.05).

CONCLUSION

Usage of low iodine concentration CM and injection with high flow rates is feasible. High flow rates (9 mL/s) of Iopromide 240 were safely injected without complications and should not be considered a drawback in clinical practice. No significant differences in peak pressure and image quality were found. This creates a doorway towards applicability of a broad variety in flow rates and IDRs and subsequently more individually tailored injection protocols.

FABRICATION OF 3D MILI-SCALE CHANNELS FOR HEMODYNAMIC STUDIES

3D mili-scale channel representing simplified anatomical models of blood vessels were constructed in polidimethylsiloxane (PDMS). The objective was to obtain a sequential method to fabricate transparent PDMS models from a mold produced by rapid prototyping. For this purpose, two types of casting methods were compared, a known lost-wax casting method and a casting method using sucrose. The channels fabricated by both casting methods were analyzed by Optical Microscopy, Scanning Electron Microscopy (SEM), and Energy Dispersive X-ray Spectroscopy (EDS). The lost-wax method is not ideal since the channels become contaminated during the removal process. The models produced with the lost-sucrose casting method exhibit much better optical characteristics. These models are transparent with no visible contamination, since the removing process is done by dissolution at room temperature rather than melting. They allow for good optical access for flow visualization and measurement of the velocity field by micro-Particle Image Velocimetry (μPIV). The channels fabricated by the lost-sucrose casting method were shown to be suitable for future hemodynamic studies using optical techniques.

Influence of contrast media viscosity and temperature on injection pressure in computed tomographic angiography: a phantom study

PURPOSE

Iodinated contrast media (CM) in computed tomographic angiography is characterized by its concentration and, consecutively, by its viscosity. Viscosity itself is directly influenced by temperature, which will furthermore affect injection pressure. Therefore, the purposes of this study were to systematically evaluate the viscosity of different CM at different temperatures and to assess their impact on injection pressure in a circulation phantom.

MATERIALS AND METHODS

Initially, viscosity of different contrast media concentrations (240, 300, 370, and 400 mgI/mL) was measured at different temperatures (20°C-40°C) with a commercially available viscosimeter. In the next step, a circulation phantom with physical conditions was used. Contrast media were prepared at different temperatures (20°C, 30°C, 37°C) and injected through a standard 18-gauge needle. All other relevant parameters were kept constant (iodine delivery rate, 1.9 g I/s; total amount of iodine, 15 g I). Peak flow rate (in milliliter per second) and injection pressure (psi) were monitored. Differences in significance were tested using the Kruskal-Wallis test (Statistical Package for the Social Sciences).

RESULTS

Viscosities for iodinated CM of 240, 300, 370, and 400 mg I/mL at 20°C were 5.1, 9.1, 21.2, and 28.8 mPa.s, respectively, whereas, at 40°C, these were substantially lower (2.8, 4.4, 8.7, and 11.2 mPa.s). In the circulation phantom, mean (SD) peak pressures for CM of 240 mg I/mL at 20°C, 30°C, and 37°C were 107 (1.5), 95 (0.6), and 92 (2.1) psi; for CM of 300 mg I/mL, 119 (1.5), 104 (0.6), and 100 (3.6) psi; for CM of 370 mg I/mL, 150 (0.6), 133 (4.4), and 120 (3.5) psi; and for CM of 400 mg I/mL, 169 (1.0), 140 (2.1), and 135 (2.9) psi, respectively, with all P values less than 0.05.

CONCLUSIONS

Low concentration, low viscosity, and high temperatures of CM are beneficial in terms of injection pressure. This should also be considered for individually tailored contrast protocols in daily routine scanning.

Intravascular enhancement with identical iodine delivery rate using different iodine contrast media in a circulation phantom

PURPOSE

Both iodine delivery rate (IDR) and iodine concentration are decisive factors for vascular enhancement in computed tomographic angiography. It is unclear, however, whether the use of high-iodine concentration contrast media is beneficial to lower iodine concentrations when IDR is kept identical. This study evaluates the effect of using different iodine concentrations on intravascular attenuation in a circulation phantom while maintaining a constant IDR.

MATERIALS AND METHODS

A circulation phantom with a low-pressure venous compartment and a high-pressure arterial compartment simulating physiological circulation parameters was used (heart rate, 60 beats per minute; stroke volume, 60 mL; blood pressure, 120/80 mm Hg). Maintaining a constant IDR (2.0 g/s) and a constant total iodine load (20 g), prewarmed (37°C) contrast media with differing iodine concentrations (240-400 mg/mL) were injected into the phantom using a double-headed power injector. Serial computed tomographic scans at the level of the ascending aorta (AA), the descending aorta (DA), and the left main coronary artery (LM) were obtained. Total amount of contrast volume (milliliters), iodine delivery (grams of iodine), peak flow rate (milliliter per second), and intravascular pressure (pounds per square inch) were monitored using a dedicated data acquisition program. Attenuation values in the AA, the DA, and the LM were constantly measured (Hounsfield unit [HU]). In addition, time-enhancement curves, aortic peak enhancement, and time to peak were determined.

RESULTS

All contrast injection protocols resulted in similar attenuation values: the AA (516 [11] to 531 [37] HU), the DA (514 [17] to 531 [32] HU), and the LM (490 [10] to 507 [17] HU). No significant differences were found between the AA, the DA, and the LM for either peak enhancement (all P > 0.05) or mean time to peak (AA, 19.4 [0.58] to 20.1 [1.05] seconds; DA, 21.1 [1.0] to 21.4 [1.15] seconds; LM, 19.8 [0.58] to 20.1 [1.05] seconds).

CONCLUSIONS

This phantom study demonstrates that constant injection parameters (IDR, overall iodine load) lead to robust enhancement patterns, regardless of the contrast material used. Higher iodine concentration itself does not lead to higher attenuation levels. These results may stimulate a shift in paradigm toward clinical usage of contrast media with lower iodine concentrations (eg, 240 mg iodine/mL) in individual tailored contrast protocols. The use of low-iodine concentration contrast media is desirable because of the lower viscosity and the resulting lower injection pressure.

SIMULATION OF CASSON FLUID FLOW AND HEAT TRANSPORT IN DIFFERENTLY SHAPED STENOSES

The present investigation deals with a mathematical model representing the response of heat transfer to blood streaming through the arteries under stenotic condition. The flowing blood is represented as the suspension of all erythrocytes assumed to be Casson fluid and the arterial wall is considered to be rigid having differently shaped stenoses in its lumen arising from various types of abnormal growth or plaque formation. The governing equations of motion accompanied by the appropriate choice of the boundary conditions are solved numerically by Marker and Cell (MAC) method. The necessary checking for numerical stability has been incorporated into the algorithm for better precision of the results computed. The quantitative analysis carried out finally includes the respective profiles of the flow-field and the temperature along with their individual distributions over the entire arterial segment as well. The key factors like the pressure drop, wall shear stress, flow separation, Nusselt number and streamlines are examined for qualitative insight into the blood flow and heat transport phenomena through arterial stenosis. In conformity with other several existing findings the present simulation predicts that the pressure drop and Nusselt number diminishes with increasing yield stress values, and significant enhancement in values of Nusselt number is observed with increasing severity of the stenosis. However, the effect of the shapes of the stenoses on flow separation cannot be ruled out from the present investigation.

Effect of Pulsatile Flow Waveform and Womersley Number on the Flow in Stenosed Arterial Geometry

The salient hemodynamic flow features in a stenosed artery depend not only on the degree of stenosis, but also on its location in the circulatory system and the physiological condition of the body. The nature of pulsatile flow waveform and local Womersley number vary in different regions of the arterial system and at different physiological state, which affects the local hemodynamic wall parameters, for example, the wall shear stress (WSS) and oscillatory shear index (OSI). Herein, we have numerically investigated the effects of different waveforms and Womersley numbers on the flow pattern and hemodynamic parameters in an axisymmetric stenosed arterial geometry with 50% diametral occlusion. Temporal evolution of the streamlines and hemodynamic parameters are investigated, and the time-averaged hemodynamic wall parameters are compared. Presence of the stenosis is found to increase the OSI of the flow even at the far-downstream side of the artery. At larger Womersley numbers, the instantaneous flow field in the stenosed region is found to have a stronger influence on the flow profiles of the previous time levels. The study delineates how an approximation in the assumption of inlet pulsatility profile may lead to significantly different prediction of hemodynamic wall parameters.

Endothelial cell morphologic response to asymmetric stenosis hemodynamics: effects of spatial wall shear stress gradients

Endothelial cells are known to respond to hemodynamic forces. Their phenotype has been suggested to differ between atheroprone and atheroprotective regions of the vasculature, which are characterized by the local hemodynamic environment. Once an atherosclerotic plaque has formed in a vessel, the obstruction creates complex spatial gradients in wall shear stress. Endothelial cell response to wall shear stress may be linked to the stability of coronary plaques. Unfortunately, in vitro studies of the endothelial cell involvement in plaque stability have been limited by unrealistic and simplified geometries, which cannot reproduce accurately the hemodynamics created by a coronary stenosis. Hence, in an attempt to better replicate the spatial wall shear stress gradient patterns in an atherosclerotic region, a three dimensional asymmetric stenosis model was created. Human abdominal aortic endothelial cells were exposed to steady flow (Re=50, 100, and 200 and tau=4.5 dyn/cm(2), 9 dyn/cm(2), and 18 dyn/cm(2)) in idealized 50% asymmetric stenosis and straight/tubular in vitro models. Local morphological changes that occur due to magnitude, duration, and spatial gradients were quantified to identify differences in cell response. In the one dimensional flow regions, where flow is fully developed and uniform wall shear stress is observed, cells aligned in flow direction and had a spindlelike shape when compared with static controls. Morphological changes were progressive and a function of time and magnitude in these regions. Cells were more randomly oriented and had a more cobblestone shape in regions of spatial wall shear stress gradients. These regions were present, both proximal and distal, at the stenosis and on the wall opposite to the stenosis. The response of endothelial cells to spatial wall shear stress gradients both in regions of acceleration and deceleration and without flow recirculation has not been previously reported. This study shows the dependence of endothelial cell morphology on spatial wall shear stress gradients and demonstrates that care must be taken to account for altered phenotype due to geometric features. These results may help explain plaque stability, as cells in shoulder regions near an atherosclerotic plaque had a cobblestone morphology indicating that they may be more permeable to subendothelial transport and express prothrombotic factors, which would increase the risk of atherothrombosis.

The response of human aortic endothelial cells in a stenotic hemodynamic environment: effect of duration, magnitude, and spatial gradients in wall shear stress

Inflammation plays a key role in the development and stability of coronary plaques. Endothelial cells alter their expression in response to wall shear stress (WSS). Straight/tubular and asymmetric stenosis models were designed to study the localized expression of atheroprone molecules and inflammatory markers due to the presence of the spatial wall shear stress gradients created by an eccentric plaque. The effects of steady wall shear stress duration (0-24 h) and magnitude (4.5-18 dynes/cm(2)) were analyzed in human abdominal aortic endothelial cells through quantitative real-time polymerase chain reaction (PCR) and immunofluorescence analysis in straight/tubular models. Regional expression was assessed by immunofluorescence and confocal microscopy in stenosis models. Under steady fully developed flow, endothelial cells exhibited a sustained increase in levels of atheroprotective genes with WSS duration and magnitude. The local response in the stenosis model showed that expression of endothelial nitric oxide synthase and Kruppel-like factor 2 is magnitude rather than gradient dependent. A WSS magnitude dependent transient increase in translocation of transcription factor nuclear factor kappaB was observed. Intercellular adhesion molecule 1, vascular cell adhesion molecule 1, and E-selectin exhibited a sustained increase in protein expression with time. The mRNA levels of these molecules were transiently upregulated and this was followed by a decrease in expression to levels lower than static controls. Regionally, increased inflammatory marker expression was observed in regions of WSS gradients both proximal and distal to the stenosis when compared with the uniform flow regions, whereas the atheroprotective markers were expressed to a greater extent in regions of elevated WSS magnitudes. The results from the straight/tubular model cannot explain the regional variation seen in the stenosis models. This may help explain the localization of inflammatory cells at the shoulders of plaques in vivo.

Neutrophil adhesion on endothelial cells in a novel asymmetric stenosis model: effect of wall shear stress gradients

Leukocytes play a pivotal role in the progression of atherosclerosis. A novel three-dimensional in vitro asymmetric stenosis model was used to better investigate the role of local hemodynamics in the adhesion of leukocytes to an established plaque. The adhesion of a human promyelocytic cell line (NB4) on a human abdominal aortic endothelial cell (EC) monolayer was quantified. NB4 cells were circulated over TNF-alpha stimulated and nonstimulated ECs for 1 or 6 h at 1.25 or 6.25 dynes/cm(2) and compared to static conditions. Cytokine stimulation increased significantly EC expression of intercellular adhesion molecule and vascular cell adhesion molecule. Under static conditions, neutrophils adhered overall more than under flow, with decreased adhesion with increasing shear. Adhesion was significantly higher in the recirculation region distal to the stenosis than in the inlet. Preshearing the ECs decreased the expression of cell adhesion molecules in inflamed endothelium and significantly decreased adhesion. However, the ratio of adhesion between the recirculation zone and the inlet increased, hence exhibiting an increased regional difference. This work suggests an important role for neutrophil-EC interactions in the atherosclerotic process, especially in wall shear stress gradient regions. This is important clinically, potentially helping to explain plaque stability.

A microfluidics device to monitor platelet aggregation dynamics in response to strain rate micro-gradients in flowing blood

This paper reports the development of a platform technology for measuring platelet function and aggregation based on localized strain rate micro-gradients. Recent experimental findings within our laboratories have identified a key role for strain rate micro-gradients in focally triggering initial recruitment and subsequent aggregation of discoid platelets at sites of blood vessel injury. We present the design justification, hydrodynamic characterization and experimental validation of a microfluidic device incorporating contraction-expansion geometries that generate strain rate conditions mimicking the effects of pathological changes in blood vessel geometry. Blood perfusion through this device supports our published findings of both in vivo and in vitro platelet aggregation and confirms a critical requirement for the coupling of blood flow acceleration to downstream deceleration for the initiation and stabilization of platelet aggregation, in the absence of soluble platelet agonists. The microfluidics platform presented will facilitate the detailed analysis of the effects of hemodynamic parameters on the rate and extent of platelet aggregation and will be a useful tool to elucidate the hemodynamic and platelet mechano-transduction mechanisms, underlying this shear-dependent process.