Image-based insilico investigation of hemodynamics and biomechanics in healthy and diabetic human retinas

Retinal hemodynamics and biomechanics play a significant role in understanding the pathophysiology of several ocular diseases. However, these parameters are significantly affected due to changed blood vessel morphology ascribed to pathological conditions, particularly diabetes. In this study, an image-based computational fluid dynamics (CFD) model is applied to examine the effects of changed vascular morphology due to diabetes on blood flow velocity, vorticity, wall shear stress (WSS), and oxygen distribution and compare it with healthy. The 3D patient-specific vascular architecture of diabetic and healthy retina is extracted from Optical Coherence Tomography Angiography (OCTA) images and fundus to extract the capillary level information. Further, Fluid-structure interaction (FSI) simulations have been performed to compare the induced tissue stresses in diabetic and healthy conditions. Results illustrate that most arterioles possess higher velocity, vorticity, WSS, and lesser oxygen concentration than arteries for healthy and diabetic cases. However, an opposite trend is observed for venules and veins. Comparisons show that, on average, the blood flow velocity in the healthy case decreases by 42 % in arteries and 21 % in veins, respectively, compared to diabetic. In addition, the WSS and von Mises stress (VMS) in healthy case decrease by 49 % and 72 % in arteries and by 6 % and 28 % in veins, respectively, when compared with diabetic, making diabetic blood vessels more susceptible to wall rupture and tissue damage. The in-silico results may help predict the possible abnormalities region early, helping the ophthalmologists use these estimates as prognostic tools and tailor patient-specific treatment plans.

A multiscale framework for defining homeostasis in distal vascular trees: applications to the pulmonary circulation

Pulmonary arteries constitute a low-pressure network of vessels, often characterized as a bifurcating tree with heterogeneous vessel mechanics. Understanding the vascular complexity and establishing homeostasis is important to study diseases such as pulmonary arterial hypertension (PAH). The onset and early progression of PAH can be traced to changes in the morphometry and structure of the distal vasculature. Coupling hemodynamics with vessel wall growth and remodeling (G&R) is crucial for understanding pathology at distal vasculature. Accordingly, the goal of this study is to provide a multiscale modeling framework that embeds the essential features of arterial wall constituents coupled with the hemodynamics within an arterial network characterized by an extension of Murray's law. This framework will be used to establish the homeostatic baseline characteristics of a pulmonary arterial tree, including important parameters such as vessel radius, wall thickness and shear stress. To define the vascular homeostasis and hemodynamics in the tree, we consider two timescales: a cardiac cycle and a longer period of vascular adaptations. An iterative homeostatic optimization, which integrates a metabolic cost function minimization, the stress equilibrium, and hemodynamics, is performed at the slow timescale. In the fast timescale, the pulsatile blood flow dynamics is described by a Womersley's deformable wall analytical solution. Illustrative examples for symmetric and asymmetric trees are presented that provide baseline characteristics for the normal pulmonary arterial vasculature. The results are compared with diverse literature data on morphometry, structure, and mechanics of pulmonary arteries. The developed framework demonstrates a potential for advanced parametric studies and future G&R and hemodynamics modeling of PAH.

MRI-based biomechanical parameters for carotid artery plaque vulnerability assessment

Carotid atherosclerotic plaques are a major cause of ischaemic stroke. The biomechanical environment to which the arterial wall and plaque is subjected to plays an important role in the initiation, progression and rupture of carotid plaques. MRI is frequently used to characterize the morphology of a carotid plaque, but new developments in MRI enable more functional assessment of carotid plaques. In this review, MRI based biomechanical parameters are evaluated on their current status, clinical applicability, and future developments. Blood flow related biomechanical parameters, including endothelial wall shear stress and oscillatory shear index, have been shown to be related to plaque formation. Deriving these parameters directly from MRI flow measurements is feasible and has great potential for future carotid plaque development prediction. Blood pressure induced stresses in a plaque may exceed the tissue strength, potentially leading to plaque rupture. Multi-contrast MRI based stress calculations in combination with tissue strength assessment based on MRI inflammation imaging may provide a plaque stress-strength balance that can be used to assess the plaque rupture risk potential. Direct plaque strain analysis based on dynamic MRI is already able to identify local plaque displacement during the cardiac cycle. However, clinical evidence linking MRI strain to plaque vulnerability is still lacking. MRI based biomechanical parameters may lead to improved assessment of carotid plaque development and rupture risk. However, better MRI systems and faster sequences are required to improve the spatial and temporal resolution, as well as increase the image contrast and signal-to-noise ratio.

Microfluidic analysis of pressure drop and flow behavior in hypertensive micro vessels

The retinal arterial network is the only source of the highly nutrient-consumptive retina, thus any insult on the arteries can impair the retinal oxygen and nutrient supply and affect its normal function. The aim of this work is to study the influences of vascular structure variation on the flow and pressure characteristics via microfluidic devices. Two sets of micro-channel were designed to mimic the stenosed microvessels and dichotomous branching structure in the retinal arteries. Three working fluids including red blood cell (RBC) suspension were employed to investigate the pressure drop in the stenosed channel. The flow behaviors of RBC suspensions inside the micro channels were observed using high speed camera system. Pressure drop of different working fluids and RBC velocity profiles in the stenosed channel were obtained. Moreover, hematocrit levels of RBC suspensions inside the bifurcated channels were analyzed from the sequential images of RBC flow. The results of the flow in the stenosed channel show that RBCs drift from the center of the channels, and RBC velocity is influenced not only by the inlet flow rate but also the interaction between RBCs. The measured pressure drops in the stenosed channel increase notably with the increase of fluid viscosity. Furthermore, the dimensionless pressure drop due to the stenosis decreases with Reynolds number. On the other hand, the results of flow through the bifurcated channels show that as the ratio of the daughter-branch width to the mother-channel width increases, the ratio of hematocrit in two connected branches (Ht/Hd) decreases, which is in favorable agreement with the available analysis results.

Extension of Murray's law including nonlinear mechanics of a composite artery wall

A goal function approach is used to derive an extension of Murray’s law that includes effects of nonlinear mechanics of the artery wall. The artery is modeled as a thin-walled tube composed of different species of nonlinear elastic materials that deform together. These materials grow and remodel in a process that is governed by a target state defined by a homeostatic radius and a homeostatic material composition. Following Murray’s original idea, this target state is defined by a principle of minimum work. We take this work to include that of pumping and maintaining blood, as well as maintaining the materials of the artery wall. The minimization is performed under a constraint imposed by mechanical equilibrium. We derive a condition for the existence of a cost-optimal homeostatic state. We also conduct parametric studies using this novel theoretical frame to investigate how the cost-optimal radius and composition of the artery wall depend on flow rate, blood pressure, and elastin content