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Guo Q, Chen J, Liu H, Sun C. Measurement of Layer-Specific Mechanical Properties of Intact Blood Vessels Based on Intravascular Optical Coherence Tomography. Cardiovasc Eng Technol 2023; 14:67-78. [PMID: 35710860 DOI: 10.1007/s13239-022-00636-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/27/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE The biomechanical analysis of stress and strain state of multilayered blood vessels has shown great importance in vascular pathology and physiology. However, there is a lack of method in measuring the mechanical property of each layer of a vascular sample without splitting up the wall. METHODS Here we develop a vascular inflation test method based on intravascular optical coherence tomography (IVOCT) imaging and inverse parametric estimation. We propose a three-step inverse parametric estimation method to solve the six constitutive parameters of the GOH models for the intima-media and adventitia of the coronaries simultaneously. A bilayer silicone vascular phantom inflation test and a virtual deformation test using finite element simulated data are conducted to evaluate the accuracy of the proposed method. RESULTS The virtual deformation test demonstrates that the errors of the constitutive constants are less than 2.56% determined by the proposed inverse parametric estimation method. The stress-strain curves of a bilayer silicone vascular phantom obtained based on the parameters determined by the proposed method match well with those obtained by the uniaxial test. CONCLUSION The proposed layer-specific vascular mechanical property measurement method provides a new experimental method for mechanical properties characterization of blood vessels. It also has the potential to be used for patient-specific mechanical properties estimation with IVOCT imaging in vivo.
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Affiliation(s)
- Qingyi Guo
- Department of Mechanical Engineering, Tianjin University, No. 135 Yaguan Road, Tianjin, 300354, China
| | - Jinlong Chen
- Department of Mechanical Engineering, Tianjin University, No. 135 Yaguan Road, Tianjin, 300354, China
- Tianjin Key Laboratory of Modern Engineering Mechanics, No. 135 Yaguan Road, Tianjin, 300354, China
| | - Haofei Liu
- Department of Mechanical Engineering, Tianjin University, No. 135 Yaguan Road, Tianjin, 300354, China
- Tianjin Key Laboratory of Modern Engineering Mechanics, No. 135 Yaguan Road, Tianjin, 300354, China
| | - Cuiru Sun
- Department of Mechanical Engineering, Tianjin University, No. 135 Yaguan Road, Tianjin, 300354, China.
- Tianjin Key Laboratory of Modern Engineering Mechanics, No. 135 Yaguan Road, Tianjin, 300354, China.
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In Vivo Intravascular Optical Coherence Tomography (IVOCT) Structural and Blood Flow Imaging Based Mechanical Simulation Analysis of a Blood Vessel. Cardiovasc Eng Technol 2022; 13:685-698. [PMID: 35112317 DOI: 10.1007/s13239-022-00608-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/04/2022] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Computer modelling of blood vessels based on biomedical imaging provides important hemodynamic and biomechanical information for vascular disease studies and diagnosis. However due to lacking well-defined physiological blood flow profiles, the accuracy of the simulation results is often not guaranteed. Flow velocity profiles of a specific cross section of a blood vessel were obtained by in vivo Doppler intravascular optical coherence tomography (IVOCT) lately. However due to the influence of the catheter, the velocity profile imaged by IVOCT can't be applied to simulation directly. METHODS A simulation-experiment combined method to determine the inlet flow boundary based on in vivo porcine carotid Doppler IVOCT imaging is proposed. A single conduit carotid model was created from the 3D IVOCT structural images using an image processing-computer aided design combined method. RESULTS With both high- resolution arterial model and near physiological blood flow profile, stress analysis by fluid-structure interaction and computational fluid dynamics were performed. The influence of the catheter to the wall shear stress, the hemodynamics and the stresses of the carotid wall under the measured inlet flow and various outlet pressure boundary conditions, are analyzed. CONCLUSION This study provides a solution to the difficulty of getting inlet flow boundary for numerical simulation of arteries. It paves the way for developing IVOCT based vascular stress analysis and imaging methods for the studies and diagnosis of vascular diseases.
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Image-Based Finite Element Modeling Approach for Characterizing In Vivo Mechanical Properties of Human Arteries. J Funct Biomater 2022; 13:jfb13030147. [PMID: 36135582 PMCID: PMC9505727 DOI: 10.3390/jfb13030147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/07/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
Mechanical properties of the arterial walls could provide meaningful information for the diagnosis, management and treatment of cardiovascular diseases. Classically, various experimental approaches were conducted on dissected arterial tissues to obtain their stress-stretch relationship, which has limited value clinically. Therefore, there is a pressing need to obtain biomechanical behaviors of these vascular tissues in vivo for personalized treatment. This paper reviews the methods to quantify arterial mechanical properties in vivo. Among these methods, we emphasize a novel approach using image-based finite element models to iteratively determine the material properties of the arterial tissues. This approach has been successfully applied to arterial walls in various vascular beds. The mechanical properties obtained from the in vivo approach were compared to those from ex vivo experimental studies to investigate whether any discrepancy in material properties exists for both approaches. Arterial tissue stiffness values from in vivo studies generally were in the same magnitude as those from ex vivo studies, but with lower average values. Some methodological issues, including solution uniqueness and robustness; method validation; and model assumptions and limitations were discussed. Clinical applications of this approach were also addressed to highlight their potential in translation from research tools to cardiovascular disease management.
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4
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Li Z, Luo T, Wang S, Jia H, Gong Q, Liu X, Sutcliffe MPF, Zhu H, Liu Q, Chen D, Xiong J, Teng Z. Mechanical and histological characteristics of aortic dissection tissues. Acta Biomater 2022; 146:284-294. [PMID: 35367380 DOI: 10.1016/j.actbio.2022.03.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 12/14/2022]
Abstract
AIMS This study investigated the association between the macroscopic mechanical response of aortic dissection (AoD) flap, its fibre features, and patient physiological features and clinical presentations. METHODS Uniaxial test was performed with tissue strips in both circumferential and longitudinal directions from 35 patients with (AoD:CC) and without (AoD:w/oCC) cerebral/coronary complications, and 19 patients with rheumatic or valve-related heart diseases (RH). A Bayesian inference framework was used to estimate the expectation of material constants (C1, D1, and D2) of the modified Mooney-Rivlin strain energy density function. Histological examination was used to visualise the elastin and collagen in the tissue strips and image processing was performed to quantify their area percentages, fibre misalignment and waviness. RESULTS The elastin area percentage was negatively associated with age (p = 0.008), while collagen increased about 6% from age 40 to 70 (p = 0.03). Elastin fibre was less dispersed and wavier in old patients and no significant association was found between patient age and collagen fibre dispersion or waviness. Features of fibrous microstructures, either elastin or collagen, were comparable between AoD:CC and AoD:w/oCC group. Elastin and collagen area percentages were positively correlated with C1 and D2, respectively, while the elastin and collagen waviness were negatively correlated with C1 and D2, respectively. Elastin dispersion was negatively correlated to D2. Multivariate analysis showed that D2 was an effective parameter which could differentiate patient groups with different age and clinical presentations, as well as the direction of tissue strip. CONCLUSION Fibre dispersion and waviness in the aortic dissection flap changed with patient age and clinical presentations, and these can be captured by the material constants in the strain energy density function. STATEMENT OF SIGNIFICANCE Aortic dissection (AoD) is a severe cardiovascular disease. Understanding the mechanical property of intimal flap is essential for its risk evaluation. In this study, mechanical testing and histology examination were combined to quantify the relationship between mechanical presentations and microstructure features. A Bayesian inference framework was employed to estimate the expectation of the material constants in the modified Mooney-Rivlin constitutive equation. It was found that fibre dispersion and waviness in the AoD flap changed with patient age and clinical presentations, and these could be captured by the material constants. This study firstly demonstrated that the expectation of material constants can be used to characterise tissue microstructures and differentiate patients with different clinical presentations.
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Bracamonte JH, Saunders SK, Wilson JS, Truong UT, Soares JS. Patient-Specific Inverse Modeling of In Vivo Cardiovascular Mechanics with Medical Image-Derived Kinematics as Input Data: Concepts, Methods, and Applications. APPLIED SCIENCES-BASEL 2022; 12:3954. [PMID: 36911244 PMCID: PMC10004130 DOI: 10.3390/app12083954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Inverse modeling approaches in cardiovascular medicine are a collection of methodologies that can provide non-invasive patient-specific estimations of tissue properties, mechanical loads, and other mechanics-based risk factors using medical imaging as inputs. Its incorporation into clinical practice has the potential to improve diagnosis and treatment planning with low associated risks and costs. These methods have become available for medical applications mainly due to the continuing development of image-based kinematic techniques, the maturity of the associated theories describing cardiovascular function, and recent progress in computer science, modeling, and simulation engineering. Inverse method applications are multidisciplinary, requiring tailored solutions to the available clinical data, pathology of interest, and available computational resources. Herein, we review biomechanical modeling and simulation principles, methods of solving inverse problems, and techniques for image-based kinematic analysis. In the final section, the major advances in inverse modeling of human cardiovascular mechanics since its early development in the early 2000s are reviewed with emphasis on method-specific descriptions, results, and conclusions. We draw selected studies on healthy and diseased hearts, aortas, and pulmonary arteries achieved through the incorporation of tissue mechanics, hemodynamics, and fluid-structure interaction methods paired with patient-specific data acquired with medical imaging in inverse modeling approaches.
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Affiliation(s)
- Johane H. Bracamonte
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Sarah K. Saunders
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - John S. Wilson
- Department of Biomedical Engineering and Pauley Heart Center, Virginia Commonwealth University, Richmond, VA 23219, USA
| | - Uyen T. Truong
- Department of Pediatrics, School of Medicine, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA 23219, USA
| | - Joao S. Soares
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA
- Correspondence:
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Fanni BM, Sauvage E, Celi S, Norman W, Vignali E, Landini L, Schievano S, Positano V, Capelli C. A Proof of Concept of a Non-Invasive Image-Based Material Characterization Method for Enhanced Patient-Specific Computational Modeling. Cardiovasc Eng Technol 2020; 11:532-543. [PMID: 32748364 DOI: 10.1007/s13239-020-00479-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 07/22/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Computational models of cardiovascular structures rely on their accurate mechanical characterization. A validated method able to infer the material properties of patient-specific large vessels is currently lacking. The aim of the present study is to present a technique starting from the flow-area (QA) method to retrieve basic material properties from magnetic resonance (MR) imaging. METHODS The proposed method was developed and tested, first, in silico and then in vitro. In silico, fluid-structure interaction (FSI) simulations of flow within a deformable pipe were run with varying elastic modules (E) between 0.5 and 32 MPa. The proposed QA-based formulation was assessed and modified based on the FSI results to retrieve E values. In vitro, a compliant phantom connected to a mock circulatory system was tested within MR scanning. Images of the phantom were acquired and post-processed according to the modified formulation to infer E of the phantom. Results of in vitro imaging assessment were verified against standard tensile test. RESULTS In silico results from FSI simulations were used to derive the correction factor to the original formulation based on the geometrical and material characteristics. In vitro, the modified QA-based equation estimated an average E = 0.51 MPa, 2% different from the E derived from tensile tests (i.e. E = 0.50 MPa). CONCLUSION This study presented promising results of an indirect and non-invasive method to establish elastic properties from solely MR images data, suggesting a potential image-based mechanical characterization of large blood vessels.
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Affiliation(s)
- B M Fanni
- BioCardioLab, Bioengineering Unit, Fondazione Toscana Gabriele Monasterio, Via Aurelia Sud, 54100, Massa, Italy.,Department of Information Engineering, University of Pisa, Via Girolamo Caruso 16, 56122, Pisa, Italy
| | - E Sauvage
- UCL Institute of Cardiovascular Science, 20c Guilford Street, London, WC1N 1DZ, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, 30 Great Ormond Street, London, WC1N 3JH, UK
| | - S Celi
- BioCardioLab, Bioengineering Unit, Fondazione Toscana Gabriele Monasterio, Via Aurelia Sud, 54100, Massa, Italy.
| | - W Norman
- UCL Institute of Cardiovascular Science, 20c Guilford Street, London, WC1N 1DZ, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, 30 Great Ormond Street, London, WC1N 3JH, UK
| | - E Vignali
- BioCardioLab, Bioengineering Unit, Fondazione Toscana Gabriele Monasterio, Via Aurelia Sud, 54100, Massa, Italy.,Department of Information Engineering, University of Pisa, Via Girolamo Caruso 16, 56122, Pisa, Italy
| | - L Landini
- BioCardioLab, Bioengineering Unit, Fondazione Toscana Gabriele Monasterio, Via Aurelia Sud, 54100, Massa, Italy.,Department of Information Engineering, University of Pisa, Via Girolamo Caruso 16, 56122, Pisa, Italy
| | - S Schievano
- UCL Institute of Cardiovascular Science, 20c Guilford Street, London, WC1N 1DZ, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, 30 Great Ormond Street, London, WC1N 3JH, UK
| | - V Positano
- BioCardioLab, Bioengineering Unit, Fondazione Toscana Gabriele Monasterio, Via Aurelia Sud, 54100, Massa, Italy
| | - C Capelli
- UCL Institute of Cardiovascular Science, 20c Guilford Street, London, WC1N 1DZ, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, 30 Great Ormond Street, London, WC1N 3JH, UK
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7
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Liu M, Liang L, Sulejmani F, Lou X, Iannucci G, Chen E, Leshnower B, Sun W. Identification of in vivo nonlinear anisotropic mechanical properties of ascending thoracic aortic aneurysm from patient-specific CT scans. Sci Rep 2019; 9:12983. [PMID: 31506507 PMCID: PMC6737100 DOI: 10.1038/s41598-019-49438-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 08/24/2019] [Indexed: 12/15/2022] Open
Abstract
Accurate identification of in vivo nonlinear, anisotropic mechanical properties of the aortic wall of individual patients remains to be one of the critical challenges in the field of cardiovascular biomechanics. Since only the physiologically loaded states of the aorta are given from in vivo clinical images, inverse approaches, which take into account of the unloaded configuration, are needed for in vivo material parameter identification. Existing inverse methods are computationally expensive, which take days to weeks to complete for a single patient, inhibiting fast feedback for clinicians. Moreover, the current inverse methods have only been evaluated using synthetic data. In this study, we improved our recently developed multi-resolution direct search (MRDS) approach and the computation time cost was reduced to 1~2 hours. Using the improved MRDS approach, we estimated in vivo aortic tissue elastic properties of two ascending thoracic aortic aneurysm (ATAA) patients from pre-operative gated CT scans. For comparison, corresponding surgically-resected aortic wall tissue samples were obtained and subjected to planar biaxial tests. Relatively close matches were achieved for the in vivo-identified and ex vivo-fitted stress-stretch responses. It is hoped that further development of this inverse approach can enable an accurate identification of the in vivo material parameters from in vivo image data.
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Affiliation(s)
- Minliang Liu
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Liang Liang
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.,Department of Computer Science, University of Miami, Coral Gables, FL, USA
| | - Fatiesa Sulejmani
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Xiaoying Lou
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.,Emory University School of Medicine, Atlanta, GA, USA
| | - Glen Iannucci
- Emory University School of Medicine, Atlanta, GA, USA
| | - Edward Chen
- Emory University School of Medicine, Atlanta, GA, USA
| | | | - Wei Sun
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.
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8
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Salman HE, Yazicioglu Y. Computational analysis for non-invasive detection of stenosis in peripheral arteries. Med Eng Phys 2019; 70:39-50. [PMID: 31230999 DOI: 10.1016/j.medengphy.2019.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 05/24/2019] [Accepted: 06/10/2019] [Indexed: 01/28/2023]
Abstract
Atherosclerosis usually affects the entire cardiovascular system, including peripheral blood vessels. Peripheral arterial stenosis may indicate possible serious vascular disorders related to more vital organs. If peripheral arterial stenosis can be discerned at an early stage, it can serve as a warning sign to take precautions, such as using more invasive diagnostic techniques or adopting a healthier life style. In this study, peripheral regions, such as the thigh, upper arm, and neck are modelled considering stenosis of their major arteries. Stenosis generates a fluctuating pressure field on the arterial wall, which leads to vibration on the skin's surface. This stenosis-induced pressure field is modelled as a harmonic load and applied to the inner surface of the arterial structure. The vibration response on bare skin is computationally determined using the superposition of modal responses. Realistic geometries and hyperelastic material properties are used in modelling the layers of skin, fat, muscle, and bones. The results indicate that stenosis severities higher than 70% lead to a considerable increase in vibration-response amplitudes, especially at frequencies greater than 250 Hz. The detailed analysis of skin responses provides useful information to detect the stenosis location, where the sum of the vibration amplitudes attains its maximum value around the stenosis.
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Affiliation(s)
- Huseyin Enes Salman
- Qatar University, Biomedical Research Center, New Research Complex-Zone 5, P.O. Box 2713, Doha, Qatar; Department of Mechanical Engineering, Middle East Technical University, Dumlupinar Street No:1, 06800 Ankara, Turkey.
| | - Yigit Yazicioglu
- Department of Mechanical Engineering, Middle East Technical University, Dumlupinar Street No:1, 06800 Ankara, Turkey.
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9
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Liu M, Liang L, Sun W. Estimation of in vivo constitutive parameters of the aortic wall using a machine learning approach. COMPUTER METHODS IN APPLIED MECHANICS AND ENGINEERING 2019; 347:201-217. [PMID: 31160830 PMCID: PMC6544444 DOI: 10.1016/j.cma.2018.12.030] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The patient-specific biomechanical analysis of the aorta requires the quantification of the in vivo mechanical properties of individual patients. Current inverse approaches have attempted to estimate the nonlinear, anisotropic material parameters from in vivo image data using certain optimization schemes. However, since such inverse methods are dependent on iterative nonlinear optimization, these methods are highly computation-intensive. A potential paradigm-changing solution to the bottleneck associated with patient-specific computational modeling is to incorporate machine learning (ML) algorithms to expedite the procedure of in vivo material parameter identification. In this paper, we developed an ML-based approach to estimate the material parameters from three-dimensional aorta geometries obtained at two different blood pressure (i.e., systolic and diastolic) levels. The nonlinear relationship between the two loaded shapes and the constitutive parameters are established by an ML-model, which was trained and tested using finite element (FE) simulation datasets. Cross-validations were used to adjust the ML-model structure on a training/validation dataset. The accuracy of the ML-model was examined using a testing dataset.
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Affiliation(s)
- Minliang Liu
- Tissue Mechanics Laboratory The Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology and Emory University, Atlanta, GA
| | - Liang Liang
- Tissue Mechanics Laboratory The Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology and Emory University, Atlanta, GA
| | - Wei Sun
- Tissue Mechanics Laboratory The Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology and Emory University, Atlanta, GA
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Wang L, Zhu J, Samady H, Monoly D, Zheng J, Guo X, Maehara A, Yang C, Ma G, Mintz GS, Tang D. Effects of Residual Stress, Axial Stretch, and Circumferential Shrinkage on Coronary Plaque Stress and Strain Calculations: A Modeling Study Using IVUS-Based Near-Idealized Geometries. J Biomech Eng 2017; 139:2580756. [PMID: 27814429 DOI: 10.1115/1.4034867] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Indexed: 11/08/2022]
Abstract
Accurate stress and strain calculations are important for plaque progression and vulnerability assessment. Models based on in vivo data often need to form geometries with zero-stress/strain conditions. The goal of this paper is to use IVUS-based near-idealized geometries and introduce a three-step model construction process to include residual stress, axial shrinkage, and circumferential shrinkage and investigate their impacts on stress and strain calculations. In Vivo intravascular ultrasound (IVUS) data of human coronary were acquired for model construction. In Vivo IVUS movie data were acquired and used to determine patient-specific material parameter values. A three-step modeling procedure was used to make our model: (a) wrap the zero-stress vessel sector to obtain the residual stress; (b) stretch the vessel axially to its length in vivo; and (c) pressurize the vessel to recover its in vivo geometry. Eight models were constructed for our investigation. Wrapping led to reduced lumen and cap stress and increased out boundary stress. The model with axial stretch, circumferential shrink, but no wrapping overestimated lumen and cap stress by 182% and 448%, respectively. The model with wrapping, circumferential shrink, but no axial stretch predicted average lumen stress and cap stress as 0.76 kPa and -15 kPa. The same model with 10% axial stretch had 42.53 kPa lumen stress and 29.0 kPa cap stress, respectively. Skipping circumferential shrinkage leads to overexpansion of the vessel and incorrect stress/strain calculations. Vessel stiffness increase (100%) leads to 75% lumen stress increase and 102% cap stress increase.
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Affiliation(s)
- Liang Wang
- Mathematical Sciences Department, Worcester Polytechnic Institute, Worcester, MA 01609
| | - Jian Zhu
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing 210009, China
| | - Habib Samady
- Department of Medicine, Emory University School of Medicine, Atlanta, GA 30307
| | - David Monoly
- Department of Medicine, Emory University School of Medicine, Atlanta, GA 30307
| | - Jie Zheng
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO 63110
| | - Xiaoya Guo
- Department of Mathematics, Southeast University, Nanjing 210096, China
| | - Akiko Maehara
- The Cardiovascular Research Foundation, Columbia University, New York, NY 10022
| | - Chun Yang
- Network Technology Research Institute, China United Network Communications Co., Ltd., Beijing 100140, China
| | - Genshan Ma
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing 210009, China
| | - Gary S Mintz
- The Cardiovascular Research Foundation, Columbia University, New York, NY 10022
| | - Dalin Tang
- Mathematical Sciences Department, Worcester Polytechnic Institute, Worcester, MA 01609;Department of Mathematics, Southeast University, Nanjing 210096, China
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11
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Liu M, Liang L, Sun W. Estimation of in vivo mechanical properties of the aortic wall: A multi-resolution direct search approach. J Mech Behav Biomed Mater 2017; 77:649-659. [PMID: 29101897 DOI: 10.1016/j.jmbbm.2017.10.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 10/02/2017] [Accepted: 10/16/2017] [Indexed: 11/18/2022]
Abstract
The patient-specific biomechanical analysis of the aorta requires in vivo mechanical properties of individual patients. Existing approaches for estimating in vivo material properties often demand high computational cost and mesh correspondence of the aortic wall between different cardiac phases. In this paper, we propose a novel multi-resolution direct search (MRDS) approach for estimation of the nonlinear, anisotropic constitutive parameters of the aortic wall. Based on the finite element (FE) updating scheme, the MRDS approach consists of the following three steps: (1) representing constitutive parameters with multiple resolutions using principal component analysis (PCA), (2) building links between the discretized PCA spaces at different resolutions, and (3) searching the PCA spaces in a 'coarse to fine' fashion following the links. The estimation of material parameters is achieved by minimizing a node-to-surface error function, which does not need mesh correspondence. The method was validated through a numerical experiment by using the in vivo data from a patient with ascending thoracic aortic aneurysm (ATAA), the results show that the number of FE iterations was significantly reduced compared to previous methods. The approach was also applied to the in vivo CT data from an aged healthy human patient, and using the estimated material parameters, the FE-computed geometry was well matched with the image-derived geometry. This novel MRDS approach may facilitate the personalized biomechanical analysis of aortic tissues, such as the rupture risk analysis of ATAA, which requires fast feedback to clinicians.
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MESH Headings
- Aged
- Algorithms
- Anisotropy
- Aorta/diagnostic imaging
- Aorta/physiology
- Aorta, Abdominal/diagnostic imaging
- Aorta, Abdominal/physiology
- Aorta, Thoracic/diagnostic imaging
- Aorta, Thoracic/physiology
- Aortic Aneurysm, Thoracic/diagnostic imaging
- Aortic Aneurysm, Thoracic/pathology
- Blood Pressure
- Computer Simulation
- Elasticity
- Endothelium, Vascular/pathology
- Finite Element Analysis
- Humans
- Models, Cardiovascular
- Principal Component Analysis
- Software
- Stress, Mechanical
- Tomography, X-Ray Computed
- Ultrasonography
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Affiliation(s)
- Minliang Liu
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Liang Liang
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Wei Sun
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States.
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12
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MRI-based patient-specific human carotid atherosclerotic vessel material property variations in patients, vessel location and long-term follow up. PLoS One 2017; 12:e0180829. [PMID: 28715441 PMCID: PMC5513425 DOI: 10.1371/journal.pone.0180829] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 06/16/2017] [Indexed: 12/15/2022] Open
Abstract
Background Image-based computational models are widely used to determine atherosclerotic plaque stress/strain conditions and investigate their association with plaque progression and rupture. However, patient-specific vessel material properties are in general lacking in those models, limiting the accuracy of their stress/strain measurements. A noninvasive approach of combining in vivo 3D multi-contrast and Cine magnetic resonance imaging (MRI) and computational modeling was introduced to quantify patient-specific carotid plaque material properties for potential plaque model improvements. Vessel material property variation in patients, along vessel segment, and between baseline and follow up were investigated. Methods In vivo 3D multi-contrast and Cine MRI carotid plaque data were acquired from 8 patients with follow-up (18 months) with written informed consent obtained. 3D thin-layer models and an established iterative procedure were used to determine parameter values of the Mooney-Rivlin models for the 81slices from 16 plaque samples. Effective Young’s Modulus (YM) values were calculated for comparison and analysis. Results Average Effective Young’s Modulus (YM) and circumferential shrinkage rate (C-Shrink) value of the 81 slices was 411kPa and 5.62%, respectively. Slice YM value varied from 70 kPa (softest) to 1284 kPa (stiffest), a 1734% difference. Average slice YM values by vessel varied from 109 kPa (softest) to 922 kPa (stiffest), a 746% difference. Location-wise, the maximum slice YM variation rate within a vessel was 311% (149 kPa vs. 613 kPa). The average slice YM variation rate for the 16 vessels was 134%. The average variation of YM values for all patients from baseline to follow up was 61.0%. The range of the variation of YM values was [-28.4%, 215%]. For plaque progression study, YM at follow-up showed negative correlation with plaque progression measured by wall thickness increase (WTI) (r = -0.7764, p = 0.0235). Wall thickness at baseline correlated with WTI negatively, with r = -0.5253 (p = 0.1813). Plaque burden at baseline correlated with YM change between baseline and follow-up, with r = 0.5939 (p = 0.1205). Conclusion In vivo carotid vessel material properties have large variations from patient to patient, along the diseased segment within a patient, and with time. The use of patient-specific, location specific and time-specific material properties in plaque models could potentially improve the accuracy of model stress/strain calculations.
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Guo X, Zhu J, Maehara A, Monoly D, Samady H, Wang L, Billiar KL, Zheng J, Yang C, Mintz GS, Giddens DP, Tang D. Quantify patient-specific coronary material property and its impact on stress/strain calculations using in vivo IVUS data and 3D FSI models: a pilot study. Biomech Model Mechanobiol 2016; 16:333-344. [PMID: 27561649 DOI: 10.1007/s10237-016-0820-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 08/17/2016] [Indexed: 01/09/2023]
Abstract
Computational models have been used to calculate plaque stress and strain for plaque progression and rupture investigations. An intravascular ultrasound (IVUS)-based modeling approach is proposed to quantify in vivo vessel material properties for more accurate stress/strain calculations. In vivo Cine IVUS and VH-IVUS coronary plaque data were acquired from one patient with informed consent obtained. Cine IVUS data and 3D thin-slice models with axial stretch were used to determine patient-specific vessel material properties. Twenty full 3D fluid-structure interaction models with ex vivo and in vivo material properties and various axial and circumferential shrink combinations were constructed to investigate the material stiffness impact on stress/strain calculations. The approximate circumferential Young's modulus over stretch ratio interval [1.0, 1.1] for an ex vivo human plaque sample and two slices (S6 and S18) from our IVUS data were 1631, 641, and 346 kPa, respectively. Average lumen stress/strain values from models using ex vivo, S6 and S18 materials with 5 % axial shrink and proper circumferential shrink were 72.76, 81.37, 101.84 kPa and 0.0668, 0.1046, and 0.1489, respectively. The average cap strain values from S18 material models were 150-180 % higher than those from the ex vivo material models. The corresponding percentages for the average cap stress values were 50-75 %. Dropping axial and circumferential shrink consideration led to stress and strain over-estimations. In vivo vessel material properties may be considerably softer than those from ex vivo data. Material stiffness variations may cause 50-75 % stress and 150-180 % strain variations.
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Affiliation(s)
- Xiaoya Guo
- Department of Mathematics, Southeast University, Nanjing, 210096, China
| | - Jian Zhu
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, 210009, China
| | - Akiko Maehara
- The Cardiovascular Research Foundation, Columbia University, New York, NY, 10022, USA
| | - David Monoly
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30307, USA
| | - Habib Samady
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30307, USA
| | - Liang Wang
- Mathematical Sciences Department, Worcester Polytechnic Institute, Worcester, MA, 01609, USA
| | - Kristen L Billiar
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, 01609, USA
| | - Jie Zheng
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, 63110, USA
| | - Chun Yang
- Network Technology Research Institute, China United Network Communications Co., Ltd., Beijing, China
| | - Gary S Mintz
- The Cardiovascular Research Foundation, Columbia University, New York, NY, 10022, USA
| | - Don P Giddens
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30307, USA.,The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Dalin Tang
- Department of Mathematics, Southeast University, Nanjing, 210096, China. .,Mathematical Sciences Department, Worcester Polytechnic Institute, Worcester, MA, 01609, USA.
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Liu H, Sun W. Computational efficiency of numerical approximations of tangent moduli for finite element implementation of a fiber-reinforced hyperelastic material model. Comput Methods Biomech Biomed Engin 2015; 19:1171-80. [PMID: 26692168 DOI: 10.1080/10255842.2015.1118467] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In this study, we evaluated computational efficiency of finite element (FE) simulations when a numerical approximation method was used to obtain the tangent moduli. A fiber-reinforced hyperelastic material model for nearly incompressible soft tissues was implemented for 3D solid elements using both the approximation method and the closed-form analytical method, and validated by comparing the components of the tangent modulus tensor (also referred to as the material Jacobian) between the two methods. The computational efficiency of the approximation method was evaluated with different perturbation parameters and approximation schemes, and quantified by the number of iteration steps and CPU time required to complete these simulations. From the simulation results, it can be seen that the overall accuracy of the approximation method is improved by adopting the central difference approximation scheme compared to the forward Euler approximation scheme. For small-scale simulations with about 10,000 DOFs, the approximation schemes could reduce the CPU time substantially compared to the closed-form solution, due to the fact that fewer calculation steps are needed at each integration point. However, for a large-scale simulation with about 300,000 DOFs, the advantages of the approximation schemes diminish because the factorization of the stiffness matrix will dominate the solution time. Overall, as it is material model independent, the approximation method simplifies the FE implementation of a complex constitutive model with comparable accuracy and computational efficiency to the closed-form solution, which makes it attractive in FE simulations with complex material models.
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Affiliation(s)
- Haofei Liu
- a Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering , Georgia Institute of Technology, Atlanta , GA , USA
| | - Wei Sun
- a Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering , Georgia Institute of Technology, Atlanta , GA , USA
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Akyildiz AC, Hansen HHG, Nieuwstadt HA, Speelman L, De Korte CL, van der Steen AFW, Gijsen FJH. A Framework for Local Mechanical Characterization of Atherosclerotic Plaques: Combination of Ultrasound Displacement Imaging and Inverse Finite Element Analysis. Ann Biomed Eng 2015; 44:968-79. [PMID: 26399991 PMCID: PMC4826666 DOI: 10.1007/s10439-015-1410-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 07/24/2015] [Indexed: 02/07/2023]
Abstract
Biomechanical models have the potential to predict plaque rupture. For reliable models, correct material properties of plaque components are a prerequisite. This study presents a new technique, where high resolution ultrasound displacement imaging and inverse finite element (FE) modeling is combined, to estimate material properties of plaque components. Iliac arteries with plaques were excised from 6 atherosclerotic pigs and subjected to an inflation test with pressures ranging from 10 to 120 mmHg. The arteries were imaged with high frequency 40 MHz ultrasound. Deformation maps of the plaques were reconstructed by cross correlation of the ultrasound radiofrequency data. Subsequently, the arteries were perfusion fixed for histology and structural components were identified. The histological data were registered to the ultrasound data to construct FE model of the plaques. Material properties of the arterial wall and the intima of the atherosclerotic plaques were estimated using a grid search method. The computed displacement fields showed good agreement with the measured displacement fields, implying that the FE models were able to capture local inhomogeneities within the plaque. On average, nonlinear stiffening of both the wall and the intima was observed, and the wall of the atheroslcerotic porcine iliac arteries was markedly stiffer than the intima (877 ± 459 vs. 100 ± 68 kPa at 100 mmHg). The large spread in the data further illustrates the wide variation of the material properties. We demonstrated the feasibility of a mixed experimental–numerical framework to determine the material properties of arterial wall and intima of atherosclerotic plaques from intact arteries, and concluded that, due to the observed variation, plaque specific properties are required for accurate stress simulations.
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Affiliation(s)
- Ali C. Akyildiz
- />Biomechanics Lab, Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
- />Department of Mechanical, Aerospace and Nuclear Engineering, Rensselaer Polytechnic Institute, Troy, USA
| | - Hendrik H. G. Hansen
- />Medical UltraSound Imaging Center (MUSIC), Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Harm A. Nieuwstadt
- />Biomechanics Lab, Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Lambert Speelman
- />Biomechanics Lab, Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Chris L. De Korte
- />Medical UltraSound Imaging Center (MUSIC), Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Antonius F. W. van der Steen
- />Biomechanics Lab, Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
- />Department of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - Frank J. H. Gijsen
- />Biomechanics Lab, Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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Boesen ME, Singh D, Menon BK, Frayne R. A systematic literature review of the effect of carotid atherosclerosis on local vessel stiffness and elasticity. Atherosclerosis 2015; 243:211-22. [PMID: 26402140 DOI: 10.1016/j.atherosclerosis.2015.09.008] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 08/14/2015] [Accepted: 09/02/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This systematic literature review sought to determine the effects of carotid atherosclerotic plaque on local arterial stiffness. METHODS MedLine, EMBASE, and grey literature were searched with the following term: ("atherosclerosis" or "carotid atherosclerosis" or "carotid artery disease" or "carotid plaque") AND ("distensibility" or "elasticity" or "stiffness" or "compliance") NOT ("pulse wave velocity" or "PWV" or "carotid-ankle" or "ankle-brachial" or "augmentation index" or "cardio-ankle" or "CAVI" or "flow mediated dilation" or "FMD"). Results were restricted to English language articles reporting local arterial stiffness in human subjects with carotid atherosclerosis. RESULTS Of the 1466 search results, 1085 abstracts were screened and 191 full-text articles were reviewed for relevance. The results of the 50 studies that assessed some measure of carotid arterial elasticity or stiffness in patients with carotid plaque were synthesized and reviewed. DISCUSSION A number of different measures of carotid elasticity were found in the literature. Regardless of which metric was used, the majority of studies found increased carotid stiffness (or decreased distensibility) to be associated with carotid plaque presence, the degree of atherosclerosis, and incident stroke. CONCLUSION Carotid artery mechanics are influenced by the presence of atherosclerotic plaque. The clinical applicability of carotid elasticity measures may be limited by the lack of reference values and standardized techniques.
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Affiliation(s)
- Mari E Boesen
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, Canada; Seaman Family Centre, Foothills Medical Centre, Alberta Health Services, Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Departments of Radiology and Clinical Neurosciences, University of Calgary, Calgary, Canada
| | - Dilip Singh
- Seaman Family Centre, Foothills Medical Centre, Alberta Health Services, Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Departments of Radiology and Clinical Neurosciences, University of Calgary, Calgary, Canada; Calgary Stroke Program, Foothills Medical Centre, Alberta Health Services, Calgary, Canada
| | - Bijoy K Menon
- Seaman Family Centre, Foothills Medical Centre, Alberta Health Services, Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Departments of Radiology and Clinical Neurosciences, University of Calgary, Calgary, Canada; Calgary Stroke Program, Foothills Medical Centre, Alberta Health Services, Calgary, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Richard Frayne
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, Canada; Seaman Family Centre, Foothills Medical Centre, Alberta Health Services, Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Departments of Radiology and Clinical Neurosciences, University of Calgary, Calgary, Canada.
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17
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Yuan J, Teng Z, Feng J, Zhang Y, Brown AJ, Gillard JH, Jing Z, Lu Q. Influence of material property variability on the mechanical behaviour of carotid atherosclerotic plaques: a 3D fluid-structure interaction analysis. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2015; 31:e02722. [PMID: 25940741 PMCID: PMC4528233 DOI: 10.1002/cnm.2722] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 03/10/2015] [Accepted: 04/27/2015] [Indexed: 06/04/2023]
Abstract
Mechanical analysis has been shown to be complementary to luminal stenosis in assessing atherosclerotic plaque vulnerability. However, patient-specific material properties are not available and the effect of material properties variability has not been fully quantified. Media and fibrous cap (FC) strips from carotid endarterectomy samples were classified into hard, intermediate and soft according to their incremental Young's modulus. Lipid and intraplaque haemorrhage/thrombus strips were classified as hard and soft. Idealised geometry-based 3D fluid-structure interaction analyses were performed to assess the impact of material property variability in predicting maximum principal stress (Stress-P1 ) and stretch (Stretch-P1 ). When FC was thick (1000 or 600 µm), Stress-P1 at the shoulder was insensitive to changes in material stiffness, whereas Stress-P1 at mid FC changed significantly. When FC was thin (200 or 65 µm), high stress concentrations shifted from the shoulder region to mid FC, and Stress-P1 became increasingly sensitive to changes in material properties, in particular at mid FC. Regardless of FC thickness, Stretch-P1 at these locations was sensitive to changes in material properties. Variability in tissue material properties influences both the location and overall stress/stretch value. This variability needs to be accounted for when interpreting the results of mechanical modelling.
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Affiliation(s)
- Jianmin Yuan
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Zhongzhao Teng
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
- Department of Engineering, University of Cambridge, Cambridge, CB2 1PZ, UK
| | - Jiaxuan Feng
- Department of Vascular Surgery, Changhai Hospital, Changhai Road, Shanghai, 200433, China
| | - Yongxue Zhang
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
- Department of Vascular Surgery, Changhai Hospital, Changhai Road, Shanghai, 200433, China
| | - Adam J Brown
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, CB2 1TN, UK
| | - Jonathan H Gillard
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Zaiping Jing
- Department of Vascular Surgery, Changhai Hospital, Changhai Road, Shanghai, 200433, China
| | - Qingsheng Lu
- Department of Vascular Surgery, Changhai Hospital, Changhai Road, Shanghai, 200433, China
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18
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Akyildiz AC, Speelman L, Gijsen FJ. Mechanical properties of human atherosclerotic intima tissue. J Biomech 2014; 47:773-83. [DOI: 10.1016/j.jbiomech.2014.01.019] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2014] [Indexed: 12/13/2022]
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19
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Tang D, Kamm RD, Yang C, Zheng J, Canton G, Bach R, Huang X, Hatsukami TS, Zhu J, Ma G, Maehara A, Mintz GS, Yuan C. Image-based modeling for better understanding and assessment of atherosclerotic plaque progression and vulnerability: data, modeling, validation, uncertainty and predictions. J Biomech 2014; 47:834-46. [PMID: 24480706 DOI: 10.1016/j.jbiomech.2014.01.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2014] [Indexed: 01/30/2023]
Abstract
Medical imaging and image-based modeling have made considerable progress in recent years in identifying atherosclerotic plaque morphological and mechanical risk factors which may be used in developing improved patient screening strategies. However, a clear understanding is needed about what we have achieved and what is really needed to translate research to actual clinical practices and bring benefits to public health. Lack of in vivo data and clinical events to serve as gold standard to validate model predictions is a severe limitation. While this perspective paper provides a review of the key steps and findings of our group in image-based models for human carotid and coronary plaques and a limited review of related work by other groups, we also focus on grand challenges and uncertainties facing the researchers in the field to develop more accurate and predictive patient screening tools.
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Affiliation(s)
- Dalin Tang
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China; Worcester Polytechnic Institute, Worcester, MA 01609, USA.
| | - Roger D Kamm
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Chun Yang
- Worcester Polytechnic Institute, Worcester, MA 01609, USA; China Information Tech. Designing & Consulting Institute Co., Ltd., Beijing 100048, China
| | - Jie Zheng
- Mallinkcrodt Inst. of Radiology, Washington University, St. Louis, MO 63110, USA
| | - Gador Canton
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Richard Bach
- Cardiovascular Division, Washington University, St. Louis, MO 63110, USA
| | - Xueying Huang
- School of Mathematical Sciences, Xiamen University, Xiamen, Fujian 361005, China
| | - Thomas S Hatsukami
- Division of Vascular Surgery, University of Washington, Seattle, WA, 98195, USA
| | - Jian Zhu
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing 210009, China
| | - Genshan Ma
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing 210009, China
| | | | - Gary S Mintz
- The Cardiovascular Research Foundation, NY, NY, USA
| | - Chun Yuan
- Deparment of Radiology, University of Washington, Seattle, WA 98195, USA
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Teng Z, Sadat U, Brown AJ, Gillard JH. Plaque hemorrhage in carotid artery disease: pathogenesis, clinical and biomechanical considerations. J Biomech 2014; 47:847-58. [PMID: 24485514 PMCID: PMC3994507 DOI: 10.1016/j.jbiomech.2014.01.013] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2014] [Indexed: 12/21/2022]
Abstract
Stroke remains the most prevalent disabling illness today, with internal carotid artery luminal stenosis due to atheroma formation responsible for the majority of ischemic cerebrovascular events. Severity of luminal stenosis continues to dictate both patient risk stratification and the likelihood of surgical intervention. But there is growing evidence to suggest that plaque morphology may help improve pre-existing risk stratification criteria. Plaque components such a fibrous tissue, lipid rich necrotic core and calcium have been well investigated but plaque hemorrhage (PH) has been somewhat overlooked. In this review we discuss the pathogenesis of PH, its role in dictating plaque vulnerability, PH imaging techniques, marterial properties of atherosclerotic tissues, in particular, those obtained based on in vivo measurements and effect of PH in modulating local biomechanics.
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Affiliation(s)
- Zhongzhao Teng
- University Department of Radiology, University of Cambridge, UK; Department of Engineering, University of Cambridge, UK.
| | - Umar Sadat
- Department of Surgery, Cambridge University Hospitals NHS Foundation Trust, UK
| | - Adam J Brown
- Department of Cardiovascular Medicine, University of Cambridge, UK
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Franquet A, Avril S, Le Riche R, Badel P, Schneider F, Boissier C, Favre JP. Identification of the in vivo elastic properties of common carotid arteries from MRI: A study on subjects with and without atherosclerosis. J Mech Behav Biomed Mater 2013; 27:184-203. [DOI: 10.1016/j.jmbbm.2013.03.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 03/11/2013] [Accepted: 03/22/2013] [Indexed: 11/28/2022]
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22
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Pei X, Wu B, Li ZY. Fatigue Crack Propagation Analysis of Plaque Rupture. J Biomech Eng 2013; 135:101003-9. [PMID: 23897295 DOI: 10.1115/1.4025106] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Accepted: 07/03/2013] [Indexed: 11/08/2022]
Abstract
Rupture of atheromatous plaque is the major cause of stroke or heart attack. Considering that the cardiovascular system is a classic fatigue environment, plaque rupture was treated as a chronic fatigue crack growth process in this study. Fracture mechanics theory was introduced to describe the stress status at the crack tip and Paris' law was used to calculate the crack growth rate. The effect of anatomical variation of an idealized plaque cross-section model was investigated. The crack initiation was considered to be either at the maximum circumferential stress location or at any other possible locations around the lumen. Although the crack automatically initialized at the maximum circumferential stress location usually propagated faster than others, it was not necessarily the most critical location where the fatigue life reached its minimum. We found that the fatigue life was minimum for cracks initialized in the following three regions: the midcap zone, the shoulder zone, and the backside zone. The anatomical variation has a significant influence on the fatigue life. Either a decrease in cap thickness or an increase in lipid pool size resulted in a significant decrease in fatigue life. Comparing to the previously used stress analysis, this fatigue model provides some possible explanations of plaque rupture at a low stress level in a pulsatile cardiovascular environment, and the method proposed here may be useful for further investigation of the mechanism of plaque rupture based on in vivo patient data.
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Affiliation(s)
- Xuan Pei
- School of Biological Science and
Medical Engineering, Southeast University, Nanjing 210096, China
| | - Baijian Wu
- Department of Engineering Mechanics, Southeast University, Nanjing 210096, China
| | - Zhi-Yong Li
- School of Biological Science and
Medical Engineering, Southeast University, Nanjing 210096, China
- University Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK e-mail:
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2012 Editors' Choice Papers. J Biomech Eng 2013; 135:020207. [DOI: 10.1115/1.4023509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Tang D, Yang C, Zheng J, Canton G, Bach RG, Hatsukami TS, Wang L, Yang D, Billiar KL, Yuan C. Image-based modeling and precision medicine: patient-specific carotid and coronary plaque assessment and predictions. IEEE Trans Biomed Eng 2013; 60:643-51. [PMID: 23362245 DOI: 10.1109/tbme.2013.2242891] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Atherosclerotic plaques may rupture without warning and cause acute cardiovascular events such as heart attack and stroke. Current clinical screening tools are insufficient to identify those patients with risks early and prevent the adverse events from happening. Medical imaging and image-based modeling have made considerable progress in recent years in identifying plaque morphological and mechanical risk factors which may be used in developing improved patient screening strategies. The key steps and factors in image-based models for human carotid and coronary plaques were illustrated, as well as grand challenges facing the researchers in the field to develop more accurate screening tools.
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Affiliation(s)
- Dalin Tang
- Southeast University, Nanjing 210018, China.
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