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Wang L, Jiang X, Zhang K, Chen K, Wu P, Li X. A hemodynamic analysis of energy loss in abdominal aortic aneurysm using three-dimension idealized model. Front Physiol 2024; 15:1330848. [PMID: 38312315 PMCID: PMC10834748 DOI: 10.3389/fphys.2024.1330848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/05/2024] [Indexed: 02/06/2024] Open
Abstract
Objective: The aim of this study is to perform specific hemodynamic simulations of idealized abdominal aortic aneurysm (AAA) models with different diameters, curvatures and eccentricities and evaluate the risk of thrombosis and aneurysm rupture. Methods: Nine idealized AAA models with different diameters (3 cm or 5 cm), curvatures (0° or 30°) and eccentricities (centered on or tangent to the aorta), as well as a normal model, were constructed using commercial software (Solidworks; Dassault Systemes S.A, Suresnes, France). Hemodynamic simulations were conducted with the same time-varying volumetric flow rate extracted from the literature and 3-element Windkessel model (3 EWM) boundary conditions were applied at the aortic outlet. Several hemodynamic parameters such as time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT), endothelial cell activation potential (ECAP) and energy loss (EL) were obtained to evaluate the risk of thrombosis and aneurysm rupture under different conditions. Results: Simulation results showed that the proportion of low TAWSS region and high OSI region increases with the rising of aneurysm diameter, whereas decreases in the curvature and eccentric models of the corresponding diameters, with the 5 cm normal model having the largest low TAWSS region (68.5%) and high OSI region (40%). Similar to the results of TAWSS and OSI, the high ECAP and high RRT areas were largest in the 5 cm normal model, with the highest wall-averaged value (RRT: 5.18 s, ECAP: 4.36 Pa-1). Differently, the increase of aneurysm diameter, curvature, and eccentricity all lead to the increase of mean flow EL and turbulent EL, such that the highest mean flow EL (0.82 W · 10-3) and turbulent EL (1.72 W · 10-3) were observed in the eccentric 5 cm model with the bending angle of 30°. Conclusion: Collectively, increases in aneurysm diameter, curvature, and eccentricity all raise mean flow EL and turbulent flow EL, which may aggravate the damage and disturbance of flow in aneurysm. In addition, it can be inferred by conventional parameters (TAWSS, OSI, RRT and ECAP) that the increase of aneurysm diameter may raise the risk of thrombosis, whereas the curvature and eccentricity appeared to have a protective effect against thrombosis.
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Affiliation(s)
- Lulu Wang
- Department of Vascular Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xudong Jiang
- Department of Vascular Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Kejia Zhang
- Artificial Organ Technology Laboratory, School of Mechanical and Electrical Engineering, Soochow University, Suzhou, China
| | - Kai Chen
- Artificial Organ Technology Laboratory, School of Mechanical and Electrical Engineering, Soochow University, Suzhou, China
| | - Peng Wu
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing, China
| | - Xiaoqiang Li
- Department of Vascular Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
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Zhao X, Garg P, Assadi H, Tan RS, Chai P, Yeo TJ, Matthews G, Mehmood Z, Leng S, Bryant JA, Teo LLS, Ong CC, Yip JW, Tan JL, van der Geest RJ, Zhong L. Aortic flow is associated with aging and exercise capacity. EUROPEAN HEART JOURNAL OPEN 2023; 3:oead079. [PMID: 37635784 PMCID: PMC10460199 DOI: 10.1093/ehjopen/oead079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/02/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023]
Abstract
Aims Increased blood flow eccentricity in the aorta has been associated with aortic (AO) pathology, however, its association with exercise capacity has not been investigated. This study aimed to assess the relationships between flow eccentricity parameters derived from 2-dimensional (2D) phase-contrast (PC) cardiovascular magnetic resonance (CMR) imaging and aging and cardiopulmonary exercise test (CPET) in a cohort of healthy subjects. Methods and Results One hundred and sixty-nine healthy subjects (age 44 ± 13 years, M/F: 96/73) free of cardiovascular disease were recruited in a prospective study (NCT03217240) and underwent CMR, including 2D PC at an orthogonal plane just above the sinotubular junction, and CPET (cycle ergometer) within one week. The following AO flow parameters were derived: AO forward and backward flow indexed to body surface area (FFi, BFi), average flow displacement during systole (FDsavg), late systole (FDlsavg), diastole (FDdavg), systolic retrograde flow (SRF), systolic flow reversal ratio (sFRR), and pulse wave velocity (PWV). Exercise capacity was assessed by peak oxygen uptake (PVO2) from CPET. The mean values of FDsavg, FDlsavg, FDdavg, SRF, sFRR, and PWV were 17 ± 6%, 19 ± 8%, 29 ± 7%, 4.4 ± 4.2 mL, 5.9 ± 5.1%, and 4.3 ± 1.6 m/s, respectively. They all increased with age (r = 0.623, 0.628, 0.353, 0.590, 0.649, 0.598, all P < 0.0001), and decreased with PVO2 (r = -0.302, -0.270, -0.253, -0.149, -0.219, -0.161, all P < 0.05). A stepwise multivariable linear regression analysis using left ventricular ejection fraction (LVEF), FFi, and FDsavg showed an area under the curve of 0.769 in differentiating healthy subjects with high-risk exercise capacity (PVO2 ≤ 14 mL/kg/min). Conclusion AO flow haemodynamics change with aging and predict exercise capacity. Registration NCT03217240.
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Affiliation(s)
- Xiaodan Zhao
- National Heart Research Institute Singapore, National Heart Centre
Singapore, 5 Hospital Drive, 169609 Singapore,
Singapore
| | - Pankaj Garg
- Cardiology Department, Norfolk and Norwich University Hospitals NHS
Foundation Trust,Colney Ln, Norwich, NR4 7UY Norfolk, UK
- Department of Cardiovascular and Metabolic Health, Norwich Medical School,
University of East Anglia, Rosalind Franklin Rd, Norwich, NR4
7UQ Norfolk, UK
| | - Hosamadin Assadi
- Cardiology Department, Norfolk and Norwich University Hospitals NHS
Foundation Trust,Colney Ln, Norwich, NR4 7UY Norfolk, UK
- Department of Cardiovascular and Metabolic Health, Norwich Medical School,
University of East Anglia, Rosalind Franklin Rd, Norwich, NR4
7UQ Norfolk, UK
| | - Ru-San Tan
- National Heart Research Institute Singapore, National Heart Centre
Singapore, 5 Hospital Drive, 169609 Singapore,
Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road,
169857 Singapore, Singapore
| | - Ping Chai
- Department of Diagnostic Imaging, National University Hospital
Singapore, 5 Lower Kent Ridge Road, 119074
Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of
Singapore, 10 Medical Drive, 117597 Singapore,
Singapore
| | - Tee Joo Yeo
- Department of Diagnostic Imaging, National University Hospital
Singapore, 5 Lower Kent Ridge Road, 119074
Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of
Singapore, 10 Medical Drive, 117597 Singapore,
Singapore
| | - Gareth Matthews
- Cardiology Department, Norfolk and Norwich University Hospitals NHS
Foundation Trust,Colney Ln, Norwich, NR4 7UY Norfolk, UK
- Department of Cardiovascular and Metabolic Health, Norwich Medical School,
University of East Anglia, Rosalind Franklin Rd, Norwich, NR4
7UQ Norfolk, UK
| | - Zia Mehmood
- Cardiology Department, Norfolk and Norwich University Hospitals NHS
Foundation Trust,Colney Ln, Norwich, NR4 7UY Norfolk, UK
- Department of Cardiovascular and Metabolic Health, Norwich Medical School,
University of East Anglia, Rosalind Franklin Rd, Norwich, NR4
7UQ Norfolk, UK
| | - Shuang Leng
- National Heart Research Institute Singapore, National Heart Centre
Singapore, 5 Hospital Drive, 169609 Singapore,
Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road,
169857 Singapore, Singapore
| | - Jennifer Ann Bryant
- National Heart Research Institute Singapore, National Heart Centre
Singapore, 5 Hospital Drive, 169609 Singapore,
Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road,
169857 Singapore, Singapore
| | - Lynette L S Teo
- Department of Diagnostic Imaging, National University Hospital
Singapore, 5 Lower Kent Ridge Road, 119074
Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of
Singapore, 10 Medical Drive, 117597 Singapore,
Singapore
| | - Ching Ching Ong
- Department of Diagnostic Imaging, National University Hospital
Singapore, 5 Lower Kent Ridge Road, 119074
Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of
Singapore, 10 Medical Drive, 117597 Singapore,
Singapore
| | - James W Yip
- Department of Diagnostic Imaging, National University Hospital
Singapore, 5 Lower Kent Ridge Road, 119074
Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of
Singapore, 10 Medical Drive, 117597 Singapore,
Singapore
| | - Ju Le Tan
- National Heart Research Institute Singapore, National Heart Centre
Singapore, 5 Hospital Drive, 169609 Singapore,
Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road,
169857 Singapore, Singapore
| | - Rob J van der Geest
- Department of Radiology, Leiden University Medical Center,
Albinusdreef 2, 2333 ZA Leiden, TheNetherlands
| | - Liang Zhong
- National Heart Research Institute Singapore, National Heart Centre
Singapore, 5 Hospital Drive, 169609 Singapore,
Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road,
169857 Singapore, Singapore
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