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Mao B, Zhao Z, Wei M, Liu X, Zhao R, Zhang W, Duan M. Study on the related factors of TCM constitution and hemodynamics in patients with coronary heart disease. Front Cardiovasc Med 2024; 11:1383082. [PMID: 38529331 PMCID: PMC10961412 DOI: 10.3389/fcvm.2024.1383082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/01/2024] [Indexed: 03/27/2024] Open
Abstract
Background The concepts of "individualization" and "preventive treatment" should be incorporated into the precise diagnosis and treatment of coronary heart disease (CHD). Both hemodynamics and Chinese medicine constitution studies align with these two concepts. Methods This study utilized data from 81 patients with CHD, including 12 patients with balanced constitution (BC), 20 patients with blood stasis constitution (BSC), 17 patients with phlegm-dampness constitution (PDC), 15 patients with qi-deficiency constitution (QDC), and 17 patients with other constitutions. Clinical data provided information on the patients' blood property, heart function, degree of coronary stenosis, coronary hemodynamics, and so on. These parameters were compared between patients with balanced constitution vs. biased constitutions as well as between those with blood stasis constitution, phlegm-dampness constitution, and qi-deficiency constitution. Results Compared to biased constitution (BC), patients with balanced constitution exhibited lower total cholesterol (TC) levels and low-density lipoprotein (LDL) levels. Additionally, they had lighter stenosis degrees in the Left anterior descending branch (LAD) and Left circumflex branch (LCX) branches. The hemodynamic condition of the LAD and LCX was better for those with balanced constitution; however there was no difference in heart function. Among the groups categorized by blood stasis, phlegm dampness or qi deficiency constituions, patients classified under phlegm dampness had higher levels of LDL compared to those classified under blood stasis or qi deficiency, while patients classified under qi deficiency had higher levels of blood glucose compared to those classified under blood stasis or phlegm dampness. Hemodynamic environments also differed among the LAD and LCX for each group but there were no significant differences observed in heart function or degree of coronary stenosis among these three groups. Conclusion The balanced constitution demonstrates superior blood property, degree of coronary artery stenosis, and coronary hemodynamics compared to the biased constitution. Furthermore, among the three constitutions with CHD, variations in blood property and certain hemodynamic parameters are observed. These findings emphasize the significant clinical value of incorporating physical factors into the diagnosis and treatment of patients with CHD.
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Affiliation(s)
- Boyan Mao
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Zhou Zhao
- Cardiac Surgery Department, Peking University People’s Hospital, Beijing, China
| | - Minghui Wei
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Xinzhu Liu
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Ruoqi Zhao
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | | | - Mengyao Duan
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Kuyanova J, Dubovoi A, Fomichev A, Khelimskii D, Parshin D. Hemodynamics of vascular shunts: trends, challenges, and prospects. Biophys Rev 2023; 15:1287-1301. [PMID: 37975016 PMCID: PMC10643646 DOI: 10.1007/s12551-023-01149-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/12/2023] [Indexed: 11/19/2023] Open
Abstract
Vascular bypass surgery takes a significant place in the treatment of vascular disease. According to various assessments, this type of surgery is associated with almost 20 % of all vascular surgery episodes (up to 23 % according to the Federal Neurosurgical Center of Novosibirsk). Even though the problem of using of vascular grafts is obvious and natural, many problems associated with them are not still elucidated. From the mechanics' point of view, a vascular bypass is a converging or diverging tee, and the functioning of such structures still does not have strict mathematical formulations and proofs in the general case, which forces many researchers to solve specific engineering problems associated with shunting. Mathematical modeling, which is the gold standard for virtual simulations of industrial and medical problems, faces great difficulties and limitations in solving problems for vascular bypasses. Complications in the treatment of the vascular disease may follow the difficulties in mathematical modeling, and the price can be a cardiac arrest or a stroke. This work is devoted to the main aspects of the medical application of vascular bypasses and their functioning as a mechanical system, as well the mathematical aspects of their possible setup.
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Affiliation(s)
- Julia Kuyanova
- Department, Lavrentyev Institute of Hydrodynamics SB RAS, Ac. Lavrentieva ave., Novosibirsk, 630090 Russian Federation
| | - Andrei Dubovoi
- Department, FSBI “Federal Neurosurgical Center”, Nemirovicha-Danchenko st., Novosibirsk, 630087 Russian Federation
| | - Aleksei Fomichev
- Department, Meshalkin National Medical Research Center, Rechkunovskaya st., Novosibirsk, 610101 Russian Federation
| | - Dmitrii Khelimskii
- Department, Meshalkin National Medical Research Center, Rechkunovskaya st., Novosibirsk, 610101 Russian Federation
| | - Daniil Parshin
- Department, Lavrentyev Institute of Hydrodynamics SB RAS, Ac. Lavrentieva ave., Novosibirsk, 630090 Russian Federation
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Li B, Liu Y, Liu J, Sun H, Feng Y, Zhang Z, Zhang L. Cerebral multi-autoregulation model based enhanced external counterpulsation treatment planning for cerebral ischemic stroke. J Cereb Blood Flow Metab 2023; 43:1764-1778. [PMID: 37254770 PMCID: PMC10581230 DOI: 10.1177/0271678x231179542] [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: 11/06/2022] [Revised: 03/03/2023] [Accepted: 04/24/2023] [Indexed: 06/01/2023]
Abstract
Enhanced external counterpulsation (EECP) treatment for cerebral ischemic stroke patients with differing severity of stenosis, is subject to uncertainties due to the varying effects of the cerebral autoregulation mechanism on haemodynamics. The current study reports the development of a cerebral multi-autoregulation (MR) mathematical model, based on cerebral arteriole regulation of neurogenic, vascular smooth muscle reflex and shear stress mechanisms which takes into account the severity of stenosis. The model was evaluated by comparison to authentic clinical measurements of cerebral autoregulatory efficiency. Then it was applied to a 0D/3D geometric multi-scale haemodynamic model of a cerebral artery. Haemodynamic indicators were calculated under different pressurization durations of EECP to evaluate the efficacy for different stenosis lesions. Moderate stenosis of 50% to 60% produced excessive time-averaged wall shear stress in the distal area of the stenosis (>7 Pa) during prolonged pressurization and may result in damage to vascular endothelial cells. However, prolonged pressurization did not result in haemodynamic risk for severe stenosis of 70% to 80%, indicating that the duration of pressurization may be extended with increasing severity of stenosis. The current MR model accurately simulated cerebral blood flow and has relevance to the simulation of cerebral haemodynamics in a clinical setting.
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Affiliation(s)
- Bao Li
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Youjun Liu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Jincheng Liu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Hao Sun
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Yili Feng
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Zhe Zhang
- Department of Cardiac Surgery, Peking University Third Hospital, Beijing, China
| | - Liyuan Zhang
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
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Li X, Simakov S, Liu Y, Liu T, Wang Y, Liang F. The Influence of Aortic Valve Disease on Coronary Hemodynamics: A Computational Model-Based Study. Bioengineering (Basel) 2023; 10:709. [PMID: 37370640 DOI: 10.3390/bioengineering10060709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/31/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Aortic valve disease (AVD) often coexists with coronary artery disease (CAD), but whether and how the two diseases are correlated remains poorly understood. In this study, a zero-three dimensional (0-3D) multi-scale modeling method was developed to integrate coronary artery hemodynamics, aortic valve dynamics, coronary flow autoregulation mechanism, and systemic hemodynamics into a unique model system, thereby yielding a mathematical tool for quantifying the influences of aortic valve stenosis (AS) and aortic valve regurgitation (AR) on hemodynamics in large coronary arteries. The model was applied to simulate blood flows in six patient-specific left anterior descending coronary arteries (LADs) under various aortic valve conditions (i.e., control (free of AVD), AS, and AR). Obtained results showed that the space-averaged oscillatory shear index (SA-OSI) was significantly higher under the AS condition but lower under the AR condition in comparison with the control condition. Relatively, the overall magnitude of wall shear stress was less affected by AVD. Further data analysis revealed that AS induced the increase in OSI in LADs mainly through its role in augmenting the low-frequency components of coronary flow waveform. These findings imply that AS might increase the risk or progression of CAD by deteriorating the hemodynamic environment in coronary arteries.
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Affiliation(s)
- Xuanyu Li
- Department of Engineering Mechanics, School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Sergey Simakov
- Marchuk Institute of Numerical Mathematics of the Russian Academy of Sciences, Moscow 119991, Russia
| | - Youjun Liu
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing 100124, China
| | - Taiwei Liu
- Department of Engineering Mechanics, School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Yue Wang
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Fuyou Liang
- Department of Engineering Mechanics, School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
- State Key Laboratory of Ocean Engineering, School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
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Mao B, Feng Y, Duan M, Dong Y, Li G, Li B, Liu J, Guo Y, Wei M, Zhao Z, Liu Y. A Novel Method to Determine the Cause of Left Internal Mammary Artery Instant Non-Patency Based on Transit Time Flow Measurement. Front Physiol 2022; 13:901280. [PMID: 35845991 PMCID: PMC9280131 DOI: 10.3389/fphys.2022.901280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: After coronary artery bypass grafting (CABG) surgery, the main causes of poor instant patency of left internal mammary arteries (LIMAs) are competitive flow and anastomotic stenosis, but how to determine the cause of LIMA non-patency without interfering with the native coronary artery is still a difficult problem to be solved urgently.Methods: In this study, a 0D-3D coupled multiscaled CABG model of anastomotic stenosis and competitive flow was constructed. After calculation, the flow waveform of the LIMA was extracted, and the waveform shape, common clinical parameters (average flow, PI, and DF), and graft flow FFT ratio results (F0/H1 and F0/H2) were analyzed.Results: For LIMA, these three common clinical parameters did not differ significantly between the anastomotic stenosis group and competitive flow group. However, the waveform shape and FFT ratio (especially F0/H2) of the competitive flow group were significantly different from those of the anastomotic stenosis group. When the cause was competitive flow, there was systolic backflow, and F0/H2 was too high (>14.89). When the cause was anastomotic stenosis, the waveform maintained a bimodal state and F0/H2 was in a normal state (about 1.17).Conclusion: When poor instant patency of the LIMA is found after CABG, the causes can be determined by graft flow waveform shape and F0/H2.
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Affiliation(s)
- Boyan Mao
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Yue Feng
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
- Medical Equipment Department, Peking University First Hospital, Beijing, China
| | - Mengyao Duan
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Yihang Dong
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Gaoyang Li
- Institute of Fluid Science, Tohoku University, Sendai, Japan
| | - Bao Li
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Jincheng Liu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Yuting Guo
- Institute of Fluid Science, Tohoku University, Sendai, Japan
| | - Minghui Wei
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Zhou Zhao
- Cardiac Surgery Department, Peking University People’s Hospital, Beijing, China
| | - Youjun Liu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
- *Correspondence: Youjun Liu,
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Self-Similar Functional Circuit Models of Arteries and Deterministic Fractal Operators: Theoretical Revelation for Biomimetic Materials. Int J Mol Sci 2021; 22:ijms222312897. [PMID: 34884701 PMCID: PMC8657472 DOI: 10.3390/ijms222312897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/15/2021] [Accepted: 11/24/2021] [Indexed: 12/15/2022] Open
Abstract
In this paper, the self-similar functional circuit models of arteries are proposed for bioinspired hemodynamic materials design. Based on the mechanical-electrical analogous method, the circuit model can be utilized to mimic the blood flow of arteries. The theoretical mechanism to quantitatively simulate realistic blood flow is developed by establishing a fractal circuit network with an infinite number of electrical components. We have found that the fractal admittance operator obtained from the minimum repeating unit of the fractal circuit can simply and directly determine the blood-flow regulation mechanism. Furthermore, according to the operator algebra, the fractal admittance operator on the aorta can be represented by Gaussian-type convolution kernel function. Similarly, the arteriolar operator can be described by Bessel-type function. Moreover, by the self-similar assembly pattern of the proposed model, biomimetic materials which contain self-similar circuits can be designed to mimic physiological or pathological states of blood flow. Studies show that the self-similar functional circuit model can efficiently describe the blood flow and provide an available and convenient structural theoretical revelation for the preparation of in vitro hemodynamic bionic materials.
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