Simulating Subject-Specific Aortic Hemodynamic Effects of Valvular Lesions in Rheumatic Heart Disease

Cebull, Hannah L.; Aremu, Olukayode; Kulkarni, Radhika; Zhang, Samuel; Samuels, Petronella; Jermy, Stephen; Ntusi, Ntobeko; Goergen, Craig J.

doi:10.1115/1.4063000

Cited by 3 publications

(1 citation statement)

References 52 publications

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“…The second limitation is the assumption of a parabolic-shaped spatial profile for the inlet velocity [44]. A few studies have suggested the importance of using a patient-specific three-dimensional velocity profile at the inlet to accurately describe the blood flow in the aorta [81][82][83]. However, the importance in general becomes less profound as the flow moves downstream due to the accumulated influence of vessel walls.…”

Section: Limitations Of Current Studymentioning

confidence: 99%

Uncertainty quantification of the impact of peripheral arterial disease on abdominal aortic aneurysms in blood flow simulations

Lo,

McCullough,

Xue

et al. 2024

J. R. Soc. Interface.

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Peripheral arterial disease (PAD) and abdominal aortic aneurysms (AAAs) often coexist and pose significant risks of mortality, yet their mutual interactions remain largely unexplored. Here, we introduce a fluid mechanics model designed to simulate the haemodynamic impact of PAD on AAA-associated risk factors. Our focus lies on quantifying the uncertainty inherent in controlling the flow rates within PAD-affected vessels and predicting AAA risk factors derived from wall shear stress. We perform a sensitivity analysis on nine critical model parameters through simulations of three-dimensional blood flow within a comprehensive arterial geometry. Our results show effective control of the flow rates using two-element Windkessel models, although specific outlets need attention. Quantities of interest like endothelial cell activation potential (ECAP) and relative residence time are instructive for identifying high-risk regions, with ECAP showing greater reliability and adaptability. Our analysis reveals that the uncertainty in the quantities of interest is 187% of that of the input parameters. Notably, parameters governing the amplitude and frequency of the inlet velocity exert the strongest influence on the risk factors’ variability and warrant precise determination. This study forms the foundation for patient-specific simulations involving PAD and AAAs which should ultimately improve patient outcomes and reduce associated mortality rates.

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Section: Limitations Of Current Studymentioning

confidence: 99%

Uncertainty quantification of the impact of peripheral arterial disease on abdominal aortic aneurysms in blood flow simulations

Lo,

McCullough,

Xue

et al. 2024

J. R. Soc. Interface.

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Subjects with carotid webs demonstrate pro-thrombotic hemodynamics compared to subjects with carotid atherosclerosis

El Sayed,

Lucas,

Cebull

et al. 2024

Sci Rep

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Carotid artery webs (CaW) are non-atherosclerotic projections into the vascular lumen and have been linked to up to one-third of cryptogenic strokes in younger patients. Determining how CaW affects local hemodynamics is essential for understanding clot formation and stroke risk. Computational fluid dynamics simulations were used to investigate patient-specific hemodynamics in carotid artery bifurcations with CaW, bifurcations with atherosclerotic lesions having a similar degree of lumen narrowing, and with healthy carotid bifurcations. Simulations were conducted using segmented computed tomography angiography geometries with inlet boundary conditions extracted from 2D phase contrast MRI scans. The study included carotid bifurcations with CaW (n = 13), mild atherosclerosis (n = 7), and healthy bifurcation geometries (n = 6). Hemodynamic parameters associated with vascular dysfunction and clot formation, including shear rate, oscillatory shear index (OSI), low velocity, and flow stasis were calculated and compared between the subject groups. Patients with CaW had significantly larger regions containing low shear rate, high OSI, low velocity, and flow stasis in comparison to subjects with mild atherosclerosis or normal bifurcations. These abnormal hemodynamic metrics in patients with CaW are associated with clot formation and vascular dysfunction and suggest that hemodynamic assessment may be a tool to assess stroke risk in these patients.

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How Irregular Geometry and Flow Waveform Affect Pulsating Arterial Mass Transfer

Strasser

2024

Journal of Biomechanical Engineering

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Alzheimer's disease is a progressive degenerative condition that has various levels of effect on one's memory. It is thought to be caused by a buildup of protein in small fluid-filled spaces in the brain called perivascular spaces (PVS). The PVS often takes on the form of an annular region around arteries and is used as a protein-clearing system for the brain. To analyze the modes of mass transfer in the PVS, a digitized scan of a mouse brain PVS segment was meshed and used for computational fluid dynamics (CFD) studies. Tandem analyses were then carried out and compared between the mouse PVS section and a cylinder with commensurate dimensionless parameters and hydraulic resistance. The geometry pair was used to first validate the CFD model and then assess mass transfer in various advection states: no flow, constant flow, sinusoidal flow, sinusoidal flow with zero net solvent flux, and an anatomically correct asymmetrical periodic flow. Two mass transfer situations were considered, one being a protein build-up and the other being a protein blend-down. The results showed that, for all the flows in question and both protein scenarios, there was nearly no protein clearance benefit by the anatomically correct PVS geometry. Surprisingly, solute blend-down was diffusion-dominated even for high Peclet numbers. Findings herein lead to the conclusion that minimal risk would be incurred by incorporating PVS geometry into existing reduce-order modeling arterial networks.

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Simulating Subject-Specific Aortic Hemodynamic Effects of Valvular Lesions in Rheumatic Heart Disease

Cited by 3 publications

References 52 publications

Uncertainty quantification of the impact of peripheral arterial disease on abdominal aortic aneurysms in blood flow simulations

Uncertainty quantification of the impact of peripheral arterial disease on abdominal aortic aneurysms in blood flow simulations

Subjects with carotid webs demonstrate pro-thrombotic hemodynamics compared to subjects with carotid atherosclerosis

How Irregular Geometry and Flow Waveform Affect Pulsating Arterial Mass Transfer

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