Seo Jung Hee, Abd Thura, George Richard T, Mittal Rajat
Department of Mechanical Engineering, Johns Hopkins University, Baltimore, Maryland; and.
School of Medicine, Johns Hopkins University, Baltimore, Maryland.
Am J Physiol Heart Circ Physiol. 2016 Jun 1;310(11):H1567-82. doi: 10.1152/ajpheart.00855.2015. Epub 2016 Mar 25.
A coupled chemo-fluidic computational model for investigating flow-mediated thrombogenesis in infarcted left ventricles (LVs) is proposed. LV thrombus (LVT) formation after the acute myocardial infarction (AMI) may lead to thromboembolic events that are associated with high mortality and morbidity, and reliable stratification of LVT risk is the key to managing the treatment of AMI patients. There have been several studies emphasizing the importance of LV blood flow patterns on thrombus formation; however, given the complex interplay between ventricular flow dynamics and biochemistry of thrombogenesis, current understanding is mostly empirical. In the present model, blood flow in the LV is obtained by solving the incompressible Navier-Stokes equations, and this is coupled to the biochemical modeling of the coagulation cascade, platelet activation, and fibrinogen polymerization. The coupled model is used to examine the effect of ventricular flow patterns on thrombogenesis in modeled ventricles. It is expected that the method developed here will enable in-depth studies of thrombogenesis in patient-derived infarcted LV models.
提出了一种用于研究梗死左心室(LV)中血流介导血栓形成的耦合化学流体计算模型。急性心肌梗死(AMI)后左心室血栓(LVT)形成可能导致血栓栓塞事件,这些事件与高死亡率和发病率相关,而LVT风险的可靠分层是管理AMI患者治疗的关键。已有多项研究强调左心室血流模式对血栓形成的重要性;然而,鉴于心室流动动力学与血栓形成生物化学之间复杂的相互作用,目前的理解大多是经验性的。在本模型中,通过求解不可压缩的纳维-斯托克斯方程获得左心室中的血流,并将其与凝血级联、血小板活化和纤维蛋白原聚合的生化模型相耦合。耦合模型用于研究心室流动模式对模拟心室中血栓形成的影响。预计此处开发的方法将能够对源自患者的梗死左心室模型中的血栓形成进行深入研究。