Department of Clinical Biochemistry and Laboratory Medicine, Poznan University of Medical Sciences, Poznan, Poland.
School of Mathematics and Statistics, The University of Sydney, Sydney, NSW, Australia.
PLoS One. 2020 Oct 13;15(10):e0239953. doi: 10.1371/journal.pone.0239953. eCollection 2020.
Atherosclerosis, a chronic inflammatory disorder of the arterial wall, is a complex process whose dynamics are affected by multiple factors. The disease control consists of restraining it by administering statins. Slowing down or halting the plaque growth depends on the patient age at which the statin treatment begins and on the thickness of the intima-media (IMT) at that time. In this paper, we propose a mathematical model to estimate the sets of atherosclerosis states, from which the use of statins can restrain the disease. Our model is control-theoretic, and the estimated sets are the viability kernels, in the parlance of viability theory. To our best knowledge, this way of modelling the atherosclerosis progression is original. We compute two viability kernels, each for a different statin-treatment dose. Each kernel is composed of the vector [age, IMT] from which the disease can be restrained. By extension, the disease can't be restrained from the kernel complements, this being mainly because of the disease and patient-age advancement. The kernels visualise tradeoffs between early and late treatments, which helps the clinician to decide when to start the statin treatment and which statin dose may be sufficient.
动脉粥样硬化是一种动脉壁的慢性炎症性疾病,是一个复杂的过程,其动态受到多种因素的影响。该疾病的控制方法是通过给予他汀类药物来抑制它。减缓或阻止斑块生长取决于患者开始他汀类药物治疗时的年龄以及当时的内中膜(IMT)厚度。在本文中,我们提出了一个数学模型来估计动脉粥样硬化状态集,从中可以使用他汀类药物来抑制疾病。我们的模型是控制理论的,估计的集是生存性核,在生存性理论的术语中。据我们所知,这种动脉粥样硬化进展的建模方法是原创的。我们计算了两个生存性核,每个核对应不同的他汀类药物治疗剂量。每个核由疾病可以被抑制的向量 [年龄,IMT] 组成。通过扩展,疾病不能从核的补集中被抑制,这主要是因为疾病和患者年龄的进展。核可视化了早期和晚期治疗之间的权衡,这有助于临床医生决定何时开始他汀类药物治疗以及哪种他汀类药物剂量可能足够。