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左冠状动脉几何结构在动脉粥样硬化易感性中的作用:考虑血液 sPTT 模型的 CFD 模拟。

Role of the left coronary artery geometry configuration in atherosusceptibility: CFD simulations considering sPTT model for blood.

机构信息

Engineering Faculty, University of Porto, Porto, Portugal.

Institute of Science and Innovation in Mechanical and Industrial Engineering (LAETA-INEGI), Porto, Portugal.

出版信息

Comput Methods Biomech Biomed Engin. 2021 Oct;24(13):1488-1503. doi: 10.1080/10255842.2021.1894555. Epub 2021 Mar 4.

Abstract

The achievement of clinically viable methodologies to simulate the hemodynamics in patient-specific coronary arteries is still a major challenge. Therefore, the novelty of this work is attained by the introduction of the viscoelastic property of blood in the numerical simulations, to study the role of the left coronary artery (LCA) geometry configuration in the atherosusceptibility. Apparently healthy patients were used and four different methodologies were tested. The methodology giving the most accurate results at the same time of having the lowest computational time is the one considering the viscoelastic property of blood and computational fluid dynamics. A Pearson correlation analysis was used to highlight relationships between geometric configuration and hemodynamic descriptors based on the simulated wall shear stress (WSS). The left main stem (LMS) has the greatest atherosusceptibility followed by the left anterior descending artery (LAD) since the relative residence time (RRT) average values are 3.81 and 3.70 Pa, respectively. The geometric parameters with relevant contribution to directional flow change are the cross-sectional areas, especially the one of LMS segment (A), and the curvature of LMS segment. For LMS and LAD segments, when A increases, blood flow disturbance (r = 0.81 in LMS and r = 0.74 in LAD) and atherosusceptibility (r = 0.84 in LMS and r = 0.85 in LAD) increases. When the LMS curvature decreases, the WSS magnitude (r = 0.80 in LMS and r = 0.83 in LAD) decreases, and disturbance (r=-0.80 in LMS and r=-0.91 in LAD) and atherosusceptibility (r=-0.74 in LMS and r=-0.74 in LAD) increases.

摘要

实现模拟患者特定冠状动脉血流动力学的临床可行方法仍然是一个主要挑战。因此,本工作的新颖之处在于在数值模拟中引入血液的粘弹性特性,以研究左冠状动脉(LCA)几何形状配置在动脉粥样硬化易感性中的作用。使用显然健康的患者,并测试了四种不同的方法。在具有相同计算时间的情况下,能够给出最准确结果的方法是同时考虑血液的粘弹性和计算流体动力学的方法。使用皮尔逊相关分析来强调基于模拟壁剪切应力(WSS)的几何形状配置与血流动力学描述符之间的关系。左主干(LMS)具有最大的动脉粥样硬化易感性,其次是左前降支(LAD),因为相对停留时间(RRT)平均值分别为 3.81 和 3.70 Pa。对流向变化有相关贡献的几何参数是横截面面积,特别是 LMS 段(A)的面积,以及 LMS 段的曲率。对于 LMS 和 LAD 段,当 A 增加时,血流干扰(LMS 中的 r=0.81 和 LAD 中的 r=0.74)和动脉粥样硬化易感性(LMS 中的 r=0.84 和 LAD 中的 r=0.85)增加。当 LMS 曲率减小时,WSS 幅度(LMS 中的 r=0.80 和 LAD 中的 r=0.83)降低,干扰(LMS 中的 r=-0.80 和 LAD 中的 r=-0.91)和动脉粥样硬化易感性(LMS 中的 r=-0.74 和 LAD 中的 r=-0.74)增加。

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