Department of Mechanical and Aerospace Engineering, Brunel University London, England, UK.
Department of Engineering 'Enzo Ferrari', University of Modena, Italy.
Proc Inst Mech Eng H. 2021 Jun;235(6):663-675. doi: 10.1177/09544119211000482. Epub 2021 Mar 12.
Cardiovascular disease (CVD) is the highest cause of death globally with more people dying annually from it than from any other cause. CVD is associated with modifiable risk factors (dyslipidaemia, hypertension and diabetes) and treating each of these factors lowers the risk of CVD. It is impossible to estimate the benefit of risk factor modification in the individual patient and extrapolating data from multiple trials is difficult. It would be useful to have a marker of risk that accurately estimates real time risk by measuring blood flow factors associated with the pathogenesis of atheroma. The aim of this preliminary study was to validate a low-cost measurement technique for obtaining blood flow velocity profiles and assess whether any of the measured and calculated factors, based on computational fluid dynamics (CFD) simulation, known to be associated with atheroma was associated with coronary heart disease (CHD), thus establishing its feasibility and acceptability as a clinical tool and suggesting areas for future research. Our study identified (i) that mean peak systolic (PS) velocity being associated with CHD; individuals without CHD: mean (SD) = 62.8 (16.1) cm/s, with CHD: mean (SD) = 53.6 (17.3) cm/s, = 0.042; and (ii) that low-cost, portable ultrasound, which is routinely available in general practice, is a suitable assessment tool.
心血管疾病(CVD)是全球范围内导致死亡的首要原因,每年因 CVD 死亡的人数多于其他任何原因。CVD 与可改变的危险因素(血脂异常、高血压和糖尿病)有关,治疗这些危险因素中的每一个都可以降低 CVD 的风险。在个体患者中评估危险因素改变的获益是不可能的,从多项试验中推断数据也很困难。如果有一种风险标志物可以通过测量与动脉粥样硬化发病机制相关的血流因素来准确估计实时风险,那将是非常有用的。本初步研究的目的是验证一种低成本的血流速度剖面获取测量技术,并评估基于计算流体动力学(CFD)模拟的任何已测量和计算的因素是否与冠心病(CHD)相关,从而确定其作为临床工具的可行性和可接受性,并为未来的研究提供建议。我们的研究发现:(i)平均收缩期峰值速度(PS)与 CHD 相关;无 CHD 个体:平均(标准差)=62.8(16.1)cm/s,有 CHD 个体:平均(标准差)=53.6(17.3)cm/s,P=0.042;(ii)低成本、便携式超声在普通实践中广泛应用,是一种合适的评估工具。