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降主动脉阻塞生长的无创性诊断——计算方法。

Non-invasive diagnostics of blockage growth in the descending aorta-computational approach.

机构信息

Center for Engineering and Industrial Design (CEID), Waikato Institute of Technology (Wintec), Hamilton, New Zealand.

Institute of Biomedical Technologies (IBTec), Auckland University of Technology (AUT), Auckland, New Zealand.

出版信息

Med Biol Eng Comput. 2022 Nov;60(11):3265-3279. doi: 10.1007/s11517-022-02665-2. Epub 2022 Sep 27.

Abstract

Atherosclerosis causes blockages to the main arteries such as the aorta preventing blood flow from delivering oxygen to the organs. Non-invasive diagnosis of these blockages is difficult, particularly in primary healthcare. In this paper, the effect of arterial blockage development and growth is investigated at the descending aorta on some possible non-invasive assessment parameters including the blood pressure waveform, wall shear stress (WSS), time-average WSS (TAWSS) and the oscillation shear index (OSI). Blockage severity growth is introduced in a simulation model as 25%, 35%, 50% and 65% stenosis at the descending aorta based on specific healthy control aorta data clinically obtained. A 3D aorta model with invasive pulsatile waveforms (blood flow and pressure) is used in the CFD simulation. Blockage severity is assessed by using blood pressure measurements at the left subclavian artery. An arterial blockage growth more than 35% of the lumen diameter significantly affects the pressure. A strong correlation is also observed between the ascending aorta pressure values, pressure at the left subclavian artery and the relative residence time (RRT). An increase of RRT downstream from the stenosis indicates a 35% stenosis at the descending aorta which results in high systolic and diastolic pressure readings. The findings of this study could be further extended by transferring the waveform reading from the left subclavian artery to the brachial artery.

摘要

动脉粥样硬化会导致主动脉等主要动脉阻塞,从而阻止血液向器官输送氧气。这些阻塞的非侵入性诊断很困难,尤其是在初级保健中。本文研究了降主动脉处动脉阻塞发展和生长对某些可能的非侵入性评估参数的影响,包括血压波形、壁切应力(WSS)、时间平均壁切应力(TAWSS)和振荡切应力指数(OSI)。根据临床上从特定健康对照主动脉获得的数据,模拟模型中在降主动脉处引入了 25%、35%、50%和 65%狭窄的阻塞严重程度生长。在 CFD 模拟中使用了具有侵入性脉动波形(血流和压力)的 3D 主动脉模型。阻塞严重程度通过测量左锁骨下动脉处的血压来评估。阻塞严重程度超过管腔直径的 35%会显著影响血压。还观察到升主动脉压力值、左锁骨下动脉压力值和相对滞留时间(RRT)之间存在很强的相关性。狭窄下游的 RRT 增加表明降主动脉存在 35%的狭窄,这会导致收缩压和舒张压读数升高。通过将波形读数从左锁骨下动脉转移到肱动脉,可以进一步扩展本研究的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c465/9537206/b95817469871/11517_2022_2665_Fig1_HTML.jpg

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