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使用计算模型对A型主动脉夹层进行研究。

Investigation of Type A Aortic Dissection Using Computational Modelling.

作者信息

Al-Rawi Mohammad, Belkacemi Djelloul, Lim Eric T A, Khashram Manar

机构信息

Center for Engineering and Industrial Design (CEID), Waikato Institute of Technology (Wintec), Hamilton 3240, New Zealand.

Faculty of Engineering, Chemical and Materials Engineering, University of Auckland, Auckland 1010, New Zealand.

出版信息

Biomedicines. 2024 Sep 1;12(9):1973. doi: 10.3390/biomedicines12091973.

Abstract

Aortic dissection is a catastrophic failure of the endothelial wall that could lead to malperfusion or rupture. Computational modelling tools may help detect arterial damage. Technological advancements have led to more sophisticated forms of modelling being made available to low-grade computers. These devices can create 3D models with clinical data, where the clinical blood pressure waveforms' model can be used to form boundary conditions for assessing hemodynamic parameters, modelling blood flow propagation along the aorta to predict the development of cardiovascular disease. This study presents patient-specific data for a rare case of severe Type A aortic dissection. CT scan images were taken nine months apart, consisting of the artery both before and after dissection. The results for the pre-dissection CT showed that the pressure waveform at the ascending aorta was higher, and the systolic pressure was lagging at the descending aorta. For the post-dissection analysis, we observed the same outcome; however, the amplitude for the waveform (systolic pressure) at the ascending aorta increased in the false lumen by 25% compared to the true lumen by 3%. Also, the waveform peak (systolic) was leading by 0.01 s. The hemodynamic parameter of wall shear stress (WSS) predicted the aneurysm's existence at the ascending aorta, as well as potential aortic dissection. The high WSS contours were located at the tear location at the peak blood flow of 0.14 s, which shows the potential of this tool for earlier diagnosis of aortic dissection.

摘要

主动脉夹层是内皮壁的灾难性故障,可能导致灌注不良或破裂。计算建模工具可能有助于检测动脉损伤。技术进步使得更复杂的建模形式可用于低级计算机。这些设备可以利用临床数据创建三维模型,其中临床血压波形模型可用于形成边界条件,以评估血流动力学参数,模拟沿主动脉的血流传播,预测心血管疾病的发展。本研究展示了一例罕见的严重A型主动脉夹层患者的特定数据。相隔九个月进行了CT扫描成像,包括夹层前后的动脉。夹层前CT的结果显示,升主动脉处的压力波形较高,而降主动脉处的收缩压滞后。对于夹层后分析,我们观察到了相同的结果;然而,升主动脉处波形(收缩压)在假腔中的幅度比真腔增加了25%,而真腔仅增加了3%。此外,波形峰值(收缩期)提前了0.01秒。壁面切应力(WSS)的血流动力学参数预测了升主动脉处动脉瘤的存在以及潜在的主动脉夹层。高WSS等高线位于血流峰值0.14秒时的撕裂位置,这表明该工具在早期诊断主动脉夹层方面的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f20/11428704/f5ae8d8ce35b/biomedicines-12-01973-g001.jpg

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