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High Wall Shear Stress can Predict Wall Degradation in Ascending Aortic Aneurysms: An Integrated Biomechanics Study.
Salmasi, M Yousuf; Pirola, Selene; Sasidharan, Sumesh; Fisichella, Serena M; Redaelli, Alberto; Jarral, Omar A; O'Regan, Declan P; Oo, Aung Ye; Moore, James E; Xu, Xiao Yun; Athanasiou, Thanos.
Afiliación
  • Salmasi MY; Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
  • Pirola S; Department of Chemical Engineering, Imperial College London, London, United Kingdom.
  • Sasidharan S; Department of Bioengineering, Imperial College London, London, United Kingdom.
  • Fisichella SM; Department of Chemical Engineering, Imperial College London, London, United Kingdom.
  • Redaelli A; Politecnico di Milano, Milan, Italy.
  • Jarral OA; Politecnico di Milano, Milan, Italy.
  • O'Regan DP; Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
  • Oo AY; MRC London Institute of Medical Sciences, Imperial College London, London, United Kingdom.
  • Moore JE; Barts Heart Centre, London, United Kingdom.
  • Xu XY; Department of Bioengineering, Imperial College London, London, United Kingdom.
  • Athanasiou T; Department of Chemical Engineering, Imperial College London, London, United Kingdom.
Front Bioeng Biotechnol ; 9: 750656, 2021.
Article en En | MEDLINE | ID: mdl-34733832
Background: Blood flow patterns can alter material properties of ascending thoracic aortic aneurysms (ATAA) via vascular wall remodeling. This study examines the relationship between wall shear stress (WSS) obtained from image-based computational modelling with tissue-derived mechanical and microstructural properties of the ATAA wall using segmental analysis. Methods: Ten patients undergoing surgery for ATAA were recruited. Exclusions: bicuspid aortopathy, connective tissue disease. All patients had pre-operative 4-dimensional flow magnetic resonance imaging (4D-MRI), allowing for patient-specific computational fluid dynamics (CFD) analysis and anatomically precise WSS mapping of ATAA regions (6-12 segments per patient). ATAA samples were obtained from surgery and subjected to region-specific tensile and peel testing (matched to WSS segments). Computational pathology was used to characterize elastin/collagen abundance and smooth muscle cell (SMC) count. Results: Elevated values of WSS were predictive of: reduced wall thickness [coef -0.0489, 95% CI (-0.0905, -0.00727), p = 0.022] and dissection energy function (longitudinal) [-15,0, 95% CI (-33.00, -2.98), p = 0.048]. High WSS values also predicted higher ultimate tensile strength [coef 0.136, 95% CI (0 0.001, 0.270), p = 0.048]. Additionally, elevated WSS also predicted a reduction in elastin levels [coef -0.276, 95% (CI -0.531, -0.020), p = 0.035] and lower SMC count ([oef -6.19, 95% CI (-11.41, -0.98), p = 0.021]. WSS was found to have no effect on collagen abundance or circumferential mechanical properties. Conclusions: Our study suggests an association between elevated WSS values and aortic wall degradation in ATAA disease. Further studies might help identify threshold values to predict acute aortic events.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Front Bioeng Biotechnol Año: 2021 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Front Bioeng Biotechnol Año: 2021 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Suiza