Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 4 de 4
Filtrar
Más filtros










Base de datos
Intervalo de año de publicación
1.
Catheter Cardiovasc Interv ; 101(6): 1036-1044, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-37017418

RESUMEN

BACKGROUND: Isolate features of the coronary anatomy have been associated with the pathophysiology of atherosclerotic disease. Computational methods have been described to allow precise quantification of the complex three-dimensional (3D) coronary geometry. The present study tested whether quantitative parameters that describe the spatial 3D coronary geometry is associated with the extension and composition of the underlying coronary artery disease (CAD). METHODS: Patients with CAD scheduled for percutaneous intervention were investigated with coronary computed tomography angiography (CCTA), and invasive coronary angiography, and virtual histology intravascular ultrasound (IVUS-VH). For all target vessels, 3D centerlines were extracted from CCTA images and processed to quantify 23 geometric indexes, grouped into 3 main categories as follows: (i) length-based; (ii) curvature-based, torsion-based, and curvature/torsion-combined; (iii) vessel path-based. The geometric variables were compared with IVUS-VH parameters assessing the extent and composition of coronary atherosclerosis. RESULTS: A total of 36 coronary patients (99 vessels) comprised the study population. From the 23 geometric indexes, 18 parameters were significantly (p < 0.05) associated with at least 1 IVUS-VH parameter at a univariate analysis. All three main geometric categories provided parameters significantly related with atherosclerosis variables. The 3D geometric indexes were associated with the degree of atherosclerotic extension, as well as with plaque composition. Geometric features remained significantly associated with all IVUS-VH parameters even after multivariate adjustment for clinical characteristics. CONCLUSIONS: Quantitative 3D vessel morphology emerges as a relevant factor associated with atherosclerosis in patients with established CAD.


Asunto(s)
Aterosclerosis , Enfermedad de la Arteria Coronaria , Placa Aterosclerótica , Humanos , Ultrasonografía Intervencional/métodos , Resultado del Tratamiento , Enfermedad de la Arteria Coronaria/patología , Angiografía Coronaria/métodos , Vasos Coronarios/diagnóstico por imagen , Vasos Coronarios/patología , Valor Predictivo de las Pruebas
2.
Biomech Model Mechanobiol ; 20(4): 1365-1382, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33772676

RESUMEN

In this work, we present a novel modeling framework to investigate the effects of collateral circulation into the coronary blood flow physiology. A prototypical model of the coronary tree, integrated with the concept of Collateral Flow Index (CFI), is employed to gain insight about the role of model parameters associated with the collateral circuitry, which results in physically-realizable solutions for specific CFI data. Then, we discuss the mathematical feasibility of pressure-derived CFI, anatomical implications and practical considerations involving the estimation of model parameters in collateral connections. A sensitivity analysis is carried out, and the investigation of the impact of the collateral circulation on FFR values is also addressed.


Asunto(s)
Circulación Colateral/fisiología , Circulación Coronaria , Vasos Coronarios/fisiopatología , Aorta/fisiología , Reserva del Flujo Fraccional Miocárdico , Corazón , Hemodinámica/fisiología , Humanos , Oclusión Vascular Mesentérica/patología , Modelos Cardiovasculares , Modelos Teóricos
3.
Front Physiol ; 9: 292, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29643815

RESUMEN

Atherosclerotic plaque rupture and erosion are the most important mechanisms underlying the sudden plaque growth, responsible for acute coronary syndromes and even fatal cardiac events. Advances in the understanding of the culprit plaque structure and composition are already reported in the literature, however, there is still much work to be done toward in-vivo plaque visualization and mechanical characterization to assess plaque stability, patient risk, diagnosis and treatment prognosis. In this work, a methodology for the mechanical characterization of the vessel wall plaque and tissues is proposed based on the combination of intravascular ultrasound (IVUS) imaging processing, data assimilation and continuum mechanics models within a high performance computing (HPC) environment. Initially, the IVUS study is gated to obtain volumes of image sequences corresponding to the vessel of interest at different cardiac phases. These sequences are registered against the sequence of the end-diastolic phase to remove transversal and longitudinal rigid motions prescribed by the moving environment due to the heartbeat. Then, optical flow between the image sequences is computed to obtain the displacement fields of the vessel (each associated to a certain pressure level). The obtained displacement fields are regarded as observations within a data assimilation paradigm, which aims to estimate the material parameters of the tissues within the vessel wall. Specifically, a reduced order unscented Kalman filter is employed, endowed with a forward operator which amounts to address the solution of a hyperelastic solid mechanics model in the finite strain regime taking into account the axially stretched state of the vessel, as well as the effect of internal and external forces acting on the arterial wall. Due to the computational burden, a HPC approach is mandatory. Hence, the data assimilation and computational solid mechanics computations are parallelized at three levels: (i) a Kalman filter level; (ii) a cardiac phase level; and (iii) a mesh partitioning level. To illustrate the capabilities of this novel methodology toward the in-vivo analysis of patient-specific vessel constituents, mechanical material parameters are estimated using in-silico and in-vivo data retrieved from IVUS studies. Limitations and potentials of this approach are exposed and discussed.

4.
Biomech Model Mechanobiol ; 15(3): 593-627, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-26329641

RESUMEN

In this work, we address the simulation of three-dimensional arterial blood flow and its effect on the stress state of arterial walls. The novel contribution is the unprecedented combination of several modeling techniques to account for (1) the fact that known configurations for the arterial wall are in a preloaded state, (2) the compliance of the vessel segments, (3) proper boundary data over the non-physical interfaces resulting from the isolation of an arterial district from the rest of the arterial tree, (4) the presence of surrounding tissues in which the vessel is embedded and (5) residual stress state due to pre-stretch. Firstly, we formulate both the forward mechanical problem when the reference (zero-load) configuration is assumed to be known and, the preload problem arising when the known domain is a configuration at equilibrium with a certain load state (typically due to internal pressure and tethering forces). Then, two additional complexities are faced: the fluid-structure interaction problem that follows when the compliant vessels are coupled with the blood flow, and the introduction of non-physical boundaries coming from the artificial isolation of the arterial district from the original vessel. This, in turn, posses the problem of coupling dimensionally heterogeneous models to incorporate the effect of upstream and downstream systemic impedances. Additionally, a viscoelastic support on the external surface of the vessel is also incorporated. Two examples are presented to quantify in a physiologically consistent scenario the differences in simulation results when either considering or not the preload state of arterial walls. These computational simulations shed light on the validity of simplifying hypotheses in most hemodynamic models.


Asunto(s)
Simulación por Computador , Hemodinámica/fisiología , Estrés Mecánico , Algoritmos , Arterias/fisiología , Fenómenos Biomecánicos , Hemorreología , Humanos , Modelos Biológicos , Análisis Numérico Asistido por Computador , Soporte de Peso
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA