On the prediction of monocyte deposition in abdominal aortic aneurysms using computational fluid dynamics.

In abdominal aortic aneurysm disease, the aortic wall is exposed to intense biological activity involving inflammation and matrix metalloproteinase-mediated degradation of the extracellular matrix. These processes are orchestrated by monocytes and rather than affecting the aorta uniformly, damage and weaken focal areas of the wall leaving it vulnerable to rupture. This study attempts to model numerically the deposition of monocytes using large eddy simulation, discrete phase modelling and near-wall particle residence time. The model was first applied to idealised aneurysms and then to three patient-specific lumen geometries using three-component inlet velocities derived from phase-contrast magnetic resonance imaging. The use of a novel, variable wall shear stress-limiter based on previous experimental data significantly improved the results. Simulations identified a critical diameter (1.8 times the inlet diameter) beyond which significant monocyte deposition is expected to occur. Monocyte adhesion occurred proximally in smaller abdominal aortic aneurysms and distally as the sac expands. The near-wall particle residence time observed in each of the patient-specific models was markedly different. Discrete hotspots of monocyte residence time were detected, suggesting that the monocyte infiltration responsible for the breakdown of the abdominal aortic aneurysm wall occurs heterogeneously. Peak monocyte residence time was found to increase with aneurysm sac size. Further work addressing certain limitations is needed in a larger cohort to determine clinical significance.

Hydrodynamic glide efficiency in swimming.

The glide is a major part of starts, turns and the stroke cycle in breaststroke. Glide performance, indicated by the average velocity, can be improved by increasing the glide efficiency, that is, the ability of the body to minimise deceleration. This paper reviews the factors that affect glide efficiency. In the first part of the review the sources of resistive force are reviewed including surface friction (skin drag), pressure (form) drag and resistance due to making waves (wave drag). The effect of body surface characteristics on the skin drag, the effect of the depth of the swimmer on wave drag, and the effects of posture and alignment, body size and shape on the form drag are reviewed. The effects of these variables on the added mass, that is, the mass of water entrained with the body are explained. The 'glide factor' as a measure of glide efficiency that takes into account the combined effect of the resistive force and the added mass is described. In the second part methods of quantifying the resistive force are reviewed. Finally, the 'hydro-kinematic method' of measuring glide efficiency is evaluated.

Acquisition of 3-D arterial geometries and integration with computational fluid dynamics.

A system for acquisition of 3-D arterial ultrasound geometries and integration with computational fluid dynamics (CFD) is described. The 3-D ultrasound is based on freehand B-mode imaging with positional information obtained using an optical tracking system. A processing chain was established, allowing acquisition of cardiac-gated 3-D data and segmentation of arterial geometries using a manual method and a semi-automated method, 3D meshing and CFD. The use of CFD allowed visualization of flow streamlines, 2-D velocity contours and 3-D wall shear stress. Three-dimensional positional accuracy was 0.17-1.8mm, precision was 0.06-0.47mm and volume accuracy was 4.4-15%. Patients with disease and volunteers were scanned, with data collection from one or more of the carotid bifurcation, femoral bifurcation and abdominal aorta. An initial comparison between a manual segmentation method and a semi-automated method suggested some advantages to the semi-automated method, including reduced operator time and the production of smooth surfaces suitable for CFD, but at the expense of over-smoothing in the diseased region. There were considerable difficulties with artefacts and poor image quality, resulting in 3-D geometry data that was unsuitable for CFD. These artefacts were exacerbated in disease, which may mean that future effort, in the integration of 3-D arterial geometry and CFD for clinical use, may best be served using alternative 3-D imaging modalities such as magnetic resonance imaging and computed tomography.

A dual-phantom system for validation of velocity measurements in stenosis models under steady flow.

A dual-phantom system is developed for validation of velocity measurements in stenosis models. Pairs of phantoms with identical geometry and flow conditions are manufactured, one for ultrasound and one for particle image velocimetry (PIV). The PIV model is made from silicone rubber, and a new PIV fluid is made that matches the refractive index of 1.41 of silicone. Dynamic scaling was performed to correct for the increased viscosity of the PIV fluid compared with that of the ultrasound blood mimic. The degree of stenosis in the models pairs agreed to less than 1%. The velocities in the laminar flow region up to the peak velocity location agreed to within 15%, and the difference could be explained by errors in ultrasound velocity estimation. At low flow rates and in mild stenoses, good agreement was observed in the distal flow fields, excepting the maximum velocities. At high flow rates, there was considerable difference in velocities in the poststenosis flow field (maximum centreline differences of 30%), which would seem to represent real differences in hydrodynamic behavior between the two models. Sources of error included: variation of viscosity because of temperature (random error, which could account for differences of up to 7%); ultrasound velocity estimation errors (systematic errors); and geometry effects in each model, particularly because of imperfect connectors and corners (systematic errors, potentially affecting the inlet length and flow stability). The current system is best placed to investigate measurement errors in the laminar flow region rather than the poststenosis turbulent flow region.

A method to estimate wall shear rate with a clinical ultrasound scanner.

A simple technique to estimate the wall shear rate in healthy arteries using a clinical ultrasound scanner has been developed. This method uses the theory of fully developed oscillatory flow together with a spectral Doppler trace and an estimate of mean arterial diameter. A method using color flow imaging was compared with the spectral Doppler method in vascular phantoms and found to have errors that were on average 35% greater. Differences from the theoretic value for the time averaged wall shear rate using the spectral Doppler method varied by artery: brachial -9 (1) %; carotid -7 (1) %; femoral -22 (4) %; and fetal aorta -17 (10) %. Test measurements obtained from one healthy volunteer demonstrated the feasibility of the technique in vivo.

Characterization of an abdominal aortic velocity waveform in patients with abdominal aortic aneurysm.

Haemodynamics studies of abdominal aortic aneurysm require data on the velocity in the normal section of the aorta. Centreline velocity waveforms were measured in abdominal aortic aneurysm patients proximal to the aneurysm using spectral Doppler ultrasound. Characteristic points were automatically found on 21 of the waveforms and their parameters were used to create an archetypal centreline velocity waveform. The maximum velocity was 45 +/- 13 cm s(-1), the minimum velocity was -15 +/- 11 cm s(-1) and the maximum diastolic velocity was 2.7 +/- 4.7 cm s(-1). The velocity wave is suitable for use as an input to in vitro or in silico investigations of abdominal aortic aneurysm haemodynamics.

An arterial wall motion test phantom for the evaluation of wall motion software.

Increasing cardiovascular disease has led to new ultrasound methods of assessing artery disease such as arterial wall motion measurement. To validate arterial wall motion software, we developed a mechanically-controlled wall motion test phantom with straight upper and lower agar tissue mimicking material layers that resemble an artery cross section. The wall separation, displacements and wall velocities and accelerations can be controlled within physiologically realistic levels. A user-definable displacement or one of several pre-defined displacement waveforms can be created by the user with custom-written software. The test phantom is then controlled using the defined waveform with a stepper motor controller. Accuracy assessment of the test phantom with a laser vibrometer yielded a positional accuracy of 36+/-2 microm. A typical application of the test phantom is demonstrated by assessing a tissue Doppler imaging (TDI) method for estimating the distension waveform. The TDI-based method was found to have a minimum resolvable displacement of 22.5 microm, and a measurement accuracy of +/-8% using a physiological wall motion movement with a peak displacement of 689 microm. The accuracy of the TDI method was found to decrease with decreasing wall displacement and increasing wall velocity.

Distribution of wall shear rate throughout the arterial tree: a case study.

The generally accepted assumption that the arterial system remodels itself to maintain constant wall shear stress throughout is based on Murray's law, utilising the principle of minimum work for steady flow. However, blood flow in the human arterial system is pulsatile. In this work we outline a method allowing for estimation of wall shear rate in arteries using the flow waveforms as the input signal and estimate wall shear rates in the common carotid, brachial, and femoral arteries to determine the uniformity of distribution of wall shear rates throughout the arterial system. Time-dependent wall shear rates occurring in fully developed pulsatile flow were obtained using Womersley's theory. Flow waveforms and radii of the arteries measured in a young healthy male subject without any known cardiac disease using magnetic resonance taken from the literature were used as the input to the model. Peak/mean wall shear rates were found to be (1640/403.2 s(-1)) in common carotid, (908.8/84.95 s(-1)) in brachial, and (1251/134.2 s(-1)) in femoral arteries. Our findings suggest a non-uniform distribution of wall shear rates throughout the arterial system. The advantage of using this method is that such input data are being routinely recorded during diagnostic ultrasonography.

Laser Doppler anemometry measurements of the shear stresses on ultrasonic contrast agent microbubbles attached to agar.

Ultrasonic contrast agents are currently being developed to target and bind to specific areas of interest such as atheromous plaque. A microbubble has been developed in-house which can be targeted to attach to specific cell-lines. To assess the feasibility of using the microbubble in vivo, the shear stresses which the bound microbubbles can withstand need to be known. A flow chamber was developed for use with intravascular ultrasound (IVUS) and laser Doppler anemometry (LDA). Biotin was incorporated into the microbubble shells and streptavidin was used to attach them to agar. IVUS at 40 MHz was then used to image the attached microbubbles under steady flow at a range of flow rates from 75 to 480 mL min(-1) through a flow area of 9 mm(2). LDA was employed to find high resolution velocity profiles of the flow in the chamber at a selection of these flow rates and the shear stresses on the bubbles were calculated. The bubbles were found to remain attached to the agar for shear stresses of up to 3.4 Pa. This compares with mean physiological arterial shear stresses of less than 1.5 Pa for pulsatile flow.