Coronary artery plaque growth: A two‐way coupled shear stress–driven model

Published on Jan 1, 2020in International Journal for Numerical Methods in Biomedical Engineering2.097
· DOI :10.1002/CNM.3293
Amirhossein Arzani13
Estimated H-index: 13
(NAU: Northern Arizona University)
Atherosclerosis in coronary arteries can lead to plaque growth, stenosis formation, and blockage of the blood flow supplying the heart tissue. Several studies have shown that hemodynamics play an important role in the growth of coronary artery plaques. Specifically, low wall shear stress (WSS) appears to be the leading hemodynamic parameter promoting atherosclerotic plaque growth, which in turn influences the blood flow and WSS distribution. Therefore, a two-way coupled interaction exists between WSS and atherosclerosis growth. In this work, a computational framework was developed to study the coupling between WSS and plaque growth in coronary arteries. Computational fluid dynamics (CFD) was used to quantify WSS distribution. Surface mesh nodes were moved in the inward normal direction according to a growth model based on WSS. After each growth stage, the geometry was updated and the CFD simulation repeated to find updated WSS values for the next growth stage. One hundred twenty growth stages were simulated in an idealized tube and an image-based left anterior descending artery. An automated framework was developed using open-source software to couple CFD simulations with growth. Changes in plaque morphology and hemodynamic patterns during different growth stages are presented. The results show larger plaque growth towards the downstream segment of the plaque, agreeing with the reported clinical observations. The developed framework could be used to establish hemodynamic-driven growth models and study the interaction between these processes.
📖 Papers frequently viewed together
3 Authors (Colin Xu Chen, ..., John A. Gear)
4 Citations
16 Citations
1 Citations
#1Parastou Eslami (Harvard University)H-Index: 6
#2Justin Tran (Stanford University)H-Index: 6
Last. Alison L. Marsden (Stanford University)H-Index: 43
view all 8 authors...
: Wall shear stress (WSS) has been shown to be associated with myocardial infarction and progression of atherosclerosis. Wall elasticity is an important feature of hemodynamic modeling affecting WSS calculations. The objective of this study was to investigate the role of wall elasticity on WSS, and justify use of either rigid or elastic models in future studies. Digital anatomic models of the aorta and coronaries were created based on coronary computed tomography angiography (CCTA) in four patie...
23 CitationsSource
#1E. DoutelH-Index: 5
#2Nuno Viriato (University of Porto)H-Index: 4
Last. João M. D. Miranda (University of Porto)H-Index: 24
view all 5 authors...
: Atherosclerosis is a common cardiovascular disease found in the left coronary artery (LCA), closely linked to local hemodynamic, which, in turn, is highly influenced by the artery geometry. The hemodynamics in the LCA was studied in a patient-specific geometry without any sign of disease using both numerical and in vitro approaches. The influence of non-planarity was evaluated through two models of the patient-specific LCA that deviate from its original geometry in their planarity. Afterwards,...
9 CitationsSource
Cardiovascular disease (CVD) is a major threat to human health since it is the leading cause of death in western countries. Atherosclerosis is a type of CVD related to hypertension, diabetes, high levels of cholesterol, smoking, oxidative stress, and age. Atherosclerosis primarily occurs in medium and large arteries, such as coronary and the carotid artery and, in particular, at bifurcations and curvatures. Atherosclerosis is compared to an inflammatory disease where a thick, porous material com...
9 CitationsSource
#1Liang Wang (SEU: Southeast University)H-Index: 7
#2Dalin Tang (SEU: Southeast University)H-Index: 30
Last. Gary S. Mintz (Columbia University)H-Index: 78
view all 13 authors...
Plaque progression and vulnerability are influenced by many risk factors. Our goal is to find a simple method to combine multiple risk factors for better plaque development prediction. Intravascular ultrasound data at baseline and follow-up were acquired from nine patients, and fluid–structure interaction models were constructed to obtain plaque wall stress/strain (PWS/PWSn) and wall shear stress (WSS). Two hundred fifty-four slices with noticeable change in plaque burden were selected for analy...
6 CitationsSource
5 CitationsSource
#1Ali Farghadan (NAU: Northern Arizona University)H-Index: 4
#2Amirhossein Arzani (NAU: Northern Arizona University)H-Index: 13
Abstract Cardiovascular disease typically initiates at the vessel wall where near-wall transport of certain biochemicals influences disease initiation and progression. Wall shear stress (WSS) influences these transport processes in a complex manner. WSS magnitude and the shear force exerted on the endothelial cells determine the biochemical flux at the vessel wall. In addition, it has been recently shown that Lagrangian WSS structures (topological features) influence near-wall transport in high ...
14 CitationsSource
#1Kirk Hansen (University of California, Berkeley)H-Index: 6
#2Amirhossein Arzani (University of California, Berkeley)H-Index: 13
Last. Shawn C. Shadden (University of California, Berkeley)H-Index: 34
view all 3 authors...
: Many cardiovascular processes involve mass transport between blood and the vessel wall. Finite element methods are commonly used to numerically simulate these processes. Cardiovascular mass transport problems are typically characterized by high Peclet numbers, requiring fine near-wall mesh resolution as well as the use of stabilization techniques to avoid numerical instabilities. In this work, we develop a set of guidelines for solving high-Peclet-number near-wall mass transport problems using...
12 CitationsSource
Patient-specific computational fluid dynamics (CFD) is a promising tool that provides highly resolved haemodynamics information. The choice of blood rheology is an assumption in CFD models that has...
40 CitationsSource
#1E. Doutel (Faculdade de Engenharia da Universidade do Porto)H-Index: 5
#2J. Carneiro (Faculdade de Engenharia da Universidade do Porto)H-Index: 3
Last. João M. D. Miranda (Faculdade de Engenharia da Universidade do Porto)H-Index: 24
view all 4 authors...
Abstract Atherosclerosis is a major cause of death in developed countries. Mass accumulation in artery walls causes obstruction to the blood flow, stenoses, giving origin to life threatening events. This work focuses on the use of a simple and effective methodology for creating three-dimensional irregular stenosis in artery models for numerical and in vitro hemodynamic studies. The method infers the artery location prone to stenoses appearance by identifying areas of low wall shear stress. Then,...
9 CitationsSource
#1Moritz P. Thon (TUM: Technische Universität München)H-Index: 3
#2André Hemmler (TUM: Technische Universität München)H-Index: 3
Last. Michael W. Gee (TUM: Technische Universität München)H-Index: 22
view all 7 authors...
This work is devoted to the development of a mathematical model of the early stages of atherosclerosis incorporating processes of all time scales of the disease and to show their interactions. The cardiovascular mechanics is modeled by a fluid–structure interaction approach coupling a non-Newtonian fluid to a hyperelastic solid undergoing anisotropic growth and a change of its constitutive equation. Additionally, the transport of low-density lipoproteins and its penetration through the endotheli...
18 CitationsSource
Cited By10
#1Yan Cai (SEU: Southeast University)H-Index: 8
#2Zhiyong Li (QUT: Queensland University of Technology)H-Index: 29
Abstract null null Mathematical modeling contributes to pathophysiological research of atherosclerosis by helping to elucidate mechanisms and by providing quantitative predictions that can be validated. In turn, the complexity of atherosclerosis is well suited to quantitative approaches as it provides challenges and opportunities for new developments of modeling. In this review, we summarize the current ‘state of the art’ on the mathematical modeling of the effects of biomechanical factors and m...
#1Yan Wang (ZJU: Zhejiang University)H-Index: 1
#2Kun Luo (ZJU: Zhejiang University)H-Index: 36
Last. Jianren Fan (ZJU: Zhejiang University)H-Index: 37
view all 4 authors...
Abstract null null Type B aortic dissection is a major aortic catastrophe that can be acutely complicated by rapid expansion, rupture, and malperfusion syndromes. The separation of the intima from aortic walls will form a second blood-filled lumen defined as “false lumen (FL)”, where the thrombus is more likely to form due to the local stasis hemodynamic conditions. Complete thrombosis of FL is associated with a beneficial outcome while patency and partial thrombosis will lead to later complicat...
#1Navid Freidoonimehr (University of Adelaide)H-Index: 17
#2Rey Chin (University of Adelaide)H-Index: 5
Last. Maziar Arjomandi (University of Adelaide)H-Index: 30
view all 0 authors...
In this study, the effect of the shape of the stenosis on the flow transition in an artery is investigated. Different shapes of the stenosis including round, oval, elongated, half-moon, bean-shape, and crescent with and without eccentricity at a constant degree of stenosis (73%) are studied. A computational model, validated against the in-house Particle Image Velocimetry experimental results, is used to investigate the flow behavior. The results showed that the length of the jet region after the...
#1Silvia Pozzi (Polytechnic University of Milan)H-Index: 1
#2Alberto Redaelli (Polytechnic University of Milan)H-Index: 49
Last. Paolo Zunino (Polytechnic University of Milan)H-Index: 28
view all 5 authors...
In this work we propose a mathematical and numerical model to describe the early stages of atherosclerotic plaque formation, which is based on the interaction of processes with different spatial and temporal scales. A fluid–structure interaction problem, used to describe the cardiovascular mechanics arising between blood and the artery wall, is coupled to a set of differential problems describing the evolution of solute concentrations. In order to manage the multiscale-in-space nature of the inv...
Near-wall blood flow and wall shear stress (WSS) regulate major forms of cardiovascular disease, yet they are challenging to quantify with high fidelity. Patient-specific computational and experimental measurement of WSS suffers from uncertainty, low resolution, and noise issues. Physics-informed neural networks (PINN) provide a flexible deep learning framework to integrate mathematical equations governing blood flow with measurement data. By leveraging knowledge about the governing equations (h...
#1Mohammadali Sharzehee (UTSA: University of Texas at San Antonio)H-Index: 3
#2Yasamin Seddighi (UTSA: University of Texas at San Antonio)
Last. Hai Chao Han (UTSA: University of Texas at San Antonio)H-Index: 28
view all 5 authors...
Myocardial bridging (MB) and coronary atherosclerotic stenosis can impair coronary blood flow and may cause myocardial ischemia or even stoke. It remains unclear how MB and stenosis are similar or different regarding their impacts on coronary hemodynamics. The purpose of this study was to compare the hemodynamic effects of MB and stenosis using experimental and computational fluid dynamics (CFD) approaches. For CFD modeling, three MB patients with different levels of lumen obstruction such as mi...
#1Sara S. Meschi (NAU: Northern Arizona University)
#2Ali Farghadan (UM: University of Michigan)H-Index: 4
Last. Amirhossein Arzani (NAU: Northern Arizona University)H-Index: 13
view all 3 authors...
Abstract Targeted drug delivery is a promising technique to direct the drug to the specific diseased region. Nanoparticles have provided an attractive approach for this purpose. In practice, the major focus of targeted delivery has been on targeting cell receptors. However, the complex fluid mechanics in diseased biomedical flows questions if a sufficient number of nanoparticles can reach the desired region. In this paper, we propose that hidden topological structures in cardiovascular flows ide...
2 CitationsSource
#1Farshad Tajeddini (Sharif University of Technology)
Last. Hossein Afshin (Sharif University of Technology)H-Index: 13
view all 6 authors...
The objective of this paper is to apply computational fluid dynamic (CFD) as a complementary tool for clinical tests to not only predict the present and future status of left coronary artery stenosis but also to evaluate some clinical hypotheses. In order to assess the present status of the coronary artery stenosis severity, and thereby, selecting the most appropriate type of treatment for each patient, fractional flow reserve (FFR), instantaneous wave free-ratio (iFR), and coronary flow reserve...
2 CitationsSource
#1Milad HabibiH-Index: 1
#2Scott T. M. DawsonH-Index: 10
Last. Amirhossein ArzaniH-Index: 13
view all 3 authors...
Dynamic mode decomposition (DMD) is a purely data-driven and equation-free technique for reduced-order modeling of dynamical systems and fluid flow. DMD finds a best fit linear reduced-order model that represents any given spatiotemporal data. In DMD, each mode evolves with a fixed frequency and therefore DMD modes represent physically meaningful structures that are ranked based on their dynamics. The application of DMD to patient-specific cardiovascular flow data is challenging. First, the inpu...
11 CitationsSource
#1Navid Freidoonimehr (University of Adelaide)H-Index: 17
#2Maziar Arjomandi (University of Adelaide)H-Index: 30
Last. Anthony C. Zander (University of Adelaide)H-Index: 20
view all 5 authors...
The turbulence in the blood flow, caused by plaque deposition on the arterial wall, increases by the combined effect of the complex plaque geometries and the pulsatile blood flow. The correlation between the plaque geometry, the pulsatile inlet flow and the induced turbulence in a constricted artery is investigated in this study. Pressure drop, flow velocity and wall shear stress are determined for stenosed coronary artery models with three different degrees of asymmetric stenosis and for differ...
8 CitationsSource