Nova platforma za brzo simuliranje interakcije fluida i strukture pri strujanju krvi kroz realne geometrije bifurkacija koronarne arterije
Sažetak
Uvod/Cilj. Praktične poteškoće, posebno dugo vreme razvoja modela, ograničavaju tipove i primenljivost računske dinamike fluida u numeričkom modeliranju strujanja krvi za veći broj bolesnika. U ovim simulacijama, parametri strujanja koji najviše pokazuju su endotelijski smicajni napon i oscilujući smicajni indeks. Cilj rada bio je da se analizira njihova uloga u dijagnozi i prognoziranju razvoja plaka na račvama (bifurkacijama) koronarnih arterija. Metode. Razvili smo novu tehniku kompjuterskog modeliranja za potrebe brzih kardiovaskularnih hemodinamičkih simulacija uzimajući u obzir interakcije između domena fluida (krv) i domena strukture (arterijskog zida). Generisana su dva numerička modela koja predstavljaju posmatrane poddomene bifurkacije koronarne arterije slučajno izabranog bolesnika, korišćenjem multi-slajsne kompjuterizovane tomografije (MSCT) koronarografije i ultrazvučnog merenja brzine strujanja krvi. Simulacija koronarnog strujanja je izvršena korišćenjem sopstvenog softvera PAK-FS. Rezultati. Sveukupno ponašanje strujanja krvi u bifurkacijama koronarnih arterija je opisano preko sledećih parametara: brzina, pritisak, endotelijski smicajni napon, oscilujući smicajni indeks, napon na zidu arterije i čvorna pomeranja. Mesta gde je (a) endotelijski smicajni napon manji od 1,5 i (b) oscilujući smicajni indeks veoma mali (blizak ili jednak 0) su sklona razvoju plaka. Zaključak. Simulacija interakcije fluida-strukture metodom konačnih elemenata je korišćena da se ispitaju dinamika strujanja krvi i mehaničke karakteristike zida bifurkacije koronarne arterije slučajno izabranog bolesnika. U numeričkom modelu je otkriveno da lateralni zidovi glavne grane i lateralni zidovi distalno od karine imaju nizak endotelijski smicajni napon što je preduslov za razvoj ateroskleroze na tim mestima. Ovaj zaključak je potvrđen i niskim vrednostima oscilatornog smicajnog indeksa na istim mestima.
Reference
Zarins CK, Giddens DP, Bharadvaj BK, Sottiurai VS, Mabon RF, Glagov S. Carotid bifurcation atherosclerosis. Quantitative cor-relation of plaque localization with flow velocity profiles and wall shear stress. Circ Res 1983; 53(4): 502−14.
Nakazawa G, Yazdani SK, Finn AV, Vorpahl M, Kolodgie FD, Virmani R. Pathological findings at bifurcation lesions: the im-pact of flow distribution on atherosclerosis and arterial healing after stent implantation. J Am Coll Cardiol 2010; 55(16): 1679−87.
Ku DN, Giddens DP, Zarins CK, Glagov S. Pulsatile flow and atherosclerosis in the human carotid bifurcation. Positive cor-relation between plaque location and low oscillating shear stress. Arteriosclerosis 1985; 5(3): 293−302.
Moore JE, Xu C, Glagov S, Zarins CK, Ku DN. Fluid wall shear stress measurements in a model of the human abdominal aorta: oscillatory behavior and relationship to atherosclerosis. Atherosclerosis 1994; 110(2): 225−40.
Chatzizisis YS, Coskun AU, Jonas M, Edelman ER, Feldman CL, Stone PH. Role of endothelial shear stress in the natural history of coronary atherosclerosis and vascular remodeling: molecu-lar, cellular, and vascular behavior. J Am Coll Cardiol 2007; 49(25): 2379−93.
Gambillara V, Chambaz C, Montorzi G, Roy S, Stergiopulos N, Si-lacci P. Plaque-prone hemodynamics impair endothelial func-tion in pig carotid arteries. Am J Physiol Heart Circ Physiol 2006; 290(6): H2320−8.
Samady H, Eshtehardi P, McDaniel MC, Suo J, Dhawan SS, May-nard C, et al. Coronary artery wall shear stress is associated with progression and transformation of atherosclerotic plaque and arterial remodeling in patients with coronary artery dis-ease. Circulation 2011; 124(7): 779−88.
Giannoglou GD, Antoniadis AP, Koskinas KC, Chatzizisis YS. Flow and atherosclerosis in coronary bifurcations. EuroIntervention 2010; 6(Suppl J): J16−23.
Kung EO, Les AS, Figueroa AC, Medina F, Arcaute K, Wicker RB, et al. In vitro validation of finite element analysis of blood flow in deformable models. Ann Biomed Eng 2011; 39(7): 1947−60.
Stepanović Ž, Živković M, Vulović S, Aćimović L, Ristić B, Matić A, et al. High, open wedge tibial osteotomy: Finite element analysis of five internal fixation modalities. Vojnosanit Pregl 2011; 68(10): 867−71. (Serbian)
Mariūnas M, Kuzborska Z. Influence of load magnitude and du-ration on the relationship between human arterial blood pres-sure and flow rate. Acta Bioeng Biomech 2011; 13(2): 67−72.
Kim H, Vignon-Clementel I, Figueroa C, Jansen K, Taylor C. Devel-oping computational methods for three-dimensional finite element simulations of coronary blood flow. Finite Elem Anal Des 2010; 46(6): 514−25.
Torii R, Oshima M, Kobayashi T, Takagi K, Tezduyar TE. Com-puter modeling of cardiovascular fluid-structure interactions with the deforming-spatial-domain/stabilized space-time for-mulation. Comput Methods Appl Mech Eng 2006; 195: 1885–95.
Bazilevs Y, Hsu MC, Zhang Y, Wang W, Liang X, Kvamsdal T, et al. A fully-coupled fluid-structure interaction simulation of cerebral aneurysms. Comput Mech 2010; 46(1): 3−16.
Weydahl ES, Moore JE. Dynamic curvature strongly affects wall shear rates in a coronary artery bifurcation model. J Biomech 2001; 34(9): 1189−96.
Nichols WW, Orourke MF. McDonalds blood flow in arteries: Theoretica, experimental and clinical principles. 5th ed. Lon-don: A Hodder Arnold Publicatio; 2005.
Slager CJ, Wentzel JJ, Gijsen FJ, Schuurbiers JC, Wal AC, Steen AF, et al. The role of shear stress in the generation of rupture-prone vulnerable plaques. Nat Clin Pract Cardiovasc Med 2005; 2(8): 401−7.
Malek AM, Alper SL, Izumo S. Hemodynamic shear stress and its role in atherosclerosis. JAMA 1999; 282(21): 2035−42.
Gimbrone MA, Topper JN, Nagel T, Anderson KR, Garcia-Cardeña G. Endothelial dysfunction, hemodynamic forces, and athero-genesis. Ann N Y Acad Sci 2000; 902: 230−9; discussion 9−40.
Stone PH, Coskun AU, Kinlay S, Clark ME, Sonka M, Wahle A, et al. Effect of endothelial shear stress on the progression of coronary artery disease, vascular remodeling, and in-stent restenosis in humans: in vivo 6-month follow-up study. Circu-lation 2003; 108(4): 438−44.
Ku DN. Blood flow in arteries. Annu Rev Fluid Mech 1997; 29(1): 399−434.
Soulis JV, Giannoglou GD, Chatzizisis YS, Farmakis TM, Gian-nakoulas GA, Parcharidis GE, et al. Spatial and phasic oscillation of non-Newtonian wall shear stress in human left coronary artery bifurcation: an insight to atherogenesis. Coron Artery Dis 2006; 17(4): 351−8.
Younis HF, Kaazempur-Mofrad MR, Chan RC, Isasi AG, Hinton DP, Chau AH, et al. Hemodynamics and wall mechanics in human carotid bifurcation and its consequences for athero-genesis: investigation of inter-individual variation. Biomech Model Mechanobiol 2004; 3(1): 17−32.
Kojić M, Filipović N, Stojanović B, Kojić N. Computer Modeling in Bioengineering: Theoretical background, examples and soft-ware. Chichester: John Wiley & Sons; 2008.
Bathe K. Finite element procedures in engineering analysis. Englewood Cliffs, NJ: Prentice Hall; 1996.
Kojic M, Slavkovic R, Zivkovic M, Grujovic N. The finite element method: Linear analysis. Kragujevac: Faculty of Mechanical Engineering of Kragujevac; 1998. (Serbian)
Živković M. Department: Department for applied mechanics and automatic control. Kragujevac: Faculty of Engineering, University of Kragujevac; 2004.
Zhao SZ, Ariff B, Long Q, Hughes AD, Thom SA, Stanton AV, Xu XY. Inter-individual variations in wall shear stress and me-chanical stress distributions at the carotid artery bifurcation of healthy humans. J Biomech 2002; 35(10): 1367−77.
Soulis JV, Farmakis TM, Giannoglou GD, Louridas GE. Wall shear stress in normal left coronary artery tree. J Biomech 2006; 39(4): 742−9.
Nguyen KT, Clark CD, Chancellor TJ, Papavassiliou DV. Carotid geometry effects on blood flow and on risk for vascular dis-ease. J Biomech 2008; 41(1): 11−9.
Goubergrits L, Affeld K, Fernandez-Brittoy J, Falcon L. Investigation of geometry and atherosclerosis in the human carotid bi-furcations. J Mech Med Biol 2003; 3(1): 31−48.
Zhang YJ, Bajaj C. Adaptive and quality quadrilat-eral/hexahedral meshing from volumetric data. Comput Methods Appl Mech Engrg 2006; 195: 942−60.
de Santis G, de Beule M, van Canneyt K, Segers P, Verdonck P, Ver-hegghe B. Full-hexahedral structured meshing for image-based computational vascular modeling. Med Eng Phys 2011; 33(10): 1318−25.
Shirsat A, Gupta S, Shevare GR. Generation of multi-block to-pology for discretisation of three-dimensional domains. Com-put Graph 1999; 23(1): 45−57.
Yuan C, Yih N. A transfinite interpolation method of grid generation based on multipoints. J Sci Comp 1998; 13(1): 105−14.
Perktold K, Resch M, Florian H. Pulsatile non-Newtonian flow characteristics in a three-dimensional human carotid bifurca-tion model. J Biomech Eng 1991; 113(4): 464−75.
Perktold K, Resch M, Peter RO. Three-dimensional numerical analysis of pulsatile flow and wall shear stress in the carotid ar-tery bifurcation. J Biomech 1991; 24(6): 409−20.
Stone PH, Feldman CL. In vivo assessment of the risk profile of evolving individual coronary plaques: a step closer. Circula-tion 2011; 124(7): 763−5.
