A Pilot Study Characterizing Flow Patterns in the Thoracic Aorta of Patients With Connective Tissue Disease: Comparison to Age- and Gender-Matched Controls via Fluid Structure Interaction

Frontiers in Pediatrics

article

Joseph A. Camarda¹  Ronak J. Dholakia²  Hongfeng Wang²  Margaret M. Samyn¹  Joseph R. Cava¹  John F. LaDisa, Jr.¹ 

[1] Department of Pediatrics, Division of Cardiology, Herma Heart Institute, Children's Wisconsin and the Medical College of Wisconsin;Department of Biomedical Engineering, Marquette University the Medical College of Wisconsin;Departments of Medicine, Division of Cardiovascular Medicine and Physiology, Medical College of Wisconsin

关键词: Marfan syndrome;    computational modeling;    patient-specific modeling;    wall shear stress;    Loeys-Dietz syndrome;   

DOI  :  10.3389/fped.2022.772142

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Prior computational and imaging studies described changes in flow patterns for patients with Marfan syndrome, but studies are lacking for related populations. This pilot study addresses this void by characterizing wall shear stress (WSS) indices for patients with Loeys-Dietz and undifferentiated connective tissue diseases. Using aortic valve-based velocity profiles from magnetic resonance imaging as input to patient-specific fluid structure interaction (FSI) models, we determined local flow patterns throughout the aorta for four patients with various connective tissue diseases (Loeys-Dietz with the native aorta, connective tissue disease of unclear etiology with native aorta in female and male patients, and an untreated patient with Marfan syndrome, as well as twin patients with Marfan syndrome who underwent valve-sparing root replacement). FSI simulations used physiological boundary conditions and material properties to replicate available measurements. Time-averaged WSS (TAWSS) and oscillatory shear index (OSI) results are presented with localized comparison to age- and gender-matched control participants. Ascending aortic dimensions were greater in almost all patients with connective tissue diseases relative to their respective control. Differences in TAWSS and OSI were driven by local morphological differences and cardiac output. For example, the model for one twin had a more pronounced proximal descending aorta in the vicinity of the ductus ligamentum that impacted WSS indices relative to the other. We are optimistic that the results of this study can serve as a foundation for larger future studies on the connective tissue disorders presented in this article.

【 授权许可】

CC BY