Predicting hemodynamic indices in coronary artery aneurysms using response surface method: An application in Kawasaki
Alireza Asadbeygi1, Simon Lee2, John Kovalchin2
1Department of Biomedical Engineering, Michigan Technological University, Houghton, MI, United States.
Insights
Coronary artery aneurysm (CAA) shape significantly impacts blood flow and thrombotic risk. Aneurysm diameter is the primary risk factor, while shorter lengths indicate higher stagnation, informing clinical assessment.
Area of Science:
- Cardiovascular Research
- Biomedical Engineering
- Medical Fluid Dynamics
Background:
- Coronary artery aneurysms (CAA), often linked to Kawasaki Disease (KD), cause altered hemodynamics, increasing thrombosis and atherosclerosis risk.
- Current risk assessment relies on Z-Scores (body surface area and diameter), lacking detailed geometric and hemodynamic correlation.
- Systematic investigation of CAA shape indices' impact on hemodynamics and thrombotic risk is needed.
Purpose of the Study:
- To investigate the effect of CAA shape indices on local hemodynamics.
- To develop regression models correlating geometric factors with hemodynamic metrics using Response Surface Method (RSM).
- To apply these models to Kawasaki Disease (KD) cases.
Main Methods:
- Transient Computational Fluid Dynamics (CFD) simulations on idealized CAA geometries.
- Development of quadratic regression models using RSM based on simulation results.
- Validation of models using patient-specific KD models.
Main Results:
- Aneurysm diameter is the primary determinant of thrombotic risk, aligning with clinical practice.
- For similar diameters, shorter CAA lengths correlate with higher Relative Residence Time (RRT) values, indicating flow stagnation.
- RSM models effectively predict hemodynamic alterations based on geometric indices.
Conclusions:
- Developed regression models offer a hemodynamic-based approach for assessing CAA thrombotic risk.
- Models demonstrated good agreement with patient-specific KD cases, validating their clinical applicability.
- Geometric factors, beyond diameter, provide crucial insights into CAA hemodynamic risks.
Background And Objectives:
Coronary artery aneurysms (CAA), such as those in Kawasaki Disease (KD), induce hemodynamic alterations associated with thrombosis and atherosclerosis. Current clinical routines assess the risk level of the CAA cases based on the Z-Score, which considers the body surface area (BSA) and the CAA's diameter. A full geometric characterization and impact on hemodynamic metrics and their correlation with thrombotic risks have not been systematically investigated. The goal of this study was to investigate the effect of CAA shape indices on local hemodynamics using the response surface method (RSM) through considering KD applications.
Methods:
Transient computational fluid dynamics (CFD) simulations have been performed on idealized CAA geometries defined by geometrical ratios combining neck diameter, CAA diameter and CAA length. The results were used to develop full quadratic regression models of the indices using the response surface method (RSM). Validation using patient-specific KD models was performed.
Results:
The results indicated that the aneurysm diameter is the main determining factor in the thrombotic risk of CAA patients, which is consistent with clinical guidelines. Furthermore, it was observed that in most CAA cases having the same diameter, the one with the shorter length experiences higher RRT values, indicating flow stagnation and circulation.
Conclusions:
The developed regression models can be used to ultimately assess the thrombotic risk of CAA cases from the hemodynamic perspective. The applicability of these models was tested on 2 KD patient specific models, with close values achieved between the models and the patient-specific results.
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