Patient-Specific Fluid-Structure Interaction Simulations Suggest Wall-Shear-Stress-Related Biomarkers in Type B...

Area of Science:

• Cardiovascular research
• Biomedical engineering
• Medical imaging analysis

Background:

• Chronic type B dissection, a tear in the descending aorta (DSC) lasting over three months, can lead to aortic dilation and organ damage.
• Connective tissue disorders like Marfan syndrome (MFS) increase the risk of chronic type B dissection.
• Current surveillance relies on aortic diameter and growth rate, which are geometric and do not capture hemodynamic changes.

Purpose of the Study:

• To assess changes in aortic geometry and hemodynamics in chronic type B dissection.
• To investigate wall-shear-stress-related biomarkers for improved clinical treatment and prognostic assessment.
• To evaluate the utility of these biomarkers in Marfan syndrome patients.

Main Methods:

• Fluid-structure interaction simulations were performed on MFS patient images before and after type B dissection.
• Shear-stress-related metrics, including endothelial cell activation potential and relative residence time, were quantified.
• Variations in these metrics over the DSC length were correlated with geometrical parameters like maximum DSC diameter and false lumen volume index.

Main Results:

• Endothelial cell activation potential and relative residence time variations correlated with maximum DSC diameter.
• Oscillatory shear index variation correlated with the false lumen volume index.
• These findings suggest a link between hemodynamic changes and disease progression metrics.

Conclusions:

• Shear-stress-related metrics show potential as noninvasive biomarkers for chronic type B dissection.
• These biomarkers may enhance surveillance and management strategies for MFS patients.
• Further research could integrate hemodynamic data into clinical decision-making for aortic dissection.