在连续流动的威利斯圆圈中建模血液流动左心室辅助装置:可能与中风相关
Srinivasan Krishna1, Komarakshi Balakrishnan2, Ramaratnam Krishna Kumar1
1Department of Engineering Design, Indian Institute of Technology Madras, Chennai, India.
Indian journal of thoracic and cardiovascular surgery
|January 17, 2025
概括
持续流动的左心室辅助器件 (CFLVADs) 可以导致高血压和中风. 将脉动性添加到CFLVAD流中可能会降低血压和中风风险,特别是在某些Willis变化的圆上.
科学领域:
- 生物医学工程 生物医学工程
- 心血管生理学心血管生理学
- 神经科学是一个神经科学.
背景情况:
- 持续流动左心室辅助器件 (CFLVADs) 对心力衰竭治疗至关重要,但与中风等不良事件有关.
- 高血压是CFLVAD患者常见的并发症,也是中风的重要危险因素.
- CFLVAD血动力学,高血压和脑血流之间的关系,特别是关于威利斯解剖圈的关系,需要进一步研究.
研究的目的:
- 调查导致CFLVAD患者高血压的物理因素.
- 为了确定威利斯圆圈中的解剖学变异是否会影响CFLVAD接受者的中风风险.
- 探索脉动流与非脉动流对大脑血液动力学的影响.
主要方法:
- 使用了一维的血流模型,包括波传播和反射.
- 在脉动和非脉动CFLVAD流量条件下分析了大脑循环动态.
- 使用ADAN86动脉网络模型模拟了解剖变异,特别是后部通讯动脉的缺失,对大脑血流和血压的影响.
主要成果:
- 与脉动性流量相比,非脉动性CFLVAD流量导致平均动脉压显著上升.
- 增加CFLVAD流动中的脉动性逐渐降低了平均动脉压.
- 缺少后部通讯动脉本身并没有影响中脑动脉的流量或压力,但与侧动脉阻塞相结合时,显著减少了它们.
结论:
- 将生理脉动性纳入CFLVAD提供了潜在的临床益处,包括降低血压,从而降低中风,血栓,胃肠道出血和大动脉无能症的风险.
- 威利斯圆的患者特异性解剖变异,例如后部通讯动脉的缺失,在特定的血液动力学条件下,可以严重影响区域大脑输液.
- 这些发现强调了考虑设备生成的血液动力学和患者特定的脑血管解剖学的重要性,以减轻CFLVAD治疗中的不良事件.
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