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Tytuł pozycji:

Computational Assessment of Blood Flow Heterogeneity in Peritoneal Dialysis Patients' Cardiac Ventricles

Tytuł :
Computational Assessment of Blood Flow Heterogeneity in Peritoneal Dialysis Patients' Cardiac Ventricles
Autorzy :
Sanjay R. Kharche
Aaron So
Fabio Salerno
Ting-Yim Lee
Chris Ellis
Daniel Goldman
Christopher W. McIntyre
Pokaż więcej
Temat :
coronary vessels
cardiac physiology
mathematical modeling
computational physiology
integrative physiology
Physiology
QP1-981
Źródło :
Frontiers in Physiology, Vol 9 (2018)
Wydawca :
Frontiers Media S.A., 2018.
Rok publikacji :
2018
Kolekcja :
LCC:Physiology
Typ dokumentu :
article
Opis pliku :
electronic resource
Język :
English
ISSN :
1664-042X
Relacje :
http://journal.frontiersin.org/article/10.3389/fphys.2018.00511/full; https://doaj.org/toc/1664-042X
DOI :
10.3389/fphys.2018.00511
Dostęp URL :
https://doaj.org/article/8607e69602de4829b3e14ee5e3656562
Prawa :
Journal Licence: CC BY
Numer akcesji :
edsdoj.8607e69602de4829b3e14ee5e3656562
Czasopismo naukowe
Dialysis prolongs life but augments cardiovascular mortality. Imaging data suggests that dialysis increases myocardial blood flow (BF) heterogeneity, but its causes remain poorly understood. A biophysical model of human coronary vasculature was used to explain the imaging observations, and highlight causes of coronary BF heterogeneity. Post-dialysis CT images from patients under control, pharmacological stress (adenosine), therapy (cooled dialysate), and adenosine and cooled dialysate conditions were obtained. The data presented disparate phenotypes. To dissect vascular mechanisms, a 3D human vasculature model based on known experimental coronary morphometry and a space filling algorithm was implemented. Steady state simulations were performed to investigate the effects of altered aortic pressure and blood vessel diameters on myocardial BF heterogeneity. Imaging showed that stress and therapy potentially increased mean and total BF, while reducing heterogeneity. BF histograms of one patient showed multi-modality. Using the model, it was found that total coronary BF increased as coronary perfusion pressure was increased. BF heterogeneity was differentially affected by large or small vessel blocking. BF heterogeneity was found to be inversely related to small blood vessel diameters. Simulation of large artery stenosis indicates that BF became heterogeneous (increase relative dispersion) and gave multi-modal histograms. The total transmural BF as well as transmural BF heterogeneity reduced due to large artery stenosis, generating large patches of very low BF regions downstream. Blocking of arteries at various orders showed that blocking larger arteries results in multi-modal BF histograms and large patches of low BF, whereas smaller artery blocking results in augmented relative dispersion and fractal dimension. Transmural heterogeneity was also affected. Finally, the effects of augmented aortic pressure in the presence of blood vessel blocking shows differential effects on BF heterogeneity as well as transmural BF. Improved aortic blood pressure may improve total BF. Stress and therapy may be effective if they dilate small vessels. A potential cause for the observed complex BF distributions (multi-modal BF histograms) may indicate existing large vessel stenosis. The intuitive BF heterogeneity methods used can be readily used in clinical studies. Further development of the model and methods will permit personalized assessment of patient BF status.

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