摘要
目的考虑血管重构和低密度脂蛋白(low-density lipoproteins,LDL)沉积,探讨分叉血管边支斑块的生长发展趋势,以及因斑块存在而可能引发继生斑块的生长位置。方法建立分叉血管理想化模型,用计算流体力学方法获取边支斑块生长前后壁面切应力分布。在低切应力区域截取7个截面:截面1~3为斑块生成前边支的低切应力区域;截面4、5为斑块上、下游边缘;截面6、7为斑块下游低切应力区域。模拟截面内血管重构和LDL沉积,讨论斑块的生长和发展趋势。结果截面1~3中,截面2产生了明显的负性重构和最高浓度LDL沉积(102.266 mmol/L),说明此处是动脉粥样硬化斑块的起始位置。当斑块产生后,相比于截面4,截面5产生了更明显的血管重构,并造成管腔的狭窄和最高的沉积浓度(110.17 mmol/L),说明斑块有向下游偏心生长的趋势。相比于截面6,截面7(血液流动分离再附着点)产生了更明显的负性重构和最高的沉积浓度(93.851 mmol/L),说明血液流动分离再附着点附近有生成新斑块的可能。结论边支低切应力处产生明显血管重构导致管腔狭窄,并引发LDL的高浓度沉积,形成动脉粥样硬化斑块。其中,分叉血管的外侧壁为动脉粥样硬化斑块生长的起始位置。在斑块生长后斑块有向下游发展的趋势,在流动分离再附着点有形成继生斑块可能。
Objective To investigate vascular remodeling and low-density lipoprotein(LDL)deposition,the growth and development trends of lateral branch plaques in bifurcated vessels,and the potential locations of subsequent plaque growth due to the presence of plaques.Methods An idealized model of bifurcated vesselswas established and the distribution of wall shear stress before and after the growth of edge-branch plaques wasobtained using computational fluid dynamics.Seven sections were intercepted in the areas of low shear stress:planes 1-3 were the low shear stress areas on the lateral branch before plaque formation,planes 4-5 were theproximal and distal edges of the plaque,and planes 6-7 were the lower shear stress areas of the plaque.Vascular remodeling and LDL deposition in the cross section were simulated.The growth and development trendsof plaques are also discussed.Results Among planes 1-3,plane 2 produced obvious negative remodeling andthe highest concentration of LDL deposition(102.266 mmol/L),thereby indicating that this was the initial locationof the atherosclerotic plaque.Compared to plane 4,plane 5 produced more pronounced vascular remodeling,lumen narrowing,and the highest deposition concentration(110.17 mmol/L)after plaque formation,whichindicated that the patch had a tendency for eccentric growth downstream.Compared to plane 6,plane 7(bloodflow separation reattachment site)produced more negative remodeling and the highest deposition concentration(93.851 mmol/L),thereby indicating the possibility of new plaque formation near the reattachment point of bloodflow separation.Conclusions Obvious vascular remodeling at low shear stress in the lateral branches leads tolumen stenosis and high LDL deposition,thus,forming atherosclerotic plaques.The lateral wall of the bifurcatedblood vessels is the initial location of atherosclerotic plaque growth.After growth,the plaque tends to developdownstream,and subsequent plaques may form at the flow separation and reattachment points.
作者
刘昭
孙浩
陶克怡
杜田明
张艳萍
刘圣文
冯继玲
乔爱科
LIU Zhao;SUN Hao;TAO Keyi;DU Tianming;ZHANG Yanping;LIU Shengwen;FENG Jiling;QIAO Aike(College of Chemistry and Life Science,Beijing University of Technology,Beijing 100124,China;Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation,Beijing 100124,China;Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing 100032,China;Department of Engineering,Faculty of Science and Engineering,Manchester Metropolitan University,Manchester M15GD,UK)
出处
《医用生物力学》
CAS
CSCD
北大核心
2024年第5期838-845,共8页
Journal of Medical Biomechanics
基金
国家自然科学基金项目(12172018)
The Royal Society-International Exchanges 2022 Cost Share(NSFC)(IEC/NSFC/223003)。
关键词
分叉血管
动脉粥样硬化
血管重构
低密度脂蛋白沉积
数值模拟
bifurcated vessels
atherosclerosis
vascular remodeling
low-density lipoproteins deposition
numerical simulation
