False lumen flow patterns and their relation with morphological and biomechanical characteristics of chronic aortic dissections: Computational model compared with magnetic resonance imaging measurements

Aortic wall stiffness, tear size and location and the presence of abdominal side branches arising from the false lumen (FL) are key properties potentially involved in FL enlargement in chronic aortic dissections (ADs). We hypothesize that temporal variations on FL flow patterns, as measured in a cro...

ver descrição completa

Detalhes bibliográficos
Autores: Rudenick, Paula A., Segers, Patrick F., Pineda, Víctor, Cuellar, Hug, García-Dorado, David, Evangelista, Arturo, Bijnens, Bart
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2017
País:España
Recursos:Universitat Pompeu Fabra
Repositório:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/48105
Acesso em linha:http://hdl.handle.net/10230/48105
http://dx.doi.org/10.1371/journal.pone.0170888
Access Level:Acceso aberto
Palavra-chave:Thoracic diaphragm
Stiffness
Magnetic resonance imaging
Aorta
Hemodynamics
Systole
Fluid flow
Diastole
id ES_8e7aaeea970a0634cab8baf0bb9baaa0
oai_identifier_str oai:repositori.upf.edu:10230/48105
network_acronym_str ES
network_name_str España
repository_id_str
spelling False lumen flow patterns and their relation with morphological and biomechanical characteristics of chronic aortic dissections: Computational model compared with magnetic resonance imaging measurementsRudenick, Paula A.Segers, Patrick F.Pineda, VíctorCuellar, HugGarcía-Dorado, DavidEvangelista, ArturoBijnens, BartThoracic diaphragmStiffnessMagnetic resonance imagingAortaHemodynamicsSystoleFluid flowDiastoleAortic wall stiffness, tear size and location and the presence of abdominal side branches arising from the false lumen (FL) are key properties potentially involved in FL enlargement in chronic aortic dissections (ADs). We hypothesize that temporal variations on FL flow patterns, as measured in a cross-section by phase-contrast magnetic resonance imaging (PC-MRI), could be used to infer integrated information on these features. In 33 patients with chronic descending AD, instantaneous flow profiles were quantified in the FL at diaphragm level by PC-MRI. We used a lumped-parameter model to assess the changes in flow profiles induced by wall stiffness, tear size/location, and the presence of abdominal side branches arising from the FL. Four characteristic FL flow patterns were identified in 31/33 patients (94%) based on the direction of flow in systole and diastole: BA = systolic biphasic flow and primarily diastolic antegrade flow (n = 6); BR = systolic biphasic flow and primarily diastolic retrograde flow (n = 14); MA = systolic monophasic flow and primarily diastolic antegrade flow (n = 9); MR = systolic monophasic flow and primarily diastolic retrograde flow (n = 2). In the computational model, the temporal variation of flow directions within the FL was highly dependent on the position of assessment along the aorta. FL flow patterns (especially at the level of the diaphragm) showed their characteristic patterns due to variations in the cumulative size and the spatial distribution of the communicating tears, and the incidence of visceral side branches originating from the FL. Changes in wall stiffness did not change the temporal variation of the flows whereas it importantly determined intraluminal pressures. FL flow patterns implicitly codify morphological information on key determinants of aortic expansion in ADs. This data might be taken into consideration in the imaging protocol to define the predictive value of FL flows.The research leading to these results has received funding from the Subprograma de Proyectos de Investigación en Salud (FIS), Instituto de Salud Carlos III, Spain (ref. PI108/0608, PI11/01709); the Programa de ayudas destinadas a universidades, centros de investigación y fundaciones hospitalarias para la contratación de personal investigador novel (FI-DGR 2011), Spain; and the EU FP7 for research, technological development and demonstration under grant agreement VP2HF (no 611823). All authors have reported that they have no relationships relevant to the contents of this paper to disclose. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Public Library of Science (PLoS)202120212017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/48105http://dx.doi.org/10.1371/journal.pone.0170888reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésPLoS ONE. 2017;12(1):e0170888info:eu-repo/grantAgreement/EC/FP7/611823© 2017 Rudenick et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. https://creativecommons.org/licenses/by/4.0/https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/481052026-06-12T07:21:37Z
dc.title.none.fl_str_mv False lumen flow patterns and their relation with morphological and biomechanical characteristics of chronic aortic dissections: Computational model compared with magnetic resonance imaging measurements
title False lumen flow patterns and their relation with morphological and biomechanical characteristics of chronic aortic dissections: Computational model compared with magnetic resonance imaging measurements
spellingShingle False lumen flow patterns and their relation with morphological and biomechanical characteristics of chronic aortic dissections: Computational model compared with magnetic resonance imaging measurements
Rudenick, Paula A.
Thoracic diaphragm
Stiffness
Magnetic resonance imaging
Aorta
Hemodynamics
Systole
Fluid flow
Diastole
title_short False lumen flow patterns and their relation with morphological and biomechanical characteristics of chronic aortic dissections: Computational model compared with magnetic resonance imaging measurements
title_full False lumen flow patterns and their relation with morphological and biomechanical characteristics of chronic aortic dissections: Computational model compared with magnetic resonance imaging measurements
title_fullStr False lumen flow patterns and their relation with morphological and biomechanical characteristics of chronic aortic dissections: Computational model compared with magnetic resonance imaging measurements
title_full_unstemmed False lumen flow patterns and their relation with morphological and biomechanical characteristics of chronic aortic dissections: Computational model compared with magnetic resonance imaging measurements
title_sort False lumen flow patterns and their relation with morphological and biomechanical characteristics of chronic aortic dissections: Computational model compared with magnetic resonance imaging measurements
dc.creator.none.fl_str_mv Rudenick, Paula A.
Segers, Patrick F.
Pineda, Víctor
Cuellar, Hug
García-Dorado, David
Evangelista, Arturo
Bijnens, Bart
author Rudenick, Paula A.
author_facet Rudenick, Paula A.
Segers, Patrick F.
Pineda, Víctor
Cuellar, Hug
García-Dorado, David
Evangelista, Arturo
Bijnens, Bart
author_role author
author2 Segers, Patrick F.
Pineda, Víctor
Cuellar, Hug
García-Dorado, David
Evangelista, Arturo
Bijnens, Bart
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Thoracic diaphragm
Stiffness
Magnetic resonance imaging
Aorta
Hemodynamics
Systole
Fluid flow
Diastole
topic Thoracic diaphragm
Stiffness
Magnetic resonance imaging
Aorta
Hemodynamics
Systole
Fluid flow
Diastole
description Aortic wall stiffness, tear size and location and the presence of abdominal side branches arising from the false lumen (FL) are key properties potentially involved in FL enlargement in chronic aortic dissections (ADs). We hypothesize that temporal variations on FL flow patterns, as measured in a cross-section by phase-contrast magnetic resonance imaging (PC-MRI), could be used to infer integrated information on these features. In 33 patients with chronic descending AD, instantaneous flow profiles were quantified in the FL at diaphragm level by PC-MRI. We used a lumped-parameter model to assess the changes in flow profiles induced by wall stiffness, tear size/location, and the presence of abdominal side branches arising from the FL. Four characteristic FL flow patterns were identified in 31/33 patients (94%) based on the direction of flow in systole and diastole: BA = systolic biphasic flow and primarily diastolic antegrade flow (n = 6); BR = systolic biphasic flow and primarily diastolic retrograde flow (n = 14); MA = systolic monophasic flow and primarily diastolic antegrade flow (n = 9); MR = systolic monophasic flow and primarily diastolic retrograde flow (n = 2). In the computational model, the temporal variation of flow directions within the FL was highly dependent on the position of assessment along the aorta. FL flow patterns (especially at the level of the diaphragm) showed their characteristic patterns due to variations in the cumulative size and the spatial distribution of the communicating tears, and the incidence of visceral side branches originating from the FL. Changes in wall stiffness did not change the temporal variation of the flows whereas it importantly determined intraluminal pressures. FL flow patterns implicitly codify morphological information on key determinants of aortic expansion in ADs. This data might be taken into consideration in the imaging protocol to define the predictive value of FL flows.
publishDate 2017
dc.date.none.fl_str_mv 2017
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/48105
http://dx.doi.org/10.1371/journal.pone.0170888
url http://hdl.handle.net/10230/48105
http://dx.doi.org/10.1371/journal.pone.0170888
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv PLoS ONE. 2017;12(1):e0170888
info:eu-repo/grantAgreement/EC/FP7/611823
dc.rights.none.fl_str_mv https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869413132487622656
score 15,812455

Registros relacionados