Document Detail

Time-efficient patient-specific quantification of regional carotid artery fluid dynamics and spatial correlation with plaque burden.
MedLine Citation:
PMID:  20229888     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Low wall shear stress (WSS) and high oscillatory shear index (OSI) influence plaque formation, yet little is known about their role in progression/regression of established plaques because of lack of practical means to calculate them in individual patients. Our aim was to use computational fluid dynamics (CFD) models of patients with carotid plaque undergoing statin treatment to calculate WSS and OSI in a time-efficient manner, and determine their relationship to plaque thickness (PT), plaque composition (PC), and regression.
METHODS: Eight patients (68 +/- 9 yr, one female) underwent multicontrast 3 T MRI at baseline and six-month post statin treatment. PT and PC were measured in carotid segments (common-CC, bifurcation-B, internal-IC) and circumferentially in nonoverlapping 600 angles and correlated with CFD models created from MRI, ultrasound, and blood pressure.
RESULTS: PT was highest in B (2.42 +/- 0.98 versus CC: 1.60 +/- 0.47, IC: 1.62 +/- 0.52 mm, p < 0.01). Circumferentially, plaque was greatest opposite the flow divider (p < 0.01), where the lowest WSS and highest OSI were observed. In B and IC, PT was inversely related to WSS (R = -0.28 and -0.37, p < 0.01) and directly related to OSI (R = 0.22 and 0.52, p < 0.05). The total plaque volume changed from 1140 +/- 437 to 974 +/- 587 mm3 at six months (p = 0.1). Baseline WSS, but not OSI, correlated with changes in PT, necrotic tissue, and hemorrhage in B and IC, but not CC. CFD modeling took 49 +/- 18 h per patient.
CONCLUSIONS: PT and PC correspond to adverse WSS and OSI in B and IC, and WSS is modestly but significantly related to changes in PT after short-term statin treatment. Regional hemodynamics from CFD can feasibly augment routine clinical imaging for comprehensive plaque evaluation.
John F LaDisa; Mark Bowers; Leanne Harmann; Robert Prost; Anil Vamsi Doppalapudi; Tayyab Mohyuddin; Osama Zaidat; Raymond Q Migrino
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Medical physics     Volume:  37     ISSN:  0094-2405     ISO Abbreviation:  Med Phys     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-16     Completed Date:  2010-04-09     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  0425746     Medline TA:  Med Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  784-92     Citation Subset:  IM    
Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin 53233, USA.
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MeSH Terms
Blood Flow Velocity*
Blood Pressure*
Carotid Arteries / physiopathology*
Carotid Stenosis / drug therapy,  physiopathology*
Computer Simulation
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
Models, Cardiovascular*
Statistics as Topic
Grant Support
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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