Faculty Collaboration Database

Time-efficient patient-specific quantification of regional carotid artery fluid dynamics and spatial correlation with plaque burden. Med Phys 2010 Feb;37(2):784-92

Date

03/17/2010

Pubmed ID

20229888

Pubmed Central ID

PMC2826384

DOI

10.1118/1.3292631

Scopus ID

2-s2.0-75749125060 (requires institutional sign-in at Scopus site)   26 Citations

Abstract

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.

Author List

LaDisa JF Jr, Bowers M, Harmann L, Prost R, Doppalapudi AV, Mohyuddin T, Zaidat O, Migrino RQ

Author

John F. LaDisa PhD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Algorithms
Blood Flow Velocity
Blood Pressure
Carotid Arteries
Carotid Stenosis
Computer Simulation
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Male
Models, Cardiovascular
Statistics as Topic