Key result
A new haemodynamic stimulus index correctly predicted 11 of 14 plaques in patient-specific carotid geometries, with minimal and maximal errors on stenosis ratio of 2.77% and 32.89%.
Why the study?
The authors sought to develop and test a mechanobiological atheroma growth model modulated by a new haemodynamic stimulus to predict the location and size of carotid plaques.
Does a new haemodynamic stimulus combining TAWSS and OSI improve the prediction of carotid plaque location and size in a mechanobiological model compared to TAWSS or OSI alone?
Does a new haemodynamic stimulus combining TAWSS and OSI improve the prediction of carotid plaque location and size in a mechanobiological model compared to TAWSS or OSI alone?
A novel computational mechanobiological model incorporating a combined haemodynamic stimulus improves the prediction of carotid plaque location and size compared to traditional indices.
May refine computational plaque prediction models; leaves open human validation before any clinical use.
In this work, we propose a mechanobiological atheroma growth model modulated by a new haemodynamic stimulus. To test this model, we analyse the development of atheroma plaques in patient-specific bifurcations of carotid arteries for a total time of 30 years. In particular, eight geometries (left or right carotid arteries) were segmented from clinical images and compared with the solutions obtained computationally to validate the model. The influence of some haemodynamical stimuli on the location and size of plaques is also studied. Plaques predicted by the mechanobiological models using the time average wall shear stress (TAWSS), the oscillatory shear index (OSI) and a new index proposed in this work are compared. The new index predicts the shape index of the endothelial cells as a combination of TAWSS and OSI values and was fitted using data from the literature. The mechanobiological model represents an evolution of the one previously proposed by the authors. This model uses Navier-Stokes equations to simulate blood flow along the lumen in the transient mode. It also employs Darcy's law and Kedem-Katchalsky equations for plasma and substance flow across the endothelium using the three-pore model. The mass balances of all the substances that have been considered in the model are implemented by convection-diffusion-reaction equations, and finally the growth of the plaques has been computed. The results show that by using the new mechanical stimulus proposed in this study, prediction of plaques is, in most cases, better than only using TAWSS or OSI with a minimal and maximal errors on stenosis ratio of 2.77 and 32.89 %, respectively. However, there are a few geometries in which haemodynamics cannot predict the location of plaques, and other biological or genetic factors would be more relevant than haemodynamics. In particular, the model predicts correctly eleven of the fourteen plaques presented in all the geometries considered. Additionally, a healthy geometry has been computed to check that plaque is not developed with the model in this case.
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Hernández-López et al. (2021) studied Carotid plaques (n=8). New haemodynamic stimulus index vs. TAWSS or OSI alone was evaluated on Prediction of plaque location and size. A new haemodynamic stimulus index correctly predicted 11 of 14 plaques in patient-specific carotid geometries, with minimal and maximal errors on stenosis ratio of 2.77% and 32.89%.
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