Enhance extemal counterpulsation （ECP） procedure has exhbited itself to be an effective therapy for the m anagem entof ischem ic card iovascu lar diseases, However, considering that EECP significantly increases the...Enhance extemal counterpulsation （ECP） procedure has exhbited itself to be an effective therapy for the m anagem entof ischem ic card iovascu lar diseases, However, considering that EECP significantly increases the acute diastolic pressure, whether it will intervene in the chronic progression of advanced plaque causing great concern in clilical applkation, but yet rein ains elusive presently. In the current paper, a flu id-structure interface （FSI） num erical model of artery with p iaque corn ponent w as developed based on in vivo hem odynam ic m easurem entperfotm ed h a porcine model, to caku late the m echanical stresses of the plaque before and during EECP, and h lum to assess the potential effects of long-term EECP treatm ent on plaque progression. The resu Its show that E E C P augm ented the wall shear stress （WSS） and plaque w all stress （PWS） over the card lac cycles, aswell as the spacial oscillatory of W SS （WSSG ）. Durhg EECP treatm ent, the PW S level respectively raised 6.82% and 6.07% in two simulation cases. The currentpilot study suggests that E E C P treatm entre ay p lay a positive effect on inh biting the conthued plaque progression by hcreashg the PW S level over the card iac cycles. Meanwhile, the plaque morphology should be taken into consideration while m aking patient- specific plan for Ion g- term E E C P treatment in clinic.展开更多
To make clear the precise hemodynamic mechanism underlying the anti-atherogenesis benefit of enhanced external couterpulsation(EECP) treatment, and to investigate the proper role of some important hemodynamic factors ...To make clear the precise hemodynamic mechanism underlying the anti-atherogenesis benefit of enhanced external couterpulsation(EECP) treatment, and to investigate the proper role of some important hemodynamic factors during the atherosclerotic progress, a comprehensive study combining long-term animal experiment and numerical solving was conducted in this paper. An experimentally induced hypercholesterolemic porcine model was developed and the chronic EECP intervention was subjected. Basic hemodynamic measurement was performed in vivo, as well as the arterial endothelial samples were extracted for physiological examination. Meanwhile, a numerical model was introduced to solve the complex hemodynamic factors such as WSS and OSI. The results show that EECP treatment resulted in significant increase of the instant levels of arterial WSS, blood pressure, and OSI. During EECP treatment, the instant OSI level of the common carotid arteries over cardiac cycles raised to a mean value of 8.58 ×10-2±2.13 ×10-2. Meanwhile, the chronic intervention of EECP treatment significantly reduced the atherosclerotic lesions in abdominal aortas and the endothelial cellular adherence. The present study suggests that the unique blood flow pattern induced by EECP treatment and the augmentation of WSS level in cardiac cycles may be the most important hemodynamic mechanism that contribute to its anti-atherogenesis effect. And as one of the indices that cause great concern in current hemodynamic study, OSI may not play a key role during the initiation of atherosclerosis.展开更多
基金Key Clinical Project from the Ministry of Heatthgrant number:25400+1 种基金National Natural Science Foundation of Chinagrant number:81170272
文摘Enhance extemal counterpulsation （ECP） procedure has exhbited itself to be an effective therapy for the m anagem entof ischem ic card iovascu lar diseases, However, considering that EECP significantly increases the acute diastolic pressure, whether it will intervene in the chronic progression of advanced plaque causing great concern in clilical applkation, but yet rein ains elusive presently. In the current paper, a flu id-structure interface （FSI） num erical model of artery with p iaque corn ponent w as developed based on in vivo hem odynam ic m easurem entperfotm ed h a porcine model, to caku late the m echanical stresses of the plaque before and during EECP, and h lum to assess the potential effects of long-term EECP treatm ent on plaque progression. The resu Its show that E E C P augm ented the wall shear stress （WSS） and plaque w all stress （PWS） over the card lac cycles, aswell as the spacial oscillatory of W SS （WSSG ）. Durhg EECP treatm ent, the PW S level respectively raised 6.82% and 6.07% in two simulation cases. The currentpilot study suggests that E E C P treatm entre ay p lay a positive effect on inh biting the conthued plaque progression by hcreashg the PW S level over the card iac cycles. Meanwhile, the plaque morphology should be taken into consideration while m aking patient- specific plan for Ion g- term E E C P treatment in clinic.
基金Key Clinical Project from the Ministry of Healthgrant number:25400+1 种基金National Natural Science Foundation of Chinagrant number:81170272
文摘To make clear the precise hemodynamic mechanism underlying the anti-atherogenesis benefit of enhanced external couterpulsation(EECP) treatment, and to investigate the proper role of some important hemodynamic factors during the atherosclerotic progress, a comprehensive study combining long-term animal experiment and numerical solving was conducted in this paper. An experimentally induced hypercholesterolemic porcine model was developed and the chronic EECP intervention was subjected. Basic hemodynamic measurement was performed in vivo, as well as the arterial endothelial samples were extracted for physiological examination. Meanwhile, a numerical model was introduced to solve the complex hemodynamic factors such as WSS and OSI. The results show that EECP treatment resulted in significant increase of the instant levels of arterial WSS, blood pressure, and OSI. During EECP treatment, the instant OSI level of the common carotid arteries over cardiac cycles raised to a mean value of 8.58 ×10-2±2.13 ×10-2. Meanwhile, the chronic intervention of EECP treatment significantly reduced the atherosclerotic lesions in abdominal aortas and the endothelial cellular adherence. The present study suggests that the unique blood flow pattern induced by EECP treatment and the augmentation of WSS level in cardiac cycles may be the most important hemodynamic mechanism that contribute to its anti-atherogenesis effect. And as one of the indices that cause great concern in current hemodynamic study, OSI may not play a key role during the initiation of atherosclerosis.
