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

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• dc.contributor.author Rudenick, Paula A.
• dc.contributor.author Segers, Patrick F.
• dc.contributor.author Pineda, Víctor
• dc.contributor.author Cuellar, Hug
• dc.contributor.author García-Dorado, David
• dc.contributor.author Evangelista, Arturo
• dc.contributor.author Bijnens, Bart
• dc.date.accessioned 2021-07-07T07:23:46Z
• dc.date.available 2021-07-07T07:23:46Z
• dc.date.issued 2017
• dc.description.abstract 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.
• dc.description.sponsorship 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.
• dc.format.mimetype application/pdf
• dc.identifier.citation Rudenick PA, Segers P, Pineda V, Cuellas H, García-Dorado D, Evangelista A, Bijnens BH. False lumen flow patterns and their relation with morphological and biomechanical characteristics of chronic aortic dissections: Computational model compared with magnetic resonance imaging measurements. PLoS ONE. 2017;12(1):e0170888. DOI: 10.1371/journal.pone.0170888
• dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0170888
• dc.identifier.issn 1932-6203
• dc.identifier.uri http://hdl.handle.net/10230/48105
• dc.language.iso eng
• dc.publisher Public Library of Science (PLoS)
• dc.relation.ispartof PLoS ONE. 2017;12(1):e0170888
• dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/611823
• dc.rights © 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/
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri https://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Thoracic diaphragm
• dc.subject.keyword Stiffness
• dc.subject.keyword Magnetic resonance imaging
• dc.subject.keyword Aorta
• dc.subject.keyword Hemodynamics
• dc.subject.keyword Systole
• dc.subject.keyword Fluid flow
• dc.subject.keyword Diastole
• dc.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
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion