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Effects of arterial blood flow on walls of the abdominal aorta: distributions of wall shear stress and oscillatory shear index determined by phase-contrast magnetic resonance imaging

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Abstract

Although abdominal aortic aneurysms (AAAs) occur mostly inferior to the renal artery, the mechanism of the development of AAA in relation to its specific location is not yet clearly understood. The objective of this study was to evaluate the hypothesis that even healthy volunteers may manifest specific flow characteristics of blood flow and alter wall shear or oscillatory shear stress in the areas where AAAs commonly develop. Eight healthy male volunteers were enrolled in this prospective study, aged from 24 to 27. Phase-contrast magnetic resonance imaging (MRI) was performed with electrocardiographic triggering. Flow-sensitive four-dimensional MR imaging of the abdominal aorta, with three-directional velocity encoding, including simple morphological image acquisition, was performed. Information on specific locations on the aortic wall was applied to the flow encodes to calculate wall shear stress (WSS) and oscillatory shear index (OSI). While time-framed WSS showed the highest peak of 1.14 ± 0.25 Pa in the juxtaposition of the renal artery, the WSS plateaued to 0.61 Pa at the anterior wall of the abdominal aorta. The OSI peaked distal to the renal arteries at the posterior wall of the abdominal aorta of 0.249 ± 0.148, and was constantly elevated in the whole abdominal aorta at more than 0.14. All subjects were found to have elevated OSI in regions where AAAs commonly occur. These findings indicate that areas of constant peaked oscillatory shear stress in the infra-renal aorta may be one of the factors that lead to morphological changes over time, even in healthy individuals.

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References

  1. Chaikof EL, Brewster DC, Dalman RL, Makaroun MS, Illig KA, Sicard GA, Timaran CH, Upchurch GR, Veith FJ, Society for Vascular Surgery (2009) The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines. J Vasc Surg 50:S2–S49

    Article  PubMed  Google Scholar 

  2. Wolinsky H (1972) Long-term effects of hypertension on the rat aortic wall and their relation to concurrent aging changes: morphological and chemical studies. Circ Res 30(3):301–309

    Article  CAS  PubMed  Google Scholar 

  3. Simão da Silva E, Rodrigues AJ, Castro Magalhães, de Tolosa E, Rodrigues CJ, Boas Villas, do Prado G, Nakamoto JC (2000) Morphology and diameter of infrarenal aortic aneurysms: a prospective autopsy study. Cardiovasc Surg 8:526–532

    Article  PubMed  Google Scholar 

  4. Gimbrone MA Jr, Anderson KR, Topper JN (1999) The critical role of mechanical forces in blood vessel development, physiology and pathology. J Vasc Surg 29:1104–1151

    Article  PubMed  Google Scholar 

  5. Venkatasubramaniam AK, Fagan MJ, Mehta T, Mylankal KJ, Ray B, Kuhan G, Chetter IC, McCollum PT (2004) A comparative study of aortic wall stress using finite element analysis for ruptured and non-ruptured abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 28:168–176

    CAS  PubMed  Google Scholar 

  6. Teutelink A, Cancrinus E, van de Heuvel D, Moll F, de Vries JP (2012) Preliminary intraobserver and interobserver variability in wall stress and rupture risk assessment of abdominal aortic aneurysms using a semiautomatic finite element model. J Vasc Surg 55:326–330

    Article  PubMed  Google Scholar 

  7. Raghavan ML, Vorp DA, Federle MP, Makaroun MS, Webster MW (2000) Wall stress distribution on three-dimensionally reconstructed models of human abdominal aortic aneurysm. J Vasc Surg 31:760–769

    Article  CAS  PubMed  Google Scholar 

  8. Vorp DA, Raghavan ML, Webster MW (1998) Mechanical wall stress in abdominal aortic aneurysm: influence of diameter and asymmetry. J Vasc Surg 27:632–639

    Article  CAS  PubMed  Google Scholar 

  9. Rayz VL, Boussel L, Lawton MT, Acevedo-Bolton G, Ge L, Young WL, Higashida RT, Saloner D (2008) Numerical modeling of the flow in intracranial aneurysms: prediction of regions prone to thrombus formation. Ann Biomed Eng 36:1793–1804

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Rayz VL, Boussel L, Acevedo-Bolton G, Martin AJ, Young WL, Lawton MT, Higashida R, Saloner D (2008) Numerical simulations of flow in cerebral aneurysms: comparison of CFD results and in vivo MRI measurements. J Biomech Eng 130:051011

    Article  PubMed  Google Scholar 

  11. Cebral JR, Putman CM, Alley MT, Hope T, Bammer R, Calamante F (2009) Hemodynamics in normal cerebral arteries: qualitative comparison of 4D phase-contrast magnetic resonance and image-based computational fluid dynamics. J Eng Math 64:367–378

    Article  PubMed  PubMed Central  Google Scholar 

  12. Yamaguchi R, Tanaka G, Liu H, Ujiie H (2015) Repression of wall shear stress inside cerebral aneurysm at bifurcation of anterior cerebral artery by stents. Heart Vessels. doi:10.1007/s00380-015-0665-1

    Google Scholar 

  13. Frydrychowicz A, Berger A, Russe MF, Stalder AF, Harloff A, Dittrich S, Hennig J, Langer M, Markl M (2008) Time-resolved magnetic resonance angiography and flow-sensitive 4-dimensional magnetic resonance imaging at 3 Tesla for blood flow and wall shear stress analysis. J Thorac Cardiovasc Surg 136:400–407

    Article  PubMed  Google Scholar 

  14. Stalder AF, Russe MF, Frydrychowicz A, Bock J, Hennig J, Markl M (2008) Quantitative 2D and 3D phase contrast MRI: optimized analysis of blood flow and vessel wall parameters. Magn Reson Med 60:1218–1231

    Article  CAS  PubMed  Google Scholar 

  15. Xu C, Prince JL (1998) Snakes, shapes, and gradient vector flow. IEEE Trans Image Process 7:359–369

    Article  CAS  PubMed  Google Scholar 

  16. Sakalihasan N, Limet R, Defawe OD (2005) Abdominal aortic aneurysm. Lancet 365(9470):1577–1589

    Article  CAS  PubMed  Google Scholar 

  17. Darling RC, Messina CR, Brewster DC, Ottinger LW (1977) Autopsy study of unoperated abdominal aortic aneurysms. The case for early resection. Circulation 56(11):161–164

    Google Scholar 

  18. Wolinsky H, Glagov S (1969) Comparison of abdominal and thoracic aortic medial structure in mammals. Circ Res 25:677–686

    Article  CAS  PubMed  Google Scholar 

  19. Hellenthal FAMVI, Ten Bosch JA, Pulinx B, Wodzig WK, de Haan MW, Prins MH, Welten RJ, Teijink JA, Schurink GW (2012) Plasma levels of matrix metalloproteinase-9: a possible diagnostic marker of successful endovascular aneurysm repair. Eur J Vasc Endovasc Surg 43:171–172

    Article  CAS  PubMed  Google Scholar 

  20. McMillan WD, Tamarina NA, Cipollone M, Johnson DA, Parker MA, Pearce WH (1997) Size matters: the relationship between MMP-9 expression and aortic diameter. Circulation 96:2228–2232

    Article  CAS  PubMed  Google Scholar 

  21. Hurks R, Pasterkamp G, Vink A, Hoefer IE, Bots ML, van de Pavoordt HD, de Vries JP, Moll FL (2012) Circumferential heterogeneity in the abdominal aortic aneurysm wall composition suggests lateral sides to be more rupture prone. J Vasc Surg 55:203–209

    Article  PubMed  Google Scholar 

  22. Hall AJ, Busse EF, McCarville DJ, Burgess JJ (2000) Aortic wall tension as a predictive factor for abdominal aortic aneurysm rupture: improving the selection of patients for abdominal aortic aneurysm repair. Ann Vasc Surg 14:152–157

    Article  CAS  PubMed  Google Scholar 

  23. Stenbaek J, Kalin B, Swedenborg J (2000) Growth of thrombus may be a better predictor of rupture than diameter in patients with abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 20:466–469

    Article  CAS  PubMed  Google Scholar 

  24. Sonesson B, Sandgren T, Länne T (1999) Abdominal aortic aneurysm wall mechanics and their relation to risk of rupture. Eur J Vasc Endovasc Surg 18:487–493

    Article  CAS  PubMed  Google Scholar 

  25. Fillinger MF, Marra SP, Raghavan ML, Kennedy FE (2003) Prediction of rupture risk in abdominal aortic aneurysm during observation: wall stress versus diameter. J Vasc Surg 37:724–732

    Article  PubMed  Google Scholar 

  26. Fillinger MF, Raghavan ML, Marra SP, Cronenwett JL, Kennedy FE (2002) In vivo analysis of mechanical wall stress and abdominal aortic aneurysm rupture risk. J Vasc Surg 36:589–597

    Article  PubMed  Google Scholar 

  27. Kleinstreuer C, Li Z (2006) Analysis and computer program for rupture-risk prediction of abdominal aortic aneurysms. Biomed Eng Online 5:19

    Article  PubMed  PubMed Central  Google Scholar 

  28. Volokh KY (2008) Vorp DA (2008) A model of growth and rupture of abdominal aortic aneurysm. J Biomech 41(5):1015–1021

    Article  CAS  PubMed  Google Scholar 

  29. Stringfellow MM, Lawrence PF, Stringfellow RG (1987) The influence of aorta-aneurysm geometry upon stress in the aneurysm wall. J Surg Res 42:425–433

    Article  CAS  PubMed  Google Scholar 

  30. Molony DS, Callanan A, Kavanagh EG, Walsh MT, McGloughlin TM (2009) Fluid-structure interaction of a patient-specific abdominal aortic aneurysm treated with an endovascular stent-graft. Biomed Eng Online 8:24

    Article  PubMed  PubMed Central  Google Scholar 

  31. Salsac AV, Sparks SR, Chomaz JM (2006) Evolution of the wall shear stresses during the progressive enlargement of symmetric abdominal aortic aneurysms. J Fluid Mech 560:19–51

    Article  Google Scholar 

  32. Ku DN, Giddens DP, Zarins CK, Glagov S (1985) Pulsatile flow and atherosclerosis in the human carotid bifurcation. Positive correlation between plaque location and low oscillating shear stress. Arteriosclerosis 5:293–302

    Article  CAS  PubMed  Google Scholar 

  33. Markl M, Harloff A, Bley TA, Zaitsev M, Jung B, Weigang E, Langer M, Hennig J, Frydrychowicz A (2007) Time-resolved 3D MR velocity mapping at 3T: improved navigator-gated assessment of vascular anatomy and blood flow. J Magn Reson Imaging 25:824–831

    Article  PubMed  Google Scholar 

  34. McGloughlin TM, Doyle BJ (2010) New approaches to abdominal aortic aneurysm rupture risk assessment: engineering insights with clinical gain. Arterioscler Thromb Vasc Biol 30:1687–1694

    Article  CAS  PubMed  Google Scholar 

  35. Oyre S, Ringgaard S, Kozerke S, Paaske WP, Erlandsen M, Boesiger P, Pedersen EM (1998) Accurate noninvasive quantitation of blood flow, cross-sectional lumen vessel area and wall shear stress by three-dimensional paraboloid modeling of magnetic resonance imaging velocity data. J Am Coll Cardiol 32:128–134

    Article  CAS  PubMed  Google Scholar 

  36. Oyre S, Pedersen EM, Ringgaard S, Boesiger P, Paaske WP (1997) In vivo wall shear stress measured by magnetic resonance velocity mapping in the normal human abdominal aorta. Eur J Vasc Endovasc Surg 13:263–271

    Article  CAS  PubMed  Google Scholar 

  37. Pedersen EM, Agerbaek M, Kristensen IB, Yoganathan AP (1997) Wall shear stress and early atherosclerotic lesions in the abdominal aorta in young adults. Eur J Vasc Endovasc Surg 13:443–451

    Article  CAS  PubMed  Google Scholar 

  38. Hammer S, Jeays A, Allan PL, Hose R, Barber D, Easson WJ, Hoskins PR (2009) Acquisition of 3-D arterial geometries and integration with computational fluid dynamics. Ultrasound Med Biol 35:2069–2083

    Article  PubMed  Google Scholar 

  39. Cheng CP, Herfkens RJ, Taylor CA (2003) Abdominal aortic hemodynamic conditions in healthy subjects aged 50–70 at rest and during lower limb exercise: in vivo quantification using MRI. Atherosclerosis 168:323–331

    Article  CAS  PubMed  Google Scholar 

  40. Tang BT, Cheng CP, Draney MT, Wilson NM, Tsao PS, Herfkens RJ, Taylor CA (2006) Abdominal aortic hemodynamics in young healthy adults at rest and during lower limb exercise: quantification using image-based computer modeling. Am J Physiol Heart Circ Physiol 291:H668–H676

    Article  CAS  PubMed  Google Scholar 

  41. Zarins CK, Giddens DP, Bharadvaj BK, Sottiurai VS, Mabon RF, Glagov S (1983) Carotid bifurcation atherosclerosis. Quantitative correlation of plaque localization with flow velocity profiles and wall shear stress. Circ Res 53:502–514

    Article  CAS  PubMed  Google Scholar 

  42. Lantz J, Renner J, Karlsson M (2011) Wall shear stress in a subject specific human aorta. Int J Appl Mechanics 03:759–778

    Article  Google Scholar 

  43. Suh G-Y, Les AS, Tenforde AS, Shadden SC, Spilker RL, Yeung JJ, Cheng CP, Herfkens RJ, Dalman RL, Taylor CA (2010) Quantification of particle residence time in abdominal aortic aneurysms using magnetic resonance imaging and computational fluid dynamics. Ann Biomed Eng 39:864–883

    Article  PubMed  PubMed Central  Google Scholar 

  44. Wang DHJ, Makaroun MS, Webster MW, Vorp DA (2002) Effect of intraluminal thrombus on wall stress in patient-specific models of abdominal aortic aneurysm. J Vasc Surg 36:598–604

    Article  PubMed  Google Scholar 

  45. Sughimoto K, Takahara Y, Mogi K, Yamazaki K, Tsubota K, Liang F, Liu H (2013) Blood flow dynamic improvement with aneurysm repair detected by a patient-specific model of multiple aortic aneurysms. Heart Vessels 29:404–412

    Article  PubMed  Google Scholar 

  46. Molony DS, Callanan A, Morris LG, Doyle BJ, Walsh MT, McGloughlin TM (2008) Geometrical enhancements for abdominal aortic stent-grafts. J Endovasc Ther 15:518–529

    Article  PubMed  Google Scholar 

  47. Morris L, Delassus P, Callanan A, Walsh M, Wallis F, Grace P, McGloughlin T (2005) 3-D numerical  simulation of blood flow through models of the human aorta. J Biomech Eng 127:767–775

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

With regard to technical assistance for data analysis, we deeply appreciate the help of Kazutoshi Miyashita. Also, we are grateful to Hirotaka Sato, Koji Matsumoto, Masatoshi Kojima for their time-consuming efforts acquiring MRI data. Finally, we gratefully acknowledge Dr. Ken Motoori for his methodological suggestions.

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Correspondence to Koichi Sughimoto.

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This study was partially supported by the Inohana Alumni Association of the Chiba University of Medicine (12046).

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Streamline in the abdominal aorta. View from the left side. Note that the aortic wall changes its size in accordance with the blood flow. After the fast flow, static looping flow remains to the renal arteries. (MPG 1766 kb)

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Sughimoto, K., Shimamura, Y., Tezuka, C. et al. Effects of arterial blood flow on walls of the abdominal aorta: distributions of wall shear stress and oscillatory shear index determined by phase-contrast magnetic resonance imaging. Heart Vessels 31, 1168–1175 (2016). https://doi.org/10.1007/s00380-015-0758-x

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