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Development of patient-specific multi-scale models to understand atherogenesis: comparison with in vivo data

Dr Vanessa Diaz ( Department of Mechanical Engineering, University College London )

Vascular calcification results in stiffening of the aorta and is associated with hypertension and atherosclerosis. Atherogenesis is a complex, multifactorial and systemic process; the result of a number of factors, each operating simultaneously at several spatial and temporal scales. The ability to predict sites of atherogenesis would be of great use to clinicians in order to improve diagnostic and treatment planning. In this paper, we analyse vascular calcification and atherosclerotic areas in an aortic dissection patient using a multi-scale modelling approach, coupling patient-specific, fluid-structure interaction simulations with a model of endothelial mechanotransduction. A number of hemodynamic factors based on state-of-the-art literature are used as inputs to the endothelial permeability model, in order to investigate plaque and calcification distributions, which are compared with clinical imaging data. A significantly improved correlation between elevated hydraulic conductivity or LDL volume flux and the presence of calcification and plaques was achieved by using a shear index comprising both mean and oscillatory shear components and a non-Newtonian viscosity model as inputs, as compared to widely used hemodynamic indicators. The improvements obtained using the combined biomechanical/biochemical modelling approach highlight the benefits of mechanistic modelling as a powerful tool to understand complex phenomena and provides insight into the relative importance of key hemodynamic parameters.

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