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Age-Related Vascular Changes Affect Turbulence in Aortic Blood Flow
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Kangwon Natl Univ, South Korea.
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.ORCID-id: 0000-0001-9184-9234
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
Vise andre og tillknytning
2018 (engelsk)Inngår i: Frontiers in Physiology, ISSN 1664-042X, E-ISSN 1664-042X, Vol. 9, artikkel-id 36Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Turbulent blood flow is implicated in the pathogenesis of several aortic diseases but the extent and degree of turbulent blood flow in the normal aorta is unknown. We aimed to quantify the extent and degree of turbulece in the normal aorta and to assess whether age impacts the degree of turbulence. 22 young normal males (23.7 +/- 3.0 y.o.) and 20 old normal males (70.9 +/- 3.5 y.o.) were examined using four dimensional flow magnetic resonance imaging (4D Flow MRI) to quantify the turbulent kinetic energy (TKE), a measure of the intensity of turbulence, in the aorta. All healthy subjects developed turbulent flow in the aorta, with total TKE of 3-19 mJ. The overall degree of turbulence in the entire aorta was similar between the groups, although the old subjects had about 73% more total TKE in the ascending aorta compared to the young subjects (young = 3.7 +/- 1.8 mJ, old = 6.4 +/- 2.4 mJ, p amp;lt; 0.001). This increase in ascending aorta TKE in old subjects was associated with age-related dilation of the ascending aorta which increases the volume available for turbulence development. Conversely, age-related dilation of the descending and abdominal aorta decreased the average flow velocity and suppressed the development of turbulence. In conclusion, turbulent blood flow develops in the aorta of normal subjects and is impacted by age-related geometric changes. Non-invasive assessment enables the determination of normal levels of turbulent flow in the aorta which is a prerequisite for understanding the role of turbulence in the pathophysiology of cardiovascular disease.

sted, utgiver, år, opplag, sider
FRONTIERS MEDIA SA , 2018. Vol. 9, artikkel-id 36
Emneord [en]
turbulent kinetic energy (TKE); turbulent blood flow; aortic blood flow; aortic dilation; normal values; 4D flow MRI; phase contrast MRI
HSV kategori
Identifikatorer
URN: urn:nbn:se:liu:diva-145129DOI: 10.3389/fphys.2018.00036ISI: 000423400000001PubMedID: 29422871OAI: oai:DiVA.org:liu-145129DiVA, id: diva2:1183661
Merknad

Funding Agencies|Swedish Research Council [2013-6077, 2014-6191]; Swedish Heart and Lung foundation [20140398]; Kangwon National University [D1001179-01-01]; Basic Science Research Program through the National Research Foundation of Korea (NRF) - Ministry of Education [2016R1A6A3A03006337]

Tilgjengelig fra: 2018-02-19 Laget: 2018-02-19 Sist oppdatert: 2019-04-17
Inngår i avhandling
1. Improving Assessments of Hemodynamics and Vascular Disease
Åpne denne publikasjonen i ny fane eller vindu >>Improving Assessments of Hemodynamics and Vascular Disease
2019 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Blood vessels are more than simple pipes, passively enabling blood to pass through them. Their form and function are dynamic, changing with both aging and disease. This process involves a feedback loop wherein changes to the shape of a blood vessel affect the hemodynamics, causing yet more structural adaptation. This feedback loop is driven in part by the hemodynamic forces generated by the blood flow, and the distribution and strength of these forces appear to play a role in the initiation, progression, severity, and the outcome of vascular diseases.

Magnetic Resonance Imaging (MRI) offers a unique platform for investigating both the form and function of the vascular system. The form of the vascular system can be examined using MR-based angiography, to generate detailed geometric analyses, or through quantitative techniques for measuring the composition of the vessel wall and atherosclerotic plaques. To complement these analyses, 4D Flow MRI can be used to quantify the functional aspect of the vascular system, by generating a full time-resolved three-dimensional velocity field that represents the blood flow.

This thesis aims to develop and evaluate new methods for assessing vascular disease using novel hemodynamic markers generated from 4D Flow MRI and quantitative MRI data towards the larger goal of a more comprehensive non-invasive examination oriented towards vascular disease. In Paper I, we developed and evaluated techniques to quantify flow stasis in abdominal aortic aneurysms to measure this under-explored aspect of aneurysmal hemodynamics. In Paper II, the distribution and intensity of turbulence in the aorta was quantified in both younger and older men to understand how aging changes this aspect of hemodynamics. A method to quantify the stresses generated by turbulence that act on the vessel wall was developed and evaluated using simulated flow data in Paper III, and in Paper V this method was utilized to examine the wall stresses of the carotid artery. The hemodynamics of vascular disease cannot be uncoupled from the anatomical changes the vessel wall undergoes, and therefore Paper IV developed and evaluated a semi-automatic method for quantifying several aspects of vessel wall composition. These developments, taken together, help generate more valuable information from imaging data, and can be pooled together with other methods to form a more comprehensive non-invasive examination for vascular disease.

sted, utgiver, år, opplag, sider
Linköping: Linköping University Electronic Press, 2019. s. 64
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1675
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-156311 (URN)10.3384/diss.diva-156311 (DOI)9789176850985 (ISBN)
Disputas
2019-05-31, Hugo Theorell, Norra Entrén, Campus US, Linköping, 13:00 (engelsk)
Opponent
Veileder
Forskningsfinansiär
Swedish Research Council, 2013-06077Swedish Research Council, 2017-03857Region Östergötland, LIO-752951
Tilgjengelig fra: 2019-04-17 Laget: 2019-04-12 Sist oppdatert: 2019-04-24bibliografisk kontrollert

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