The Hemodynamic Effect of Enhanced External Counterpulsation Treatment on Atherosclerotic Plaque in the Carotid Artery: A Framework of Patient-Specific Computational Fluid Dynamics Analysis

Long-term enhanced external counterpulsation (EECP) therapy has been recommended for antiatherogenesis in recent clinical observations and trials. However, the precise mechanism underlying the benefits has not been fully clarified. To quantify the effect of EECP intervention on arterial hemodynamic...

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Main Authors: Jianhang Du, Guangyao Wu, Bokai Wu, Chang Liu, Zhouming Mai, Yumeng Liu, Yawei Wang, Pandeng Zhang, Guifu Wu, Jia Liu
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Cardiology Research and Practice
Online Access:http://dx.doi.org/10.1155/2020/5903790
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author Jianhang Du
Guangyao Wu
Bokai Wu
Chang Liu
Zhouming Mai
Yumeng Liu
Yawei Wang
Pandeng Zhang
Guifu Wu
Jia Liu
author_facet Jianhang Du
Guangyao Wu
Bokai Wu
Chang Liu
Zhouming Mai
Yumeng Liu
Yawei Wang
Pandeng Zhang
Guifu Wu
Jia Liu
author_sort Jianhang Du
collection DOAJ
description Long-term enhanced external counterpulsation (EECP) therapy has been recommended for antiatherogenesis in recent clinical observations and trials. However, the precise mechanism underlying the benefits has not been fully clarified. To quantify the effect of EECP intervention on arterial hemodynamic environment, a framework of numerical assessment was introduced using a parallel computing algorithm. A 3D endothelial surface of the carotid artery with mild atherosclerotic plaque was constructed from images of magnetic resonance angiography (MRA). Physiologic boundary conditions were derived from images of the ultrasound flow velocity spectrum measured at the common carotid artery and before and during EECP intervention. Hemodynamic factors relating to wall shear stress (WSS) and its spatial and temporal fluctuations were calculated and analyzed, which included AWSS, OSI, and AWSSG. Measuring and computational results showed that diastole blood pressure, perfusion, and WSS level in carotid bifurcation were significantly increased during EECP intervention. Mean AWSS level throughout the model increased by 16.9%, while OSI level did not show a significant change during EECP. We thus suggested that long-term EECP treatment might inhibit the initiation and development of atherosclerotic plaque via improving the hemodynamic environment in the carotid artery. Meanwhile, EECP performance induced a 19.6% increase in AWSSG level, and whether it would influence the endothelial functions may need a further study. Moreover, the numerical method proposed in this study was expected to be useful for the instant assessment of clinical application of EECP .
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spelling doaj-art-f0160fade63f4e2dbe212945a6db240d2025-08-20T03:21:19ZengWileyCardiology Research and Practice2090-80162090-05972020-01-01202010.1155/2020/59037905903790The Hemodynamic Effect of Enhanced External Counterpulsation Treatment on Atherosclerotic Plaque in the Carotid Artery: A Framework of Patient-Specific Computational Fluid Dynamics AnalysisJianhang Du0Guangyao Wu1Bokai Wu2Chang Liu3Zhouming Mai4Yumeng Liu5Yawei Wang6Pandeng Zhang7Guifu Wu8Jia Liu9Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen 518033, ChinaDepartment of Radiology, Shenzhen University General Hospital, Shenzhen 518055, ChinaLaboratory for Engineering and Scientific Computing, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, ChinaLaboratory for Engineering and Scientific Computing, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, ChinaDepartment of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen 518033, ChinaLaboratory for Engineering and Scientific Computing, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, ChinaSchool of Biological Science and Medical Engineering, Beihang University, Beijing 100083, ChinaLaboratory for Engineering and Scientific Computing, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, ChinaDepartment of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen 518033, ChinaLaboratory for Engineering and Scientific Computing, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, ChinaLong-term enhanced external counterpulsation (EECP) therapy has been recommended for antiatherogenesis in recent clinical observations and trials. However, the precise mechanism underlying the benefits has not been fully clarified. To quantify the effect of EECP intervention on arterial hemodynamic environment, a framework of numerical assessment was introduced using a parallel computing algorithm. A 3D endothelial surface of the carotid artery with mild atherosclerotic plaque was constructed from images of magnetic resonance angiography (MRA). Physiologic boundary conditions were derived from images of the ultrasound flow velocity spectrum measured at the common carotid artery and before and during EECP intervention. Hemodynamic factors relating to wall shear stress (WSS) and its spatial and temporal fluctuations were calculated and analyzed, which included AWSS, OSI, and AWSSG. Measuring and computational results showed that diastole blood pressure, perfusion, and WSS level in carotid bifurcation were significantly increased during EECP intervention. Mean AWSS level throughout the model increased by 16.9%, while OSI level did not show a significant change during EECP. We thus suggested that long-term EECP treatment might inhibit the initiation and development of atherosclerotic plaque via improving the hemodynamic environment in the carotid artery. Meanwhile, EECP performance induced a 19.6% increase in AWSSG level, and whether it would influence the endothelial functions may need a further study. Moreover, the numerical method proposed in this study was expected to be useful for the instant assessment of clinical application of EECP .http://dx.doi.org/10.1155/2020/5903790
spellingShingle Jianhang Du
Guangyao Wu
Bokai Wu
Chang Liu
Zhouming Mai
Yumeng Liu
Yawei Wang
Pandeng Zhang
Guifu Wu
Jia Liu
The Hemodynamic Effect of Enhanced External Counterpulsation Treatment on Atherosclerotic Plaque in the Carotid Artery: A Framework of Patient-Specific Computational Fluid Dynamics Analysis
Cardiology Research and Practice
title The Hemodynamic Effect of Enhanced External Counterpulsation Treatment on Atherosclerotic Plaque in the Carotid Artery: A Framework of Patient-Specific Computational Fluid Dynamics Analysis
title_full The Hemodynamic Effect of Enhanced External Counterpulsation Treatment on Atherosclerotic Plaque in the Carotid Artery: A Framework of Patient-Specific Computational Fluid Dynamics Analysis
title_fullStr The Hemodynamic Effect of Enhanced External Counterpulsation Treatment on Atherosclerotic Plaque in the Carotid Artery: A Framework of Patient-Specific Computational Fluid Dynamics Analysis
title_full_unstemmed The Hemodynamic Effect of Enhanced External Counterpulsation Treatment on Atherosclerotic Plaque in the Carotid Artery: A Framework of Patient-Specific Computational Fluid Dynamics Analysis
title_short The Hemodynamic Effect of Enhanced External Counterpulsation Treatment on Atherosclerotic Plaque in the Carotid Artery: A Framework of Patient-Specific Computational Fluid Dynamics Analysis
title_sort hemodynamic effect of enhanced external counterpulsation treatment on atherosclerotic plaque in the carotid artery a framework of patient specific computational fluid dynamics analysis
url http://dx.doi.org/10.1155/2020/5903790
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