The loss of helical flow in the thoracic aorta might be an identifying marker for the risk of acute type B aortic dissection

Da Li; Jiarong Wang; Wen Zeng; Xiangguo Zeng; Zhan Liu; Haoyao Cao; Ding Yuan; Tinghui Zheng

doi:10.1016/j.cmpb.2022.107331

The loss of helical flow in the thoracic aorta might be an identifying marker for the risk of acute type B aortic dissection

Comput Methods Programs Biomed. 2023 Mar:230:107331. doi: 10.1016/j.cmpb.2022.107331. Epub 2022 Dec 30.

Authors

Da Li¹, Jiarong Wang², Wen Zeng³, Xiangguo Zeng⁴, Zhan Liu¹, Haoyao Cao¹, Ding Yuan⁵, Tinghui Zheng⁶

Affiliations

¹ Department of Applied Mechanics, Sichuan University, No.24 South Section 1, Chengdu 610065, China; Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, China.
² Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China.
³ Division of radiology, West China Hospital, Sichuan University, Chengdu, China.
⁴ Department of Applied Mechanics, Sichuan University, No.24 South Section 1, Chengdu 610065, China.
⁵ Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China; Med-X center for informatics, Sichuan University, Chengdu, China. Electronic address: yuanding@wchscu.cn.
⁶ Department of Applied Mechanics, Sichuan University, No.24 South Section 1, Chengdu 610065, China; Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, China; Med-X center for informatics, Sichuan University, Chengdu, China. Electronic address: tinghuizh@scu.edu.cn.

PMID: 36621070
DOI: 10.1016/j.cmpb.2022.107331

Abstract

Background and objective: The occurrence of acute type B aortic dissection (TBAD) remained unclear. This study aimed to investigate the association between flow features and hemodynamic parameters in aortas that demonstrated the risk of TBAD occurrence.

Methods: The geometries of 15 hyperacute TBAD and 12 control patients (with healthy aorta) were reconstructed from computed tomography angiography images. Pre-TBAD models were then obtained by eliminating the dissection flaps. Flow features and hemodynamic parameters, including wall shear stress-related parameters and helicities, were compared between pre-TBAD and control models using computational fluid dynamics.

Results: There were no significant differences in baseline characteristics and anatomical parameters between the two groups. Significant contralateral helical blood flow was present in the healthy thoracic aorta, while almost no helical flow was observed in the pre-TBAD group. In addition, the mean normal transverse wall shear stress (NtransWSS) was significantly higher in the pre-TBAD group (aortic arch 0.49±0.09 vs. 0.40±0.05, P = 0.04; descending aorta: 0.46±0.05 vs. 0.33±0.02, P<0.01). Moreover, a significantly negative correlation was found between helicity and NtransWSS in the descending aorta. Moreover, the location of primary tears in 12 pre-TABD subjects matched well with regions of high NtransWSS.

Conclusions: Loss of helical flow in the aortic arch and descending aorta may be a major flow feature in patients with underlying TBAD, resulting in increased flow disturbance and wall lesions.

Keywords: Helical flow; Hemodynamics; Type B aortic dissection.

MeSH terms

Aorta
Aortic Aneurysm, Thoracic* / diagnostic imaging
Aortic Aneurysm, Thoracic* / surgery
Aortic Dissection* / diagnostic imaging
Hemodynamics
Humans
Retrospective Studies
Treatment Outcome