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Publications (244)
Plaque erosion (PE) with secondary thrombosis is one of the key mechanisms of acute coronary syndrome (ACS) which often leads to drastic cardiovascular events. Identification and prediction of PE are of fundamental significance for disease diagnosis, prevention and treatment. In vivo optical coherence tomography (OCT) data of eight eroded plaques a...
Mechanical mismatch between native aortas and aortic grafts can induce graft failure. This study aims to compare the mechanical and microstructural properties of different graft materials used in aortic repair surgeries with those of normal and dissected human ascending aortas. Five types of materials including normal aorta (n = 10), dissected aort...
Purpose: Type A aortic dissection (TAAD) is a life-threatening aortic disease. The tear involves the ascending aorta and progresses into the separation of the layers of the aortic wall and the occurrence of a false lumen. Accurate segmentation of TAAD could provide assistance for disease assessment and guidance for clinical treatment. Methods: This...
BACKGROUND
While it has been hypothesized that high plaque stress and strain may be related to plaque rupture, its direct verification using in vivo coronary plaque rupture data and full 3-dimensional fluid-structure interaction models is lacking in the current literature due to difficulty in obtaining in vivo plaque rupture imaging data from patie...
Introduction
Mechanical stress and strain conditions play an important role in atherosclerosis plaque progression, remodeling and potential rupture and may be used in plaque vulnerability assessment for better clinical diagnosis and treatment decisions. Single layer plaque models without residual stress have been widely used due to unavailability o...
Mechanical stress and strain conditions are closely related to atherosclerotic plaque progression and rupture and have been under intensive investigations in recent years. It is well known that arteries have a three-layer structure: intima, media and adventitia. However, in vivo image-based multilayer plaque models are not available in the current...
Optimal reverse remodeling of the right ventricle (RV), a sentinel goal of pulmonary valve replacement (PVR) in patients with repaired tetralogy of Fallot, is not fully predicted by volume-based pre-PVR parameters. Our objectives were to characterize novel geometric RV parameters in patients receiving PVR and in controls, and to identify associatio...
The tissue-engineered blood vessel (TEBV) has been developed and used in cardiovascular disease modeling, preclinical drug screening, and for replacement of native diseased arteries. Increasing attention has been paid to biomechanical cues in TEBV and other tissue-engineered organs to better recapitulate the functional properties of the native orga...
Assessment and prediction of vulnerable plaque progression and rupture risk are of utmost importance for diagnosis, management and treatment of cardiovascular diseases and possible prevention of acute cardiovascular events such as heart attack and stroke. However, accurate assessment of plaque vulnerability assessment and prediction of its future c...
Coronary vessel layer structure may have a considerable impact on plaque stress/strain calculations. Most current plaque models use single-layer vessel structures due to the lack of available multilayer segmentation techniques. In this paper, an automatic multilayer segmentation and repair method was developed to segment coronary optical coherence...
Mechanical properties of the arterial walls could provide meaningful information for the diagnosis, management and treatment of cardiovascular diseases. Classically, various experimental approaches were conducted on dissected arterial tissues to obtain their stress–stretch relationship, which has limited value clinically. Therefore, there is a pres...
Background
A method using in vivo Cine IVUS and VH-IVUS data has been proposed to quantify material properties of coronary plaques. However, correlations between plaque morphological characteristics and mechanical properties have not been studied in vivo.
Method: In vivo Cine IVUS and VH-IVUS data were acquired at 32 plaque cross-sections from 19 p...
Introduction: Coronary stenosis due to atherosclerosis restricts blood flow. Stenosis progression would lead to increased clinical risk such as heart attack. Although many risk factors were found to contribute to atherosclerosis progression, factors associated with fatigue is underemphasized. Our goal is to investigate the relationship between fati...
Introduction
Cardiac pacing has been an effective treatment in the management of patients with bradyarrhythmia and tachyarrhythmia. Different pacemaker location has different responses, and pacemaker effectiveness to each individual can also be different. A novel image-based ventricle animal modeling approach was proposed to optimize ventricular pa...
Atherosclerotic plaque progression and rupture play an important role in cardiovascular disease development and the final drastic events such as heart attack and stroke. Medical imaging and image-based computational modeling methods advanced considerably in recent years to quantify plaque morphology and biomechanical conditions and gain a better un...
Introduction: Cyclic plaque structural stress has been hypothesized as a mechanism for plaque fatigue and eventually plaque rupture. A novel approach to derive cyclic plaque stress in vivo from optical coherence tomography (OCT) is hereby developed.
Materials and Methods: All intermediate lesions from a previous OCT study were enrolled. OCT cross-s...
Introduction: Mechanical forces are closely associated with plaque progression and rupture. Precise quantifications of biomechanical conditions using in vivo image-based computational models depend heavily on the accurate estimation of patient-specific plaque mechanical properties. Currently, mechanical experiments are commonly performed on ex vivo...
Accurate plaque cap thickness quantification and cap stress/strain calculations are of fundamental importance for vulnerable plaque research. To overcome uncertainties due to intravascular ultrasound (IVUS) resolution limitation, IVUS and optical coherence tomography (OCT) coronary plaque image data were combined together to obtain accurate and rel...
Several image-based computational models have been used to perform mechanical analysis for atherosclerotic plaque progression and vulnerability investigations. However, differences of computational predictions from those models have not been quantified at multi-patient level. In vivo intravascular ultrasound (IVUS) coronary plaque data were acquire...
Patients with repaired Tetralogy of Fallot (ToF), a congenital heart defect which includes a ventricular septal defect and severe right ventricular outflow obstruction, account for the majority of cases with late-onset right ventricle (RV) failure. Current surgery procedures, including pulmonary valve replacement (PVR) with right ventricle remodeli...
Intracoronary thrombus from plaque erosion could cause fatal acute coronary syndrome (ACS). A conservative anti-thrombotic therapy has been proposed to treat ACS patients in lieu of stenting. It is speculated that the residual thrombus after aspiration thrombectomy would influence the prognosis of this treatment. However, biomechanical mechanisms a...
Background
Coronary plaque vulnerability prediction is difficult because plaque vulnerability is non-trivial to quantify, clinically available medical image modality is not enough to quantify thin cap thickness, prediction methods with high accuracies still need to be developed, and gold-standard data to validate vulnerability prediction are often...
Background
Porcine aortic valve (PAV) and bovine aortic valve (BAV) are commonly used in aortic valve replacement (AVR) surgeries. A detailed comparison for their hemodynamic and structural stress/strain performances would help to better understand valve cardiac function and select valve type and size for AVR outcome optimizations.
Methods
Eight f...
Background
Patient-specific active fluid–structure interactions (FSI) model is a useful approach to non-invasively investigate the hemodynamics in the heart. However, it takes a lot of effort to obtain the proper external force boundary conditions for active models, which heavily restrained the time-sensitive clinical applications of active computa...
Aortic valve replacement (AVR) remains a major treatment option for patients with severe aortic valve disease. Clinical outcome of AVR is strongly dependent on implanted prosthetic valve size. Fluid-structure interaction (FSI) aortic root models were constructed to investigate the effect of valve size on hemodynamics of the implanted bioprosthetic...
Background
Detecting coronary vulnerable plaques in vivo and assessing their vulnerability have been great challenges for clinicians and the research community. Intravascular ultrasound (IVUS) is commonly used in clinical practice for diagnosis and treatment decisions. However, due to IVUS limited resolution (about 150–200 µm), it is not sufficient...
Background. Patient-specific active Fluid-Structure Interactions (FSI) model is a useful approach to non-invasively investigate the hemodynamics in the heart. However, it takes a lot of effort to obtain the proper external force boundary conditions for active models, which heavily restrained the time-sensitive clinical applications for active compu...
Background. Patient-specific active Fluid-Structure Interactions (FSI) model is a useful approach to non-invasively investigate the hemodynamics in the heart. However, it takes a lot of effort to obtain the proper external force boundary conditions for active models, which heavily restrained the time-sensitive clinical applications of active comput...
Background. Patient-specific active Fluid-Structure Interactions (FSI) model is a useful approach to non-invasively investigate the hemodynamics in the heart. However, it takes a lot of effort to obtain the proper external force boundary conditions for active models, which heavily restrained the time-sensitive clinical applications of active comput...
Plaque vulnerability prediction is of great importance in cardiovascular research. In vivo follow-up intravascular ultrasound (IVUS) coronary plaque data were acquired from nine patients to construct fluid-structure interaction models to obtain plaque biomechanical conditions. Morphological plaque vulnerability index (MPVI) was defined to measure p...
Introduction
Right ventricle (RV) failure is one of the most common symptoms among patients with repaired tetralogy of Fallot (TOF). The current surgery treatment approach including pulmonary valve replacement (PVR) showed mixed post-surgery outcomes. A novel PVR surgical strategy using active contracting bands is proposed to improve the post-PVR o...
Image-based computational models have been used by many researchers to quantify mechanical stress/strain conditions and flow wall shear stress and try to use them to understand mechanisms governing vulnerable plaque progression and rupture processes. In this chapter, we will focus on human coronary plaque modeling efforts based on in vivo imaging d...
Plaque progression and vulnerability are influenced by many risk factors. Our goal is to find a simple method to combine multiple risk factors for better plaque development prediction. Intravascular ultrasound data at baseline and follow-up were acquired from nine patients, and fluid–structure interaction models were constructed to obtain plaque wa...
Patient-specific in vivo ventricle mechanical wall stress and strain conditions are important for cardiovascular investigations and should be calculated from correct zero-load ventricle morphologies. Cardiac magnetic resonance (CMR) data were obtained from 6 healthy volunteers and 12 Tetralogy of Fallot (TOF) patients with consent obtained. 3D pati...
Plaque progression prediction is of fundamental significance to cardiovascular research and disease diagnosis, prevention, and treatment. Magnetic resonance image (MRI) data of carotid atherosclerotic plaques were acquired from 20 patients with consent obtained. 3D thin-layer models were constructed to calculate plaque stress and strain. Data for t...
Medical image resolution has been a serious limitation in plaque progression research. A modeling approach combining intravascular ultrasound (IVUS) and optical coherence tomography (OCT) was introduced and patient follow-up IVUS and OCT data were acquired to construct 3D coronary models for plaque progression investigations. Baseline and follow-up...
Pulmonary valve stenosis (PVS) is one common right ventricular outflow tract obstruction problem in patients with tetralogy of Fallot (TOF). Congenital bicuspid pulmonary valve (BPV) is a condition of valvular stenosis, and the occurrence of congenital BPV is often associated with TOF. Dynamic computational models of normal pulmonary root (PR) with...
The mechanisms of systolic anterior motion (SAM) of the mitral valve in hypertrophic obstructive cardiomyopathy (HOCM) remain unclear. To investigate the angle of attack between blood flow and mitral valve leaflets at pre-SAM time point, patient-specific CT-based computational models were constructed for 5 patients receiving septal myectomy surgery...
Patient-specific in vivo ventricle material parameter determination is important for cardiovascular investigations. A new cardiac magnetic image (CMR)-based modeling approach with different zero-load diastole and systole geometries was adopted to estimate right ventricle material parameter values for healthy and patients with Tetralogy of Fallot (T...
It has been hypothesized that combining morphological and mechanical risk factors may improve plaque progression prediction. In this paper, plaque burden (PB), cap thickness (CT), lipid percent (LP), plaque wall stress (PWS), plaque wall strain (PWSn) and their combinations were used as predictors to identify the best predictor(s) for plaque progre...
Plaque progression and vulnerability are influenced by many risk factors. Our goal is to find simple methods to combine multiple risk factors for better plaque development predictions.
A sample size of 374 intravascular ultrasound (IVUS) slices with matched follow-up was obtained from 9 patients (Mean age 59, 7 m) with informed consent obtained. 3D...
A new modeling approach using two different zero-load geometries (diastole and systole) was introduced to properly model active contraction and relaxation for more accurate stress/strain calculations. Ventricle diastole and systole material parameter values were also determined based on in vivo data. Echo-based computational two-layer left ventricl...
Left ventricular outflow tract obstruction is observed in 70% of patients with hypertrophic cardiomyopathy, which occurs in about 1 of every 500 adults in the general population. It has been widely believed that the motion of the mitral valve, in particular, its systolic anterior motion (SAM), attributes significantly to such obstruction. For a bet...
Accurate cap thickness quantification is of fundamental importance for vulnerable plaque detection in cardiovascular research. A segmentation method for intracoronary optical coherence tomography (OCT) image based on least squares support vector machine (LS-SVM) was performed to characterize plaque component borders and quantify fibrous cap thickne...
Patient-specific vessel material properties are in general lacking in image-based computational models. Carotid plaque stress and strain conditions with in vivo material and old material models were investigated (8 patients, 16 plaques). Plaque models using patient-specific in vivo vessel material properties showed significant differences from mode...
Computer simulations of the blood flow through right coronary arteries with two stenoses in the same arterial segment are carried out to investigate the interactions of serial stenoses, especially the effect of the distal stenosis. Various mathematical models are developed by varying the location of the distal stenosis. The numerical results show t...
Patients with repaired Tetralogy of Fallot (ToF), a congenital heart defect which includes a ventricular septal defect and severe right ventricular outflow obstruction, account for the majority of cases with late onset right ventricle (RV) failure. The current surgical approach, which includes pulmonary valve replacement/insertion (PVR), has yielde...
Cardiovascular diseases are closely linked to atherosclerotic plaque development and rupture. Assessment of plaque vulnerability is of fundamental significance to cardiovascular research and disease diagnosis, prevention, treatment and management. Magnetic resonance image (MRI) data of carotid atherosclerotic plaques from 8 patients (5 male, 3 fema...
Plaque morphology and biomechanics are believed to be closely associated with plaque progression. In this paper, we test the hypothesis that integrating morphological and biomechanical risk factors would result in better predictive power for plaque progression prediction. A sample size of 374 intravascular ultrasound (IVUS) slices was obtained from...
Accurate cap thickness and stress/strain quantifications are of fundamental importance for vulnerable plaque research. Virtual histology intravascular ultrasound (VH-IVUS) sets cap thickness to zero when cap is under resolution limit and IVUS does not see it. An innovative modeling approach combining IVUS and optical coherence tomography (OCT) is i...
Introduction:
Arteries can be considered as layered composite material. Experimental data on the stiffness of human atherosclerotic carotid arteries and their media and adventitia layers is very limited. This study used uniaxial tests to determine the stiffness (tangent modulus) of human carotid artery sections containing AHA type II and III lesio...
Background
Image-based computational models are widely used to determine atherosclerotic plaque stress/strain conditions and investigate their association with plaque progression and rupture. However, patient-specific vessel material properties are in general lacking in those models, limiting the accuracy of their stress/strain measurements. A noni...
Blood pressure loss along the coronary arterial length and the local magnitude of the spatial wall pressure gradient (WPG) are important factors for atherosclerosis initiation and intimal hyperplasia development. The pressure drop coefficient (CDP) is defined as the ratio of mean trans-stenotic pressure drop to proximal dynamic pressure. It is a un...
It is hypothesized that artery stiffness may be associated with plaque progression. However, in vivo vessel material stiffness follow-up data is lacking in the literature.
In vivo 3D multi-contrast and Cine magnetic resonance imaging (MRI) carotid plaque data were acquired from 8 patients with follow-up (18 months) with written informed consent obt...
Accurate cap thickness and stress/strain quantifications are of fundamental importance for vulnerable plaque research. An innovative modeling approach combining intravascular ultrasound (IVUS) and optical coherence tomography (OCT) is introduced for more accurate patient-specific coronary morphology and stress/strain calculations.
In vivo IVUS and...
Computational models have been used to calculate plaque stress and strain for plaque progression and rupture investigations. An intravascular ultrasound (IVUS)-based modeling approach is proposed to quantify in vivo vessel material properties for more accurate stress/strain calculations. In vivo Cine IVUS and VH-IVUS coronary plaque data were acqui...
Patients with repaired tetralogy of Fallot (TOF) account for the majority of cases with late onset right ventricle failure. Comparing TOF patients with healthy people may provide information to address this challenge. Cardiac magnetic resonance (CMR) data were obtained from 16 TOF patients (patient group, PG) and 6 healthy volunteers (healthy group...
Plaque rupture may be triggered by extreme stress/strain conditions. Inflammation is also implicated and can be imaged using novel imaging techniques. The impact of cap inflammation on plaque stress/strain and flow shear stress were investigated. A patient-specific MRI-PET/CT-based modeling approach was used to develop 3D fluid-structure interactio...
Accurate stress and strain calculations are important for plaque progression and vulnerability assessment. Models based on in vivo data often need to form geometries with zero-stress/strain conditions. The goal of this paper is to use IVUS-based nearidealized geometries and introduce a three-step model construction process to include residual stres...
Background:
Accurate calculation of ventricular stress and strain is critical for cardiovascular investigations. Sarcomere shortening in active contraction leads to change of ventricular zero-stress configurations during the cardiac cycle. A new model using different zero-load diastole and systole geometries was introduced to provide more accurate...
Background
Ventricle material properties are difficult to obtain under in vivo conditions and are not readily available in the current literature. It is also desirable to have an initial determination if a patient had an infarction based on echo data before more expensive examinations are recommended. A noninvasive echo-based modeling approach and...
Image-based computational modeling has been used more and more for cardiovascular disease management and surgical planning in recent years. Computational modeling could perform virtual surgery with different surgical options avoiding risks associated with actual surgical experimentation on patients. For patients with repaired tetralogy of Fallot (T...
Methods to quantify ventricle material properties noninvasively using in vivo data are of great importance in clinical applications. Echo image data were acquired from ten people, five patients with myocardial infarction (Group 1) and five healthy volunteers as control (Group 2). 3D finite element models were constructed to obtain ventricle stress...
It is believed that mechanical stress plays an important role in atherosclerotic plaque progression and rupture process. However, 3D model construction is very time consuming and not practical for clinical implementation. This paper is investigating if 2D models could be used to replace 3D models to perform correlation analysis and achieve similar...
It is believed that mechanical stresses play an important role in atherosclerotic plaque rupture process and may be used for better plaque vulnerability assessment and rupture risk predictions. IVUS data were acquired from 14 patients (11M, 3F, Mean age: 59,) for constructing 3D computational models combining fluid-structure interaction (FSI), cycl...
Plaque vulnerability, defined as the likelihood that a plaque would rupture, is difficult to quantify due to lack of in vivo plaque rupture data. Morphological and stress-based plaque vulnerability indices were introduced as alternatives to obtain quantitative vulnerability assessment. Correlations between these indices and key plaque features were...
Objective:
Patients with repaired tetralogy of Fallot account for a substantial proportion of cases with late-onset right ventricular failure. The current surgical approach, which includes pulmonary valve replacement/insertion, has yielded mixed results. Therefore, it may be clinically useful to identify parameters that can be used to predict righ...
Computational modeling has been used extensively in cardiovascular and biological research, providing valuable information. However, 3D vulnerable plaque model construction with complex geometrical features and multicomponents is often very time consuming and not practical for clinical implementation. This paper investigated if 2D atherosclerotic p...
Right ventricular (RV) dysfunction is a common cause of heart failure in patients with congenital heart defects and often leads to impaired functional capacity and premature death. Myocardial tissue regeneration techniques are being developed for the potential that viable myocardium may be regenerated to replace scar tissues in the heart or used as...
Introduction: Mechanical forces play an important role in plaque progression and rupture process. It is of interest to introduce stress-based plaque vulnerability indices and to study their associations with morphology-based vulnerability indices. Stress-based indices include both mechanical and morphological conditions and may improve over image-o...
Introduction: Recent studies indicated that plaque rupture may be associated with: a) extreme mechanical stress/strain conditions; b) large lipid-rich necrotic core; c) thin and weakening fibrous cap; d) cap inflammation; e) intraplaque hemorrhage. Fayad et al and others have been developing multi-modality imaging technology using PET/CT (Positron...
As a dual-modality contrast agent, magnetic microbubbles (MMBs) can not only improve contrast of ultrasound (US) image, but can also serve as a contrast agent of magnetic resonance image (MRI). With the help of MMBs, a new registration method between US image and MRI is presented.
In this method, MMBs were used in both ultrasound and magnetic reson...
In literature, the effect of the inflow boundary condition was investigated by examining the impact of the waveform and the shape of the spatial profile of the inlet velocity on the cardiac hemodynamics. However, not much work has been reported on comparing the effect of the different combinations of the inlet/outlet boundary conditions on the quan...
Cardiovascular disease (CVD) is the leading cause of death worldwide. Huge effort has been made in many disciplines including medical imaging, computational modeling, biomechanics, bioengineering, medical devices, animal and clinical studies, population studies as well as genomic, molecular, cellular and organ-level studies seeking improved methods...
Methods to quantify ventricle material properties noninvasively using in vivo data are of great important in clinical applications. An ultrasound echo-based computational modeling approach was proposed to quantify left ventricle (LV) material properties, curvature and stress/strain conditions and find differences between normal LV and LV with infar...
Atherosclerotic plaque progression is believed to be associated with mechanical stress conditions. Patient follow-up in vivo intravascular ultrasound coronary plaque data were acquired to construct fluid-structure interaction (FSI) models with cyclic bending to obtain flow wall shear stress (WSS), plaque wall stress (PWS) and strain (PWSn) data and...
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Identifying ventricle material properties and its infarct area after heart attack noninvasively is of great important in clinical applications. An echo-based computational modeling approach was proposed to investigate left ventricle (LV) mechanical properties and stress conditions using patient-specific data. Echo data was acquired from one healthy...
A method for determining cardiac status comprises for a given patient, constructing a patient-specific, three-dimensional, computational model of the patient's heart; and executing the constructed computational model, said executing generating a quantitative analysis of cardiac function. A method of performing cardiac surgeries comprises: a) assess...
Atherosclerotic plaque progression and rupture are believed to be associated with mechanical stress conditions. In this paper, patient-specific in vivo intravascular ultrasound (IVUS) coronary plaque image data were used to construct computational models with fluid-structure interaction (FSI) and cyclic bending to investigate correlations between p...
Medical imaging and image-based modeling have made considerable progress in recent years in identifying atherosclerotic plaque morphological and mechanical risk factors which may be used in developing improved patient screening strategies. However, a clear understanding is needed about what we have achieved and what is really needed to translate re...
