Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 100

Search results for: coronary artery bypass graft

100 Constitutive Equations for Human Saphenous Vein Coronary Artery Bypass Graft

Authors: Hynek Chlup, Lukas Horny, Rudolf Zitny, Svatava Konvickova, Tomas Adamek

Abstract:

Coronary artery bypass grafts (CABG) are widely studied with respect to hemodynamic conditions which play important role in presence of a restenosis. However, papers which concern with constitutive modeling of CABG are lacking in the literature. The purpose of this study is to find a constitutive model for CABG tissue. A sample of the CABG obtained within an autopsy underwent an inflation–extension test. Displacements were recoredered by CCD cameras and subsequently evaluated by digital image correlation. Pressure – radius and axial force – elongation data were used to fit material model. The tissue was modeled as onelayered composite reinforced by two families of helical fibers. The material is assumed to be locally orthotropic, nonlinear, incompressible and hyperelastic. Material parameters are estimated for two strain energy functions (SEF). The first is classical exponential. The second SEF is logarithmic which allows interpretation by means of limiting (finite) strain extensibility. Presented material parameters are estimated by optimization based on radial and axial equilibrium equation in a thick-walled tube. Both material models fit experimental data successfully. The exponential model fits significantly better relationship between axial force and axial strain than logarithmic one.

Keywords: Constitutive model, coronary artery bypass graft, digital image correlation, fiber reinforced composite, inflation test, saphenous vein.

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99 Long Term Follow-Up, Clinical Outcomes and Quality of Life after Total Arterial Revascularisation versus Conventional Coronary Surgery: A Retrospective Study

Authors: Jitendra Jain, Cassandra Hidajat, Hansraj Riteesh Bookun

Abstract:

Graft patency underpins long-term prognosis after coronary artery bypass grafting surgery (CABG). The benefits of the combined use of only the left internal mammary artery and radial artery, referred to as total arterial revascularisation (TAR), on long-term clinical outcomes and quality of life are relatively unknown. The aim of this study was to identify whether there were differences in long term clinical outcomes between recipients of TAR compared to a cohort of mostly arterial revascularization involving the left internal mammary, at least one radial artery and at least one saphenous vein graft. A retrospective analysis was performed on all patients who underwent TAR or were re-vascularized with supplementary saphenous vein graft from February 1996 to December 2004. Telephone surveys were conducted to obtain clinical outcome parameters including major adverse cardiac and cerebrovascular events (MACCE) and Short Form (SF-36v2) Health Survey responses. A total of 176 patients were successfully contacted to obtain postop follow up results. The mean follow-up length from time of surgery in our study was TAR 12.4±1.8 years and conventional 12.6±2.1. PCS score was TAR 45.9±8.8 vs LIMA/Rad/ SVG 44.9±9.2 (p=0.468) and MCS score was TAR 52.0±8.9 vs LIMA/Rad/SVG 52.5±9.3 (p=0.723). There were no significant differences between groups for NYHA class 3+ TAR 9.4% vs. LIMA/Rad/SVG 6.6%; or CCS 3+ TAR 2.35% vs. LIMA/Rad/SVG 0%.

Keywords: CABG, MACCEs, quality of life, total arterial revascularization.

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98 Investigating the Effect of Velocity Inlet and Carrying Fluid on the Flow inside Coronary Artery

Authors: Mohammadreza Nezamirad, Nasim Sabetpour, Azadeh Yazdi, Amirmasoud Hamedi

Abstract:

In this study OpenFOAM 4.4.2 was used to investigate flow inside the coronary artery of the heart. This step is the first step of our future project, which is to include conjugate heat transfer of the heart with three main coronary arteries. Three different velocities were used as inlet boundary conditions to see the effect of velocity increase on velocity, pressure, and wall shear of the coronary artery. Also, three different fluids, namely the University of Wisconsin solution, gelatin, and blood was used to investigate the effect of different fluids on flow inside the coronary artery. A code based on Reynolds Stress Navier Stokes (RANS) equations was written and implemented with the real boundary condition that was calculated based on MRI images. In order to improve the accuracy of the current numerical scheme, hex dominant mesh is utilized. When the inlet velocity increases to 0.5 m/s, velocity, wall shear stress, and pressure increase at the narrower parts.

Keywords: CFD, heart, simulation, OpenFOAM.

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97 A Review of Pharmacological Prevention of Peri-and Post-Procedural Myocardial Injury after Percutaneous Coronary Intervention

Authors: Syed Dawood Md. Taimur, Md. Hasanur Rahman, Syeda Fahmida Afrin, Farzana Islam

Abstract:

The concept of myocardial injury, although first recognized from animal studies, is now recognized as a clinical phenomenon that may result in microvascular damage, no-reflow phenomenon, myocardial stunning, myocardial hibernation and ischemic preconditioning. The final consequence of this event is left ventricular (LV) systolic dysfunction leading to increased morbidity and mortality. The typical clinical case of reperfusion injury occurs in acute myocardial infarction (MI) with ST segment elevation in which an occlusion of a major epicardial coronary artery is followed by recanalization of the artery. This may occur spontaneously or by means of thrombolysis and/or by primary percutaneous coronary intervention (PCI) with efficient platelet inhibition by aspirin (acetylsalicylic acid), clopidogrel and glycoprotein IIb/IIIa inhibitors. In recent years, percutaneous coronary intervention (PCI) has become a well-established technique for the treatment of coronary artery disease. PCI improves symptoms in patients with coronary artery disease and it has been increasing safety of procedures. However, peri- and post-procedural myocardial injury, including angiographical slow coronary flow, microvascular embolization, and elevated levels of cardiac enzyme, such as creatine kinase and troponin-T and -I, has also been reported even in elective cases. Furthermore, myocardial reperfusion injury at the beginning of myocardial reperfusion, which causes tissue damage and cardiac dysfunction, may occur in cases of acute coronary syndrome. Because patients with myocardial injury is related to larger myocardial infarction and have a worse long-term prognosis than those without myocardial injury, it is important to prevent myocardial injury during and/or after PCI in patients with coronary artery disease. To date, many studies have demonstrated that adjunctive pharmacological treatment suppresses myocardial injury and increases coronary blood flow during PCI procedures. In this review, we highlight the usefulness of pharmacological treatment in combination with PCI in attenuating myocardial injury in patients with coronary artery disease.

Keywords: Coronary artery disease, Percutaneous coronary intervention, Myocardial injury, Pharmacology.

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96 Computational Study of Blood Flow Analysis for Coronary Artery Disease

Authors: Radhe Tado, Ashish B. Deoghare, K. M. Pandey

Abstract:

The aim of this study is to estimate the effect of blood flow through the coronary artery in human heart so as to assess the coronary artery disease.Velocity, wall shear stress (WSS), strain rate and wall pressure distribution are some of the important hemodynamic parameters that are non-invasively assessed with computational fluid dynamics (CFD). These parameters are used to identify the mechanical factors responsible for the plaque progression and/or rupture in left coronary arteries (LCA) in coronary arteries.The initial step for CFD simulations was the construction of a geometrical model of the LCA. Patient specific artery model is constructed using computed tomography (CT) scan data with the help of MIMICS Research 19.0. For CFD analysis ANSYS FLUENT-14.5 is used.Hemodynamic parameters were quantified and flow patterns were visualized both in the absence and presence of coronary plaques. The wall pressure continuously decreased towards distal segments and showed pressure drops in stenotic segments. Areas of high WSS and high flow velocities were found adjacent to plaques deposition.

Keywords: Computational fluid dynamics, hemodynamics, velocity, strain rate, wall pressure, wall shear stress.

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95 Numerical Simulation of Restenosis in a Stented Coronary Artery

Authors: Weronika Kurowska-Nouyrigat, Jacek Szumbarski

Abstract:

Nowadays, cardiac disease is one of the most common cause of death. Each year almost one million of angioplasty interventions and stents implantations are made all over the world. Unfortunately, in 20-30% of cases neointimal proliferations leads to restenosis occurring within the following period of 3-6 months. Three major factors are believed to contribute mostly to the edge restenosis: (a) mechanical damage of the artery-s wall caused by the stent implantation, (b) interaction between the stent and the blood constituents and (c) endothelial growth stimulation by small (lower that 1.5 Pa) and oscillating wall shear stress. Assuming that this last actor is particularly important, a numerical model of restenosis basing on wall shear stress distribution in the stented artery was elaborated. A numerical simulations of the development of in-stent restenosis have been performed and realistic geometric patterns of a progressing lumen reduction have been obtained

Keywords: Coronary artery disease, coronary blood flow, instent restenosis.

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94 The Association of Matrix Metalloproteinase-3 Gene -1612 5A/6A Polymorphism with Susceptibility to Coronary Artery Stenosis in an Iranian Population

Authors: M. Seifi, S. Fallah, M. Firoozrai

Abstract:

Matrix metalloproteinase-3 (MMP3) is key member of the MMP family, and is known to be present in coronary atherosclerotic. Several studies have demonstrated that MMP-3 5A/6A polymorphism modify each transcriptional activity in allele specific manner. We hypothesized that this polymorphism may play a role as risk factor for development of coronary stenosis. The aim of our study was to estimate MMP-3 (5A/6A) gene polymorphism on interindividual variability in risk for coronary stenosis in an Iranian population.DNA was extracted from white blood cells and genotypes were obtained from coronary stenosis cases (n=95) and controls (n=100) by PCR (polymerase chain reaction) and restriction fragment length polymorphism techniques. Significant differences between cases and controls were observed for MMP3 genotype frequencies (X2=199.305, p< 0.001); the 6A allele was less frequently seen in the control group, compared to the disease group (85.79 vs. 78%, 6A/6A+5A/6A vs. 5A/5A, P≤0.001). These data imply the involvement of -1612 5A/6A polymorphism in coronary stenosis, and suggest that probably the 6A/6A MMP-3 genotype is a genetic susceptibility factor for coronary stenosis.

Keywords: Coronary artery stenosis, matrixmetalloproteinase-3, polymorphism, polymerase chain reaction.

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93 A Structural Constitutive Model for Viscoelastic Rheological Behavior of Human Saphenous Vein Using Experimental Assays

Authors: Rassoli Aisa, Abrishami Movahhed Arezu, Faturaee Nasser, Seddighi Amir Saeed, Shafigh Mohammad

Abstract:

Cardiovascular diseases are one of the most common causes of mortality in developed countries. Coronary artery abnormalities and carotid artery stenosis, also known as silent death, are among these diseases. One of the treatment methods for these diseases is to create a deviatory pathway to conduct blood into the heart through a bypass surgery. The saphenous vein is usually used in this surgery to create the deviatory pathway. Unfortunately, a re-surgery will be necessary after some years due to ignoring the disagreement of mechanical properties of graft tissue and/or applied prostheses with those of host tissue. The objective of the present study is to clarify the viscoelastic behavior of human saphenous tissue. The stress relaxation tests in circumferential and longitudinal direction were done in this vein by exerting 20% and 50% strains. Considering the stress relaxation curves obtained from stress relaxation tests and the coefficients of the standard solid model, it was demonstrated that the saphenous vein has a non-linear viscoelastic behavior. Thereafter, the fitting with Fung’s quasilinear viscoelastic (QLV) model was performed based on stress relaxation time curves. Finally, the coefficients of Fung’s QLV model, which models the behavior of saphenous tissue very well, were presented.

Keywords: Fung’s quasilinear viscoelastic (QLV) model, strain rate, stress relaxation test, uniaxial tensile test, viscoelastic behavior.

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92 3D Shape Modelling of Left Ventricle: Towards Correlation of Myocardial Scintigraphy Data and Coronarography Result

Authors: A. Ben Abdallah, H. Essabbah, M. H. Bedoui

Abstract:

The myocardial sintigraphy is an imaging modality which provides functional informations. Whereas, coronarography modality gives useful informations about coronary arteries anatomy. In case of coronary artery disease (CAD), the coronarography can not determine precisely which moderate lesions (artery reduction between 50% and 70%), known as the “gray zone", are haemodynamicaly significant. In this paper, we aim to define the relationship between the location and the degree of the stenosis in coronary arteries and the observed perfusion on the myocardial scintigraphy. This allows us to model the impact evolution of these stenoses in order to justify a coronarography or to avoid it for patients suspected being in the gray zone. Our approach is decomposed in two steps. The first step consists in modelling a coronary artery bed and stenoses of different location and degree. The second step consists in modelling the left ventricle at stress and at rest using the sphercical harmonics model and myocardial scintigraphic data. We use the spherical harmonics descriptors to analyse left ventricle model deformation between stress and rest which permits us to conclude if ever an ischemia exists and to quantify it.

Keywords: Spherical harmonics model, vascular bed, 3D reconstruction, left ventricle, myocardial scintigraphy.

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91 Influence of Apo E Polymorphism on Coronary Artery Disease

Authors: S. Fallah, M. Seifi, M. Firoozrai, T. Godarzi, M. Jafarzadeh, L. H. Ghohari

Abstract:

The ε4 allele of the ε2, ε3 and ε4 protein isoform polymorphism in the gene encoding apolipoprotein E (Apo E) has previously been associated with increased cardiac artery disease (CAD); therefore to investigate the significance of this polymorphism in pathogenesis of CAD in Iranian patients with stenosis and control subjects. To investigate the association between  Apo E polymorphism and coronary artery disease we performed a comparative case control study of the frequency of Apo E  polymorphism in One hundred CAD patients with stenosis who underwent coronary angiography (>50% stenosis) and 100 control subjects (<10% stenosis). The Apo E alleles and genotypes were determined by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). We observed an association between the Apo E polymorphism and CAD in this study. These data suggest that the Apo ε4 and ε2 alleles increase the risk for CAD in Iranian population (χ2 =4.26, p= 0.05, OR=2 and χ2 =0.38, p=0.53, OR=1.2). These results suggest that ε4 and ε2 alleles are risk factors for stenosis.

Keywords: Arterial blood vessels, atherosclerosis, cholesterol.

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90 Angiographic Evaluation of ETT (Treadmill) Positive Patients in a Tertiary Care Hospital of Bangladesh

Authors: Syed Dawood Md. Taimur, Saidur Rahman Khan, Farzana Islam

Abstract:

To evaluate the factors which predetermine the coronary artery disease in patients having positive Exercise Tolerance Test (ETT) that is treadmill results and coronary artery findings. This descriptive study was conducted at Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from 1st January, 2014 to 31st August, 2014. All patients who had done ETT (treadmill) for chest pain diagnosis were studied. One hundred and four patients underwent coronary angiogram after positive treadmill result. Patients were divided into two groups depending upon the angiographic findings, i.e. true positive and false positive. Positive treadmill test patients who have coronary artery involvement these are called true positive and who have no involvement they are called false positive group. Both groups were compared with each other. Out of 104 patients, 81 (77.9%) patients had true positive ETT and 23 (22.1%) patients had false positive ETT. The mean age of patients in positive ETT was 53.46± 8.06 years and male mean age was 53.63±8.36 years and female was 52.87±7.0 years. Sixty nine (85.19%) male patients and twelve (14.81%) female patients had true positive ETT, whereas 15 (65.21%) males and 8 (34.79%) females had false positive ETT, this was statistically significant (p<0.032) in the two groups (sex) in comparison of true and false positive ETT. The risk factors of these patients like diabetes mellitus, hypertension, dyslipidemia, family history and smoking were seen among these patients. Hypertensive patients having true positive which were statistically significant (p<0.004) and diabetic, dyslipidemic patients having true positive which were statistically significant (p<0.032 & 0.030).True positive patients had family history were 68(83.95%) and smoking were 52 (64.20%), where family history patients had statistically significant (p<0.017) between two groups of patients and smokers were significant (p<0.012). 46 true positive patients achieved THR which was not statistically significant (P<0.138) and 79 true patients had abnormal resting ECG whether it was significant (p<0.036). Amongst the vessels involvement the most common was LAD 55 (67.90 %) followed by LCX 42 (51.85%), RCA 36 (44.44%), and the LMCA was 9 (11.11%). 40 patients (49.38%) had SVD, 26 (30.10%) had DVD, 15(18.52%) had TVD and 23 had normal coronary arteries. It can be concluded that among the female patients who have positive ETT with normal resting ECG, who had achieved target heart rate are likely to have a false positive test result. Conversely male patients, resting abnormal ECG who had not achieved THR, symptom limited ETT, have a hypertension, diabetes, dyslipidemia, family history and smoking are likely to have a true positive treadmill test result.

Keywords: Exercise tolerance test, Coronary artery disease, Coronary angiography, True positive, False positive.

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89 A 3D Approach for Extraction of the Coronaryartery and Quantification of the Stenosis

Authors: Mahdi Mazinani, S. D. Qanadli, Rahil Hosseini, Tim Ellis, Jamshid Dehmeshki

Abstract:

Segmentation and quantification of stenosis is an important task in assessing coronary artery disease. One of the main challenges is measuring the real diameter of curved vessels. Moreover, uncertainty in segmentation of different tissues in the narrow vessel is an important issue that affects accuracy. This paper proposes an algorithm to extract coronary arteries and measure the degree of stenosis. Markovian fuzzy clustering method is applied to model uncertainty arises from partial volume effect problem. The algorithm employs: segmentation, centreline extraction, estimation of orthogonal plane to centreline, measurement of the degree of stenosis. To evaluate the accuracy and reproducibility, the approach has been applied to a vascular phantom and the results are compared with real diameter. The results of 10 patient datasets have been visually judged by a qualified radiologist. The results reveal the superiority of the proposed method compared to the Conventional thresholding Method (CTM) on both datasets.

Keywords: 3D coronary artery tree extraction, segmentation, quantification, fuzzy clustering, and Markov random field

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88 Termination of the Brachial Artery in the Arm and Its Clinical Significance

Authors: Ramya Rathan, Miral N. F. Salama

Abstract:

The variations in the arteries have been drawing attention of anatomists for a long time because of their clinical significance. The brachial artery is the principal artery of the arm which is the continuation of the axillary artery from the lower border of the Teres Major. It terminates into the radial and ulnar arteries below the elbow joint at the neck radius. The present study aims at exploring the clinical significance of the high termination of the brachial artery. During the routine cadaveric dissection of the arm, for the undergraduate students of medicine at our university, we observed a high bifurcation of the radial and the ulnar artery at the midshaft of the humerus. The median nerve was seen passing between these two junctions. Further, the course and the relations of this artery were studied. The accurate knowledge regarding these kinds of variation in the blood vessels is mandatory for planning of designing. General physicians, surgeons and radiologists should keep in mind the variations in the branching pattern of the arteries in their daily medical, diagnostic and therapeutic procedures to avoid complications in diagnostic and surgical procedures.

Keywords: Brachial artery, high termination, radial artery, ulnar artery.

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87 Automatic 3D Reconstruction of Coronary Artery Centerlines from Monoplane X-ray Angiogram Images

Authors: Ali Zifan, Panos Liatsis, Panagiotis Kantartzis, Manolis Gavaises, Nicos Karcanias, Demosthenes Katritsis

Abstract:

We present a new method for the fully automatic 3D reconstruction of the coronary artery centerlines, using two X-ray angiogram projection images from a single rotating monoplane acquisition system. During the first stage, the input images are smoothed using curve evolution techniques. Next, a simple yet efficient multiscale method, based on the information of the Hessian matrix, for the enhancement of the vascular structure is introduced. Hysteresis thresholding using different image quantiles, is used to threshold the arteries. This stage is followed by a thinning procedure to extract the centerlines. The resulting skeleton image is then pruned using morphological and pattern recognition techniques to remove non-vessel like structures. Finally, edge-based stereo correspondence is solved using a parallel evolutionary optimization method based on f symbiosis. The detected 2D centerlines combined with disparity map information allow the reconstruction of the 3D vessel centerlines. The proposed method has been evaluated on patient data sets for evaluation purposes.

Keywords: Vessel enhancement, centerline extraction, symbiotic reconstruction.

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86 Visfatin and Apelin Are New Interrelated Adipokines Playing Role in the Pathogenesis of Type 2 Diabetes Mellitus Associated Coronary Artery Disease in Postmenopausal Women

Authors: Hala O. El-Mesallamy, Salwa M. Suwailem, Mae M. Seleem

Abstract:

Visfatin and apelin are two new adipokines that recently gained a special interest in diabetes research. This study was conducted to study the interplay between these two adipokines and their correlation with other inflammatory and biochemical parameters in type 2 diabetic (T2D) postmenopausal women with CAD. Visfatin and apelin were measured by enzyme-linked immunoassay (ELISA). Visfatin was found to be significantly higher in the following groups: T2D patients without CAD, non-obese and obese T2D patients with CAD when compared to control group. Apelin was found to be significantly lower in non-obese and obese T2D patients with CAD when compared to control group. Visfatin and apelin were found to be significantly associated with each other and with other biochemical parameters. The current study provides evidence for the interplay between visfatin and apelin through the inflammatory milieu characteristic of T2D and their possible role in the pathogenesis of CAD complication of T2D. 

Keywords: Apelin, Coronary artery disease, Inflammation, Type 2 diabetes, Visfatin.

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85 HERMES System: a Virtual Reality Simulator for the Angioplasty Intervention Training

Authors: Giovanni Aloisio, Lucio T. De Paolis, Luciana Provenzano, Lucio Colizzi, Gianluca Pantile

Abstract:

One of the essential requirements in order to have a realistic surgical simulator is real-time interaction by means of a haptic interface is. In fact, reproducing haptic sensations increases the realism of the simulation. However, the interaction need to be performed in real-time, since a delay between the user action and the system reaction reduces the user immersion. In this paper, we present a prototype of the coronary stent implant simulator developed in the HERMES Project; this system allows real-time interactions with a artery by means of a specific haptic device; thus the user can interactively navigate in a reconstructed artery and force feedback is produced when contact occurs between the artery walls and the medical instruments

Keywords: Collision Detection, Haptic Interface, Real-Time Interaction, Surgical Simulator.

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84 Analysis of Endovascular Graft Features Affecting Endotension Following Endovascular Aneurysm Repair

Authors: Zeinab Hooshyar, Alireza Mehdizadeh

Abstract:

Endovascular aneurysm repair is a new and minimally invasive repair for patients with abdominal aortic aneurysm (AAA). This method has potential advantages that are incomparable with other repair methods. However, the enlargement of aneurysm in the absence of endoleak, which is known as endotension, may occur as one of post-operative compliances of this method. Typically, endotension is mainly as a result of pressure transmitted to aneurysm sac by endovascular installed graft. After installation of graft the aneurysm sac reduces significantly but remains non-zero. There are some factors which affect this pressure transmitted. In this study, the geometry features of installed vascular graft have been considered. It is inferred that graft neck angle and iliac bifurcation angle are two factors which can affect the drag force on graft and consequently the pressure transmitted to aneurysm.

Keywords: Endovascular graft, transmitted pressure, Drag force, Finite Element Modeling, neck angle, iliac bifurcation angle.

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83 Hypolipidemic and Antioxidant Effects of Black Tea Extract and Quercetin in Atherosclerotic Rats

Authors: Wahyu Widowati, Hana Ratnawati, Tjandrawati Mozefis, Dwiyati Pujimulyani, Yelliantty Yelliantty

Abstract:

Background: Atherosclerosis is the main cause of cardiovascular disease (CVD) with complex and multifactorial process including atherogenic lipoprotein, oxidized low density lipoprotein (LDL), endothelial dysfunction, plaque stability, vascular inflammation, thrombotic and fibrinolytic disorder, exercises and genetic factor Epidemiological studies have shown tea consumption inversely associated with the development and progression of atherosclerosis. The research objectives: to elucidate hypolipidemic, antioxidant effects, as well as ability to improve coronary artery’s histopathologyof black tea extract (BTE) and quercetin in atherosclerotic rats. Methods: The antioxidant activity was determined by using Superoxide Dismutase activity (SOD) of serum and lipid peroxidation product (Malondialdehyde) of plasma and lipid profile including cholesterol total, LDL, triglyceride (TG), High Density Lipoprotein (HDL) of atherosclerotic rats. Inducing atherosclerotic, rats were given cholesterol and cholic acid in feed during ten weeks until rats indicated atherosclerotic symptom with narrowed artery and foamy cells in the artery’s wall. After rats suffered atherosclerotic, the high cholesterol feed and cholic acid were stopped and rats were given BTE 450; 300; 150 mg/kg body weight (BW) daily, quercetin 15; 10; 5 mg/kg BW daily, compared to rats were given vitamin E 60 mg/kg/BW; simvastatin 2.7 mg/kg BW, probucol 30 mg/kg BW daily for 21 days (first treatment) and 42 days (second treatment), negative control (normal feed), positive control (atherosclerotic rats). Results: BTE and quercetin could lower cholesterol total, triglyceride, LDL MDA and increase HDL, SOD were comparable with simvastatin, probucol both for 21 days and 42 days treatment, as well to improve coronary arteries histopathology. Conclusions: BTE andquercetin have hypolipidemic and antioxidant effects, as well as improve coronary arteries histopathology in atherosclerotic rats.

Keywords: Black tea, quercetin, atherosclerosis, antioxidant, hypolipidemic, cardiovascular disease.

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82 Computational Study on Cardiac-Coronary Interaction in Terms of Coronary Flow-Pressure Waveforms in Presence of Drugs: Comparison Between Simulated and In Vivo Data

Authors: C. De Lazzari, E. Del Prete, I. Genuini, F. Fedele

Abstract:

Cardiovascular human simulator can be a useful tool in understanding complex physiopathological process in cardiocirculatory system. It can also be a useful tool in order to investigate the effects of different drugs on hemodynamic parameters. The aim of this work is to test the potentiality of our cardiovascular numerical simulator CARDIOSIM© in reproducing flow/pressure coronary waveforms in presence of two different drugs: Amlodipine (AMLO) and Adenosine (ADO). In particular a time-varying intramyocardial compression, assumed to be proportional to the left ventricular pressure, was related to the venous coronary compliances in order to study its effects on the coronary blood flow and the flow/pressure loop. Considering that coronary circulation dynamics is strongly interrelated with the mechanics of the left ventricular contraction, relaxation, and filling, the numerical model allowed to analyze the effects induced by the left ventricular pressure on the coronary flow.

Keywords: Cardiovascular system, Coronary blood flow, Hemodynamic, Numerical simulation.

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81 Effect of Modeling of Hydraulic Form Loss Coefficient to Break on Emergency Core Coolant Bypass

Authors: Young S. Bang, Dong H. Yoon, Seung H. Yoo

Abstract:

Emergency Core Coolant Bypass (ECC Bypass) has been regarded as an important phenomenon to peak cladding temperature of large-break loss-of-coolant-accidents (LBLOCA) in nuclear power plants (NPP). A modeling scheme to address the ECC Bypass phenomena and the calculation of LBLOCA using that scheme are discussed in the present paper. A hydraulic form loss coefficient (HFLC) from the reactor vessel downcomer to the broken cold leg is predicted by the computational fluid dynamics (CFD) code with a variation of the void fraction incoming from the downcomer. The maximum, mean, and minimum values of FLC are derived from the CFD results and are incorporated into the LBLOCA calculation using a system thermal-hydraulic code, MARS-KS. As a relevant parameter addressing the ECC Bypass phenomena, the FLC to the break and its range are proposed.

Keywords: CFD analysis, ECC Bypass, hydraulic form loss coefficient, system thermal-hydraulic code.

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80 Effect of a Multiple Stenosis on Blood Flow through a Tube

Authors: Vipin Kumar Verma, Praveen Saraswat

Abstract:

The development of double stenosis in an artery can have serious consequences and can disrupt the normal functioning of the circulatory system. It has been realized that various hydrodynamics effects (i.e. wall shear, pressure distribution etc.) play important role in the development of this disease. Generally in the literature, the cross-section of the artery is assumed to be uniform with a single stenosis. However, in real situation the multiple stenosis develops in series along the length of artery whose cross-section varies slowly. Therefore, the flow of blood is laminar through a small diameter artery with axisymmetric identical double stenosis in series.

Keywords: Wall shear, multiple stenosis, artery.

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79 The Method of Evaluation Artery Diameter from Ultrasound Video

Authors: U. Rubins, Z. Marcinkevics, K.Volceka

Abstract:

The cardiovascular system has become the most important subject of clinical research, particularly measurement of arterial blood flow. Therefore correct determination of arterial diameter is crucial. We propose a novel, semi-automatic method for artery lumen detection. The method is based on Gaussian probability function. Usability of our proposed method was assessed by analyzing ultrasound B-mode CFA video sequences acquired from eleven healthy volunteers. The correlation coefficient between the manual and semi-automatic measurement of arterial diameter was 0.996. Our proposed method for detecting artery boundary is novel and accurate enough for the measurement of artery diameter.

Keywords: Ultrasound, boundary detection, artery diameter, curve fitting.

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78 Hemodynamic Characteristics in the Human Carotid Artery Model Induced by Blood-Arterial Wall Interactions

Authors: Taewon Seo

Abstract:

The characteristics of physiological blood flow in human carotid arterial bifurcation model have been numerically studied using a fully coupled fluid-structure interaction (FSI) analysis. This computational model with the fluid-structure interaction is constructed to investigate the flow characteristics and wall shear stress in the carotid artery. As the flow begins to decelerate after the peak flow, a large recirculation zone develops at the non-divider wall of both internal carotid artery (ICA) and external carotid artery (ECA) in FSI model due to the elastic energy stored in the expanding compliant wall. The calculated difference in wall shear stress (WSS) in both Non-FSI and FSI models is a range of between 5 and 11% at the mean WSS. The low WSS corresponds to regions of carotid artery that are more susceptible to atherosclerosis.

Keywords: Carotid artery, Fluid-structure interaction, Hemodynamics, Wall shear stress.

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77 Bayes Net Classifiers for Prediction of Renal Graft Status and Survival Period

Authors: Jiakai Li, Gursel Serpen, Steven Selman, Matt Franchetti, Mike Riesen, Cynthia Schneider

Abstract:

This paper presents the development of a Bayesian belief network classifier for prediction of graft status and survival period in renal transplantation using the patient profile information prior to the transplantation. The objective was to explore feasibility of developing a decision making tool for identifying the most suitable recipient among the candidate pool members. The dataset was compiled from the University of Toledo Medical Center Hospital patients as reported to the United Network Organ Sharing, and had 1228 patient records for the period covering 1987 through 2009. The Bayes net classifiers were developed using the Weka machine learning software workbench. Two separate classifiers were induced from the data set, one to predict the status of the graft as either failed or living, and a second classifier to predict the graft survival period. The classifier for graft status prediction performed very well with a prediction accuracy of 97.8% and true positive values of 0.967 and 0.988 for the living and failed classes, respectively. The second classifier to predict the graft survival period yielded a prediction accuracy of 68.2% and a true positive rate of 0.85 for the class representing those instances with kidneys failing during the first year following transplantation. Simulation results indicated that it is feasible to develop a successful Bayesian belief network classifier for prediction of graft status, but not the graft survival period, using the information in UNOS database.

Keywords: Bayesian network classifier, renal transplantation, graft survival period, United Network for Organ Sharing

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76 CFD Analysis of the Blood Flow in Left Coronary Bifurcation with Variable Angulation

Authors: Midiya Khademi, Ali Nikoo, Shabnam Rahimnezhad Baghche Jooghi

Abstract:

Cardiovascular diseases (CVDs) are the main cause of death globally. Most CVDs can be prevented by avoiding habitual risk factors. Separate from the habitual risk factors, there are some inherent factors in each individual that can increase the risk potential of CVDs. Vessel shapes and geometry are influential factors, having great impact on the blood flow and the hemodynamic behavior of the vessels. In the present study, the influence of bifurcation angle on blood flow characteristics is studied. In order to approach this topic, by simplifying the details of the bifurcation, three models with angles 30°, 45°, and 60° were created, then by using CFD analysis, the response of these models for stable flow and pulsatile flow was studied. In the conducted simulation in order to eliminate the influence of other geometrical factors, only the angle of the bifurcation was changed and other parameters remained constant during the research. Simulations are conducted under dynamic and stable condition. In the stable flow simulation, a steady velocity of 0.17 m/s at the inlet plug was maintained and in dynamic simulations, a typical LAD flow waveform is implemented. The results show that the bifurcation angle has an influence on the maximum speed of the flow. In the stable flow condition, increasing the angle lead to decrease the maximum flow velocity. In the dynamic flow simulations, increasing the bifurcation angle lead to an increase in the maximum velocity. Since blood flow has pulsatile characteristics, using a uniform velocity during the simulations can lead to a discrepancy between the actual results and the calculated results.

Keywords: Coronary artery, cardiovascular disease, bifurcation, atherosclerosis, CFD, artery wall shear stress.

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75 Graft Copolymerization of Cellulose Acetate with Nitro-N-Amino Phenyl Maleimides

Authors: Azza. A. Al-Ghamdi, Abir. A. Abdel-Naby

Abstract:

The construction of Nitro -N-amino phenyl maleimide branches onto Cellulose acetate (CA) substrate by free radical graft copolymerization using benzoyl peroxide as initiator led to formation of highly thermal stable copolymers as shown from the results of gravimetric analysis (TGA). CA-g-2,4-dinitro amino phenyl maleimide exhibited higher thermal stability than the CA-g-4-nitro amino phenyl maleimide as shown from the initial decomposition temperature (To). This is due to the ability of nitro group to form hydrogen bonding with hydroxyl group of the glucopyranose ring which increases the crystallinity of polymeric matrix. The crystalline shapes representing the graft part are clearly distinct in the Emission scanning electron microscope (ESEM) morphology of the copolymer. A suggested reaction mechanism for the grafting process was also discussed.

Keywords: Cellulose acetate, crystallinity, graft copolymerization, thermal properties.

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74 A Comparative CFD Study on the Hemodynamics of Flow through an Idealized Symmetric and Asymmetric Stenosed Arteries

Authors: B. Prashantha, S. Anish

Abstract:

The aim of the present study is to computationally evaluate the hemodynamic factors which affect the formation of atherosclerosis and plaque rupture in the human artery. An increase of atherosclerosis disease in the artery causes geometry changes, which results in hemodynamic changes such as flow separation, reattachment, and adhesion of new cells (chemotactic) in the artery. Hence, geometry plays an important role in the determining the nature of hemodynamic patterns. Influence of stenosis in the non-bifurcating artery, under pulsatile flow condition, has been studied on an idealized geometry. Analysis of flow through symmetric and asymmetric stenosis in the artery revealed the significance of oscillating shear index (OSI), flow separation, low WSS zones and secondary flow patterns on plaque formation. The observed characteristic of flow in the post-stenotic region highlight the importance of plaque eccentricity on the formation of secondary stenosis on the arterial wall.

Keywords: Atherosclerotic plaque, Oscillatory Shear Index, Stenosis nature, Wall Shear Stress.

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73 Applying Similarity Theory and Hilbert Huang Transform for Estimating the Differences of Pig-s Blood Pressure Signals between Situations of Intestinal Artery Blocking and Unblocking

Authors: Jia-Rong Yeh, Tzu-Yu Lin, Jiann-Shing Shieh, Yun Chen

Abstract:

A mammal-s body can be seen as a blood vessel with complex tunnels. When heart pumps blood periodically, blood runs through blood vessels and rebounds from walls of blood vessels. Blood pressure signals can be measured with complex but periodic patterns. When an artery is clamped during a surgical operation, the spectrum of blood pressure signals will be different from that of normal situation. In this investigation, intestinal artery clamping operations were conducted to a pig for simulating the situation of intestinal blocking during a surgical operation. Similarity theory is a convenient and easy tool to prove that patterns of blood pressure signals of intestinal artery blocking and unblocking are surely different. And, the algorithm of Hilbert Huang Transform can be applied to extract the character parameters of blood pressure pattern. In conclusion, the patterns of blood pressure signals of two different situations, intestinal artery blocking and unblocking, can be distinguished by these character parameters defined in this paper.

Keywords: Blood pressure, spectrum, intestinal artery, similarity theory and Hilbert Huang Transform.

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72 Common Carotid Artery Intima Media Thickness Segmentation Survey

Authors: L. Ashok Kumar, C. Nagarajan

Abstract:

The ultrasound imaging is very popular to diagnosis the disease because of its non-invasive nature. The ultrasound imaging slowly produces low quality images due to the presence of spackle noise and wave interferences. There are several algorithms to be proposed for the segmentation of ultrasound carotid artery images but it requires a certain limit of user interaction. The pixel in an image is highly correlated so the spatial information of surrounding pixels may be considered in the process of image segmentation which improves the results further. When data is highly correlated, one pixel may belong to more than one cluster with different degree of membership. There is an important step to computerize the evaluation of arterial disease severity using segmentation of carotid artery lumen in 2D and 3D ultrasonography and in finding vulnerable atherosclerotic plaques susceptible to rupture which can cause stroke.

Keywords: IMT measurement, Image Segmentation, common carotid artery, internal and external carotid arteries, ultrasound imaging.

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71 The Role Played by Swift Change of the Stability Characteristic of Mean Flow in Bypass Transition

Authors: Dong Ming, Su Caihong

Abstract:

The scenario of bypass transition is generally described as follows: the low-frequency disturbances in the free-stream may generate long stream-wise streaks in the boundary layer, which later may trigger secondary instability, leading to rapid increase of high-frequency disturbances. Then possibly turbulent spots emerge, and through their merging, lead to fully developed turbulence. This description, however, is insufficient in the sense that it does not provide the inherent mechanism of transition that during the transition, a large number of waves with different frequencies and wave numbers appear almost simultaneously, producing sufficiently large Reynolds stress, so the mean flow profile can change rapidly from laminar to turbulent. In this paper, such a mechanism will be figured out from analyzing DNS data of transition.

Keywords: boundary layer, breakdown, bypass transition, stability, streak.

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