Objective: Ascending thoracic aortic aneu-rysm (aTAA) is a major cause of human deaths. Despite important recent progress to better understand its pathogenesis and development, the role played by deranged hemodynamics on aTAA risk of rupture is still partially unknown. Our aim was to develop and apply a novel methodology to assess the correlation between aTAA rupture risk and hemodynamic biomarkers combining for the first time in vivo, in vitro, and in silico analyses. Methods: Computational fluid dynamic analyses were performed and validated on ten patients using patient-specific data derived from CT scan and four-dimensional MRI. Systolic wall shear stress, time-averaged wall shear stress (TAWSS), flow eccentricity (Flow_eccentricity), and helicity intensity (h₂) were assessed. A bulge inflation test was carried out in vitro on the ten aTAA samples resected during surgical repair. The biomechanical and rupture properties of these samples were derived: the burst pressure, the physiological tangent elastic modulus $({{{\bf{E}}_{{\bf{physio}}}}})$, the Cauchy stress at rupture $({{{\bf{\sigma }}_{{\bf{rupt}}}}})$, the rupture stretch $({{{\bf{\lambda }}_{{\bf{rupt}}}}})$, and the rupture stretch criterion $({\Upsilon_{\boldsymbol{stretch}}})$. Statistical analysis was performed to determine correlation between all variables. Results: Statistically highly significant (p < 0.01) positive correlation between ${{\bf{\lambda }}_{{\bf{rupt}}}}$ and the TAWSS (r = 0.867 and p = 0.001) was found. Conclusion: This study shows that relatively low TAWSS significantly correlates with reduced rupture properties in aTAAs. Significance: Understanding the pathogenesis of aTAA remains crucial to reduce morbidity and mortality. Our aim is to establish possible correlations between aTAA rupture risk and hemodynamic biomarkers by combining for the first time in vivo, in vitro, and in silico analyses.

中文翻译：

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升胸主动脉瘤血流动力学与生物力学特性的关系

客观的：升胸主动脉瘤 (aTAA) 是导致人类死亡的主要原因。尽管最近在更好地了解其发病机制和发展方面取得了重要进展，但紊乱的血流动力学对 aTAA 破裂风险所起的作用仍然部分未知。我们的目标是开发和应用一种新的方法来评估 aTAA 破裂风险与血流动力学生物标志物之间的相关性，这是首次结合体内, 体外， 和 电脑模拟 分析。 方法：使用来自 CT 扫描和四维 MRI 的患者特定数据对 10 名患者进行了计算流体动力学分析并进行了验证。对收缩壁剪应力、时间平均壁剪应力 (TAWSS)、流动偏心度 (Flow _eccentricity ) 和螺旋强度 (h ₂ ) 进行了评估。进行了膨胀膨胀试验体外在手术修复期间切除的十个 aTAA 样本上。推导出这些样品的生物力学和断裂特性：爆破压力、生理切线弹性模量$({{{\bf{E}}_{{\bf{physio}}}}})$, 断裂时的柯西应力 $({{{\bf{\sigma }}_{{\bf{rupt}}}}})$, 断裂拉伸 $({{{\bf{\lambda }}_{{\bf{rupt}}}}})$, 和断裂拉伸准则 $({\Upsilon_{\boldsymbol{stretch}}})$. 进行统计分析以确定所有变量之间的相关性。结果： 之间的统计高度显着（p < 0.01）正相关 ${{\bf{\lambda }}_{{\bf{rupt}}}}$ 并且发现了 TAWSS（r = 0.867 和 p = 0.001）。 结论： 该研究表明，相对较低的 TAWSS 与 aTAA 的断裂特性降低显着相关。 意义：了解 aTAA 的发病机制对于降低发病率和死亡率仍然至关重要。我们的目标是通过首次结合建立 aTAA 破裂风险和血流动力学生物标志物之间可能的相关性体内, 体外， 和 电脑模拟 分析。