Effect of head posture on the healthy human carotid bifurcation hemodynamics

Head and neck postures may cause morphology changes to the geometry of the carotid bifurcation (CB) that alter the low and oscillating wall shear stress (WSS) regions previously reported as important in the development of atherosclerosis. Here the right and left CB were imaged by MRI in two healthy subjects in the neutral head posture with the subject in the supine position and in two other head postures with the subject in the prone position: (1) rightward rotation up to 80°, and (2) leftward rotation up to 80°. Image-based computational models were constructed to investigate the effect of posture on arterial geometry and local hemodynamics. The area exposure to unfavorable hemodynamics, based on thresholds set for oscillatory shear index (OSI), WSS and relative residence time, was used to quantify the hemodynamic impact on the wall. Torsion of the head was found to: (1) cause notable changes in the bifurcation and internal carotid artery angles and, in most cases, on cross-sectional area ratios for common, internal and external carotid artery, (2) change the spatial distribution of wall regions exposed to unfavorable hemodynamics, and (3) cause a marked change in the hemodynamic burden on the wall when the OSI was considered. These findings suggest that head posture may be associated with the genesis and development of atherosclerotic disease as well as complications in stenotic and stented vessels.

[1]  E. Lakatta,et al.  Effect of common carotid artery inlet length on normal carotid bifurcation hemodynamics. , 2010, Journal of biomechanical engineering.

[2]  A. Hazel,et al.  Spatial comparison between wall shear stress measures and porcine arterial endothelial permeability. , 2004, American journal of physiology. Heart and circulatory physiology.

[3]  B. Mwipatayi,et al.  Fracture of a carotid stent: an unexpected complication. , 2007, Journal of vascular surgery.

[4]  Qi Zhang,et al.  Use of factor analysis to characterize arterial geometry and predict hemodynamic risk: application to the human carotid bifurcation. , 2010, Journal of biomechanical engineering.

[5]  S. Alper,et al.  Hemodynamic shear stress and its role in atherosclerosis. , 1999, JAMA.

[6]  B. Rutt,et al.  Reconstruction of carotid bifurcation hemodynamics and wall thickness using computational fluid dynamics and MRI , 2002, Magnetic resonance in medicine.

[7]  David A. Steinman,et al.  Flow Imaging and Computing: Large Artery Hemodynamics , 2005, Annals of Biomedical Engineering.

[8]  Charles Taylor,et al.  EXPERIMENTAL AND COMPUTATIONAL METHODS IN CARDIOVASCULAR FLUID MECHANICS , 2004 .

[9]  Chun Yuan,et al.  In vivo accuracy of multisequence MR imaging for identifying unstable fibrous caps in advanced human carotid plaques , 2003, Journal of magnetic resonance imaging : JMRI.

[10]  L. Antiga,et al.  Geometry of the Carotid Bifurcation Predicts Its Exposure to Disturbed Flow , 2008, Stroke.

[11]  K. Perktold,et al.  Computer simulation of local blood flow and vessel mechanics in a compliant carotid artery bifurcation model. , 1995, Journal of biomechanics.

[12]  D J Doorly,et al.  The influence of out-of-plane geometry on pulsatile flow within a distal end-to-side anastomosis. , 2002, Journal of biomechanics.

[13]  J P Cooke,et al.  Exposure to shear stress alters endothelial adhesiveness. Role of nitric oxide. , 1995, Circulation.

[14]  David A. Steinman,et al.  Robust and objective decomposition and mapping of bifurcating vessels , 2004, IEEE Transactions on Medical Imaging.

[15]  L. Formaggia,et al.  Computational models to predict stenosis growth in carotid arteries: Which is the role of boundary conditions? , 2009 .

[16]  A. Hughes,et al.  Reproducibility Study of Magnetic Resonance Image-Based Computational Fluid Dynamics Prediction of Carotid Bifurcation Flow , 2003, Annals of Biomedical Engineering.

[17]  D. Ku,et al.  Pulsatile Flow and Atherosclerosis in the Human Carotid Bifurcation: Positive Correlation between Plaque Location and Low and Oscillating Shear Stress , 1985, Arteriosclerosis.

[18]  D. Mozaffarian,et al.  Heart disease and stroke statistics--2011 update: a report from the American Heart Association. , 2011, Circulation.

[19]  Michael M. Resch,et al.  Three-dimensional numerical analysis of pulsatile flow and wall shear stress in the carotid artery bifurcation. , 1991, Journal of biomechanics.

[20]  L. Antiga,et al.  Scan–Rescan reproducibility of carotid bifurcation geometry from routine contrast‐enhanced MR angiography , 2011, Journal of magnetic resonance imaging : JMRI.

[21]  L. Antiga,et al.  On the importance of blood rheology for bulk flow in hemodynamic models of the carotid bifurcation. , 2011, Journal of biomechanics.

[22]  Y. Cho,et al.  Experimental investigation of branch flow ratio, angle, and Reynolds number effects on the pressure and flow fields in arterial branch models. , 1985, Journal of biomechanical engineering.

[23]  Christopher P. Cheng,et al.  In vivo MR angiographic quantification of axial and twisting deformations of the superficial femoral artery resulting from maximum hip and knee flexion. , 2006, Journal of vascular and interventional radiology : JVIR.

[24]  J A Frangos,et al.  Temporal gradient in shear but not steady shear stress induces PDGF-A and MCP-1 expression in endothelial cells: role of NO, NF kappa B, and egr-1. , 1999, Arteriosclerosis, thrombosis, and vascular biology.

[25]  Ioannis Seimenis,et al.  Effect of Posture Change on the Geometric Features of the Healthy Carotid Bifurcation , 2009, IEEE Transactions on Information Technology in Biomedicine.

[26]  T. Gupta,et al.  Role of Nitric Oxide , 1998, Digestion.

[27]  L. Antiga,et al.  Outflow conditions for image-based hemodynamic models of the carotid bifurcation: implications for indicators of abnormal flow. , 2010, Journal of biomechanical engineering.

[28]  M D Nowak,et al.  Flow Studies in a Model Carotid Bifurcation , 1981, Arteriosclerosis.

[29]  A. Hughes,et al.  Influence of head position on carotid hemodynamics in young adults. , 2004, American journal of physiology. Heart and circulatory physiology.

[30]  B. Rutt,et al.  Reproducibility of Image-Based Computational Fluid Dynamics Models of the Human Carotid Bifurcation , 2003, Annals of Biomedical Engineering.

[31]  Timothy M. Wick,et al.  Hemodynamic modulation of monocytic cell adherence to vascular endothelium , 1996, Annals of Biomedical Engineering.

[32]  D. Steinman,et al.  On the relative importance of rheology for image-based CFD models of the carotid bifurcation. , 2007, Journal of biomechanical engineering.

[33]  S Glagov,et al.  Shear stress at a compliant model of the human carotid bifurcation. , 1994, Journal of biomechanical engineering.

[34]  L. Antiga,et al.  Inlet conditions for image-based CFD models of the carotid bifurcation: is it reasonable to assume fully developed flow? , 2006, Journal of biomechanical engineering.

[35]  Guido Gerig,et al.  User-guided 3D active contour segmentation of anatomical structures: Significantly improved efficiency and reliability , 2006, NeuroImage.