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Patient specific assessment of hemodynamics by computational fluid dynamics in patients with chronic aortic dissection

Research Project

Project/Area Number 18K08770
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 55030:Cardiovascular surgery-related
Research InstitutionJichi Medical University

Principal Investigator

Kimura Naoyuki  自治医科大学, 医学部, 教授 (20382898)

Co-Investigator(Kenkyū-buntansha) 坂元 尚哉  東京都立大学, システムデザイン研究科, 准教授 (20361115)
中村 匡徳  名古屋工業大学, 工学(系)研究科(研究院), 教授 (20448046)
伊藤 智  自治医科大学, 医学部, 講師 (30382881)
田中 正史  日本大学, 医学部, 教授 (80382927)
Project Period (FY) 2018-04-01 – 2023-03-31
Project Status Completed (Fiscal Year 2022)
Budget Amount *help
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2020: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Keywords大動脈解離 / 剪断応力 / 数値流体力学計算 / 共培養モデル / 単培養モデル / 大動脈拡大
Outline of Final Research Achievements

We investigated influence of hemodynamic stress on aortic enlargement in patients with aortic dissection (AD). Of acute type A AD patients who underwent surgery, we selected 6 who showed aortic growth (> 10 mm/year) and 5 who showed no aortic growth (< 3 mm/year). Wall shear stress (WSS) and wall pressure in false lumen were compared between the groups. Both groups showed WSS and wall pressure were highest at the mid-systolic, however, hemodynamic parameters were not different.
Using a coculture model of endothelial cells (ECs) on collagen gels containing smooth muscle cells (SMCs) (non-AD model) and a monocultured SMCs model (false lumen model), we investigated influence of WSS on MMP expression in SMCs. Coculture model showed MMP-9 expression was increased as with WSS increase, and monocultured SMCs model showed MMP-2 expression was increased as with WSS increase, suggesting lack of interaction between ECs and SMCs may lead to different pathway promoting negative remodelling.

Academic Significance and Societal Importance of the Research Achievements

A型解離術後の慢性大動脈解離を対象とした血流解析はこれまでなかった。本研究では大動脈非拡大群・拡大群の2群間で血行力学因子の発現に差を認めなかったが、人工血管置換後という要因が影響した可能性がある。in vitro 実験では、WSS依存性に平滑筋細胞からのMMP-2産生が増加しており、偽腔壁ではWSS直接負荷に応じ平滑筋細胞のphenotypeが変化し中膜組織の構造変化が進行する可能性が示唆された。
今後も、大動脈解離に対する多角的な研究を継続して行い、臨床応用可能な新規の画像診断法やバイオマーカーの開発を目指す。また、安全で効果的な手術治療術式の確立のためにCFD解析を活用する予定である。

Report

(6 results)
  • 2022 Annual Research Report   Final Research Report ( PDF )
  • 2021 Research-status Report
  • 2020 Research-status Report
  • 2019 Research-status Report
  • 2018 Research-status Report
  • Research Products

    (14 results)

All 2022 2021 2020 2019 2018 Other

All Int'l Joint Research (1 results) Journal Article (2 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 2 results) Presentation (10 results) (of which Int'l Joint Research: 1 results) Remarks (1 results)

  • [Int'l Joint Research] The University Medical Center Freiburg/Heart Centre Freiburg University/Department of Cardiovascular Surgery(ドイツ)

    • Related Report
      2018 Research-status Report
  • [Journal Article] Utility of Double Arterial Cannulation for Surgical Repair of Acute Type A Dissection2020

    • Author(s)
      Kusadokoro S, Kimura N, Hori D, Hattori M, Matsunaga W, Itagaki R, Yuri K, Mieno M, Nakamura M, Yamaguchi A.
    • Journal Title

      European Journal of Cardiothoracic Surgery

      Volume: 57 Issue: 6 Pages: 1068-1075

    • DOI

      10.1093/ejcts/ezaa007

    • Related Report
      2020 Research-status Report 2019 Research-status Report
    • Peer Reviewed
  • [Journal Article] Outcomes of Early-Onset Acute Type A Aortic Dissection ― Influence of Etiologic Factors ―2019

    • Author(s)
      Kimura N, Aizawa K, Kawahito K, Itagaki R, Yamaguchi A, Misawa Y, Siepe M, Czerny M, Beyersdorf F, Kari FA, Rylski B
    • Journal Title

      Circulation Journal

      Volume: 83 Issue: 2 Pages: 285-294

    • DOI

      10.1253/circj.CJ-18-0969

    • NAID

      130007557087

    • ISSN
      1346-9843, 1347-4820
    • Year and Date
      2019-01-25
    • Related Report
      2018 Research-status Report
    • Peer Reviewed / Int'l Joint Research
  • [Presentation] 急性A型解離術後遠隔期TEVARの治療成績2022

    • Author(s)
      住吉力、木村直行、堀大治郎、中野光規、野村陽平、白石学、山口敦司
    • Organizer
      第31回日本大動脈外科研究会
    • Related Report
      2022 Annual Research Report
  • [Presentation] 腹部臓器灌流障害を合併した急性B型大動脈解離に対するTEVAR:computational fluid dynamicsによる治療効果判定2022

    • Author(s)
      木村直行、今田修多、堀大治郎、山本貴裕、山口敦司、小宮賢士、中村匡徳
    • Organizer
      第51回日本血管外科学会学術総会
    • Related Report
      2022 Annual Research Report
  • [Presentation] 急性A型大動脈解離術後遠隔期の遠位側追加(再)手術の治療成績2021

    • Author(s)
      木村直行、堀大治郎、山本貴裕'、玉井宏一、白杉岳洋、野村陽平、荒川衛、野中崇央、白石学、山口敦司
    • Organizer
      第74回日本胸部外科学会定期学術集会
    • Related Report
      2021 Research-status Report
  • [Presentation] 急性A型大動脈解離でのhemiarch repair における選択的順行性脳灌流の有用性に関する検討2021

    • Author(s)
      木村直行、百瀬直樹、堀大治郎、白石学、山口敦司
    • Organizer
      第74回日本胸部外科学会定期学術集会
    • Related Report
      2021 Research-status Report
  • [Presentation] 弓部大動脈奇形を有する急性A型大動脈解離症例の臨床像と治療成績に関する検討2021

    • Author(s)
      山本貴裕、木村直行、白杉岳洋、野村陽平、荒川衛、野中崇央、堀大治郎、白石学、山口敦司
    • Organizer
      第52回日本心臓血管外科学会学術総会
    • Related Report
      2021 Research-status Report
  • [Presentation] 急性Non-A Non-B大動脈解離の臨床像と数値流体力学計算による血流解析2020

    • Author(s)
      木村直行、外山豊、服部将大、堀大治郎、山口敦司、川人宏次、中村匡徳
    • Organizer
      第51回日本心臓血管外科学会学術総会
    • Related Report
      2020 Research-status Report
  • [Presentation] Utility of double arterial cannulation for surgical repair of acute type a dissection2019

    • Author(s)
      Kusadokoro S, Kimura N, Hori D, Hattori M, Yuri K, Nakamura M, Yamaguchi A
    • Organizer
      33rd European Association for Cardiothoracic Surgery Annual Meeting, Lisbon, Portugal. October 5, 2019
    • Related Report
      2019 Research-status Report
    • Int'l Joint Research
  • [Presentation] 急性大動脈解離診療におけるステントグラフト治療の有効性2018

    • Author(s)
      木村直行 由利康一 堀大治郎 白石学 野中崇央 野村陽平 松本春信 山口敦司
    • Organizer
      第80回日本臨床外科学会総会
    • Related Report
      2018 Research-status Report
  • [Presentation] 慢性大動脈解離に対するステント治療におけるcomputational fluid dynamics解析の有用性2018

    • Author(s)
      木村直行 田中高志 服部将大 中村匡徳
    • Organizer
      第11回血流会
    • Related Report
      2018 Research-status Report
  • [Presentation] UTILITY OF COMPUTATIONAL FLUID DYNAMICS FOR THORACIC AORTIC PATHOLOGY IN THE ERA OF PRECISION MEDICINE2018

    • Author(s)
      NAOYUKI KIMURA, KOJI KAWAHITO, DAIJIRO HORI, KOICHI YURI, ATSUSHI YAMAGUCHI, YUUKI OHYAMA, NAOYA SAKAMOTO, MASANORI NAKAMURA
    • Organizer
      第83回日本循環器学会学術集会
    • Related Report
      2018 Research-status Report
  • [Remarks] Outcomes of early onset acute type A dissection

    • URL

      https://www.ncbi.nlm.nih.gov/pubmed/30584230

    • Related Report
      2018 Research-status Report

URL: 

Published: 2018-04-23   Modified: 2024-01-30  

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