生物标记物对动脉粥样硬化血流动力学的作用

Ruchira Ray, Bibaswan Dey
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摘要

动脉粥样硬化是一种慢性炎症性心血管疾病,由于脂质、胆固醇和各种物质在动脉壁内堆积,导致动脉收缩。这种斑块会破裂,形成血凝块,阻塞主要动脉,可能引发心肌梗死、缺血性中风等。动脉粥样硬化斑块的形成始于泡沫细胞和巨噬细胞在动脉壁内膜层的聚集。后期,平滑肌细胞从动脉壁深层移出,促使纤维帽形成并使斑块稳定。形成的斑块逐渐进入管腔,使管腔变窄,阻碍血流。我们引入了一个两阶段的宏观模型来研究斑块在晚期的生长过程,并分析动脉粥样硬化动脉内血细胞可以通过的最小间隙(管腔通畅度)。心肌肌钙蛋白是一种特异性和灵敏度都很高的生物标记物,有助于早期发现心肌梗死、缺血性中风等风险的升高。本研究旨在建立动脉粥样硬化动脉中肌钙蛋白浓度与其内部清除率之间的关系,这将大大提高我们对疾病进展的认识。我们的观察结果表明,斑块在初期阶段会发生快速演变,随着时间的推移逐渐放缓,最终达到稳定状态。与此同时,管腔清除率则表现出相反的行为,随着时间的推移缓慢下降。我们的研究发现,在动脉粥样硬化中,斑块深度与血液中肌钙蛋白浓度呈正相关,而肌钙蛋白浓度与管腔清除率呈负相关。
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The Role of Biomarkers on Haemodynamics in Atherosclerotic Artery
Atherosclerosis, a chronic inflammatory cardiovascular disease, leads to arterial constriction caused by the accumulation of lipids, cholesterol, and various substances within artery walls. Such plaque can rupture, resulting in a blood clot that obstructs major arteries and may initiate myocardial infarction, ischemic stroke, etc. Atherosclerotic plaque formation begins with the accumulation of foam cells and macrophages within the intima layer of the arterial wall. At the latter stage, the smooth muscle cells migrated from deeper artery wall layers, contributing to the fibrous cap formation and plaque stabilizing. A developed plaque gradually enters the lumen and narrows down the lumen to impede blood flow. We introduce a two-phase and macroscopic model to investigate the progression of plaque growth in its advanced stage and analyze the minimum gap (Lumen Clearance) within an atherosclerotic artery so that blood cells can pass through. Cardiac troponin, a high specificity and sensitivity biomarker, facilitates early detection of elevated myocardial infarction, Ischemic stroke, etc. risks. This study aims to establish a relationship between the troponin concentration in atherosclerotic arteries and their internal clearance, which could significantly improve our understanding of disease progression. Our observations show that the plaque undergoes rapid evolution in its initial stages, gradually slowing down over time to reach a steady state. At the same time, the lumen clearance exhibits an opposite behavior, decreasing slowly over time. Our study finds a positive correlation between plaque depth and troponin concentration in the blood and a negative relationship between troponin concentrations and lumen clearance in atherosclerotic arteries.
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