Correlations of coronary plaque wall thickness with wall pressure and wall pressure gradient: A representative case study

BACKGROUND: There are two major hemodynamic stresses imposed at the blood arterial wall interface by flowing blood: the wall shear stress (WSS) acting tangentially to the wall, and the wall pressure (WP) acting normally to the wall. The role of flow wall shear stress in atherosclerosis progression has been under intensive investigation, while the impact of blood pressure on plaque progression has been under-studied. METHOD: The correlations of wall thickness (WT) with wall pressure (WP, blood pressure on the lumen wall) and spatial wall pressure gradient (WPG) in a human atherosclerotic right coronary artery were studied. The pulsatile blood flow was simulated using a three dimensional mathematical model. The blood was treated as an incompressible viscous non-Newtonian fluid. The geometry of the artery was re-constructed using an in vivo intravascular ultrasound (IVUS) 44-slice dataset obtained from a patient with consent obtained. The WT, the WP and the WPG were averaged on each slice, respectively, and Pearson correlation analysis was performed on slice averaged base. Each slice was then divided into 8 segments and averaged vessel WT, WP and WPG were collected from all 352 segments for correlation analysis. Each slice was also divided into 2 segments (inner semi-wall of bend and outer semi-wall of bend) and the correlation analysis was performed on the 88 segments. RESULTS: Under mean pressure, the Pearson coefficient for correlation between WT and WP was r = − 0.52 (p < 0.0001) by 2-segment analysis and r = − 0.81 (p < 0.0001) by slice averaged analysis, respectively. The Pearson coefficient for correlation between WT and WPG was r = 0.30 (p = 0.004) by 2-segment analysis and r = 0.45 (p = 0.002) by slice averaged analysis, respectively. The r-values corresponding to systole and diastole pressure conditions were similar. CONCLUSIONS: Results from this representative case report indicated that plaque wall thickness correlated negatively with wall pressure (r = −0.81 by slice) and positively with wall pressure gradient (r = 0.45). The slice averaged WT has a strong linear relationship with the slice averaged WP. Large-scale patient studies are needed to further confirm our findings

Influence of model boundary conditions on blood flow patterns in a patient specific stenotic right coronary artery

BACKGROUND: In literature, the effect of the inflow boundary condition was investigated by examining the impact of the waveform and the shape of the spatial profile of the inlet velocity on the cardiac hemodynamics. However, not much work has been reported on comparing the effect of the different combinations of the inlet/outlet boundary conditions on the quantification of the pressure field and flow distribution patterns in stenotic right coronary arteries. METHOD: Non-Newtonian models were used to simulate blood flow in a patient-specific stenotic right coronary artery and investigate the influence of different boundary conditions on the phasic variation and the spatial distribution patterns of blood flow. The 3D geometry of a diseased artery segment was reconstructed from a series of IVUS slices. Five different combinations of the inlet and the outlet boundary conditions were tested and compared. RESULTS: The temporal distribution patterns and the magnitudes of the velocity, the wall shear stress (WSS), the pressure, the pressure drop (PD), and the spatial gradient of wall pressure (WPG) were different when boundary conditions were imposed using different pressure/velocity combinations at inlet/outlet. The maximum velocity magnitude in a cardiac cycle at the center of the inlet from models with imposed inlet pressure conditions was about 29% lower than that from models using fully developed inlet velocity data. Due to the fact that models with imposed pressure conditions led to blunt velocity profile, the maximum wall shear stress at inlet in a cardiac cycle from models with imposed inlet pressure conditions was about 29% higher than that from models with imposed inlet velocity boundary conditions. When the inlet boundary was imposed by a velocity waveform, the models with different outlet boundary conditions resulted in different temporal distribution patterns and magnitudes of the phasic variation of pressure. On the other hand, the type of different boundary conditions imposed at the inlet and the outlet did not have significant effect on the spatial distribution patterns of the PD, the WPG and the WSS on the lumen surface, regarding the locations of the maximum and the minimum of each quantity. CONCLUSIONS: The observations from this study indicated that the ways how pressure and velocity boundary conditions are imposed in computational models have considerable impact on flow velocity and shear stress predictions. Accuracy of in vivo measurements of blood pressure and velocity is of great importance for reliable model predictions

Twisted Edwards-Form Elliptic Curve Cryptography for 8-bit AVR-based Sensor Nodes

Wireless Sensor Networks (WSNs) pose a number of unique security challenges that demand innovation in several areas including the design of cryptographic primitives and protocols. Despite recent progress, the efficient implementation of Elliptic Curve Cryptography (ECC) for WSNs is still a very active research topic and techniques to further reduce the time and energy cost of ECC are eagerly sought. This paper presents an optimized ECC implementation that we developed from scratch to comply with the severe resource constraints of 8-bit sensor nodes such as the MICAz and IRIS motes. Our ECC software uses Optimal Prime Fields (OPFs) as underlying algebraic structure and supports two different families of elliptic curves, namely Weierstraß-form and twisted Edwards-form curves. Due to the combination of efficient field arithmetic and fast group operations, we achieve an execution time of 5.8*10^6 clock cycles for a full 158-bit scalar multiplication on an 8-bit ATmega128 microcontroller, which is 2.78 times faster than the widely-used TinyECC library. Our implementation also shows that the energy cost of scalar multiplication on a MICAz (or IRIS) mote amounts to just 19 mJ when using a twisted Edwards curve over a 160-bit OPF. This result compares fairly well with the energy figures of two recently-presented hardware designs of ECC based on twisted Edwards curves

Influence of non-Newtonian Properties of Blood on the Wall Shear Stress in Human Atherosclerotic Right Coronary Arteries

The objective of this work is to investigate the effect of non-Newtonian properties of blood on the wall shear stress (WSS) in atherosclerotic coronary arteries using both Newtonian and non-Newtonian models. Numerical simulations were performed to examine how the spatial and temporal WSS distributions are influenced by the stenosis size, blood viscosity, and flow rate. The computational results demonstrated that blood viscosity properties had considerable effect on the magnitude of the WSS, especially where disturbed flow was observed. The WSS distribution is highly non-uniform both temporally and spatially, especially in the stenotic region. The maximum WSS occurred at the proximal side of the stenosis, near the outer wall in the curved artery with no stenosis. The lumen area near the inner wall distal to the stenosis region experienced a lower WSS during the entire cardiac cycle. Among the factors of stenosis size, blood viscosity, and flow rate, the size of the stenosis has the most significant effect on the spatial and temporal WSS distributions qualitatively and quantitatively