Feasibility of a longitudinal statistical atlas model to study aortic growth in congenital heart disease

Sophocleous, Froso; Bône, Alexandre; Shearn, Andrew I U; Forte, Marí Nieves Velasco; Bruse, Jan L.; Caputo, Massimo; Biglino, Giovanni

doi:10.1016/j.compbiomed.2022.105326

Cited by 8 publications

(6 citation statements)

References 18 publications

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“…In addition, large animal models simulating the corrective treatments employed in children are warranted to determine the positive and negative effects of cardiac surgery on post-natal heart maturation ( 19 – 22 ). Finally, computational growth models can help in tracking disease progression and stratifying patients with CHD ( 23 , 24 ).…”

Section: Introductionmentioning

confidence: 99%

Accelerated Cardiac Aging in Patients With Congenital Heart Disease

Iacobazzi

Alvino

Caputo

et al. 2022

Front. Cardiovasc. Med.

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An increasing number of patients with congenital heart disease (CHD) survive into adulthood but develop long-term complications including heart failure (HF). Cellular senescence, classically defined as stable cell cycle arrest, is implicated in biological processes such as embryogenesis, wound healing, and aging. Senescent cells have a complex senescence-associated secretory phenotype (SASP), involving a range of pro-inflammatory factors with important paracrine and autocrine effects on cell and tissue biology. While senescence has been mainly considered as a cause of diseases in the adulthood, it may be also implicated in some of the poor outcomes seen in patients with complex CHD. We propose that patients with CHD suffer from multiple repeated stress from an early stage of the life, which wear out homeostatic mechanisms and cause premature cardiac aging, with this term referring to the time-related irreversible deterioration of the organ physiological functions and integrity. In this review article, we gathered evidence from the literature indicating that growing up with CHD leads to abnormal inflammatory response, loss of proteostasis, and precocious age in cardiac cells. Novel research on this topic may inspire new therapies preventing HF in adult CHD patients.

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Section: Introductionmentioning

confidence: 99%

Accelerated Cardiac Aging in Patients With Congenital Heart Disease

Iacobazzi

Alvino

Caputo

et al. 2022

Front. Cardiovasc. Med.

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“…Additionally, if a growth model of the aorta with CoA was developed following a recent methodology (26), it would be interesting to include factors such as recurrent arch obstruction, which is more prevalent in patients with a CoA index <0.7, extending the observations from this study. The flow separation results suggest that small variations in the morphology of the aortic arch (native or resulting from surgical repair) lead to changes in flow velocity acceleration and also to changes in WSS in the descending aorta.…”

Section: Discussionmentioning

confidence: 81%

Isolating the Effect of Arch Architecture on Aortic Hemodynamics Late After Coarctation Repair: A Computational Study

Ardakani

Goordoyal

Ordóñez

et al. 2022

Front. Cardiovasc. Med.

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ObjectivesEffective management of aortic coarctation (CoA) affects long-term cardiovascular outcomes. Full appreciation of CoA hemodynamics is important. This study aimed to analyze the relationship between aortic shape and hemodynamic parameters by means of computational simulations, purposely isolating the morphological variable.MethodsComputational simulations were run in three aortic models. MRI-derived aortic geometries were generated using a statistical shape modeling methodology. Starting from n = 108 patients, the mean aortic configuration was derived in patients without CoA (n = 37, “no-CoA”), with surgically repaired CoA (n = 58, “r-CoA”) and with unrepaired CoA (n = 13, “CoA”). As such, the aortic models represented average configurations for each scenario. Key hemodynamic parameters (i.e., pressure drop, aortic velocity, vorticity, wall shear stress WSS, and length and number of strong flow separations in the descending aorta) were measured in the three models at three time points (peak systole, end systole, end diastole).ResultsComparing no-CoA and CoA revealed substantial differences in all hemodynamic parameters. However, simulations revealed significant increases in vorticity at the site of CoA repair, higher WSS in the descending aorta and a 12% increase in power loss, in r-CoA compared to no-CoA, despite no clinically significant narrowing (CoA index >0.8) in the r-CoA model.ConclusionsSmall alterations in aortic morphology impact on key hemodynamic indices. This may contribute to explaining phenomena such as persistent hypertension in the absence of any clinically significant narrowing. Whilst cardiovascular events in these patients may be related to hypertension, the role of arch geometry may be a contributory factor.

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“…This procedure could be applied to any vessel-like geometry of arbitrary topology and also to many other anatomical structures where open boundaries are created by clipping the region of interest from the other structures. In addition, the methodology could also be used to study shape modification over time using prospective studies of the same patient, as in Capellini et al (2018) and Sophocleous et al (2022) . Again, as in the previously mentioned studies, the latter one does not include supra-aortic vessels in the analysis.…”

Section: Discussionmentioning

confidence: 99%

“…This is particularly useful in medical applications where the lack of available data often prevents further investigations. In the landscape of the most widely used tools for SMMs, Deformetrica has emerged as the predominant choice due to its power and versatility ( Bruse et al, 2016 ; Bruse et al, 2017 ; Sophocleous et al, 2019 ; Goparaju et al, 2022 ; Sophocleous et al, 2022 ). Despite its popularity, Deformetrica necessitates the selection of at least three parameters which determine the spatial resolution of the method: two kernel sizes and one regularization parameter.…”

Section: Discussionmentioning

confidence: 99%

Enabling supra-aortic vessels inclusion in statistical shape models of the aorta: a novel non-rigid registration method

Scarpolini¹,

Mazzoli²,

Celi³

2023

Front. Physiol.

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Statistical Shape Models (SSMs) are well-established tools for assessing the variability of 3D geometry and for broadening a limited set of shapes. They are widely used in medical imaging due to their ability to model complex geometries and their high efficiency as generative models. The principal step behind these techniques is a registration phase, which, in the case of complex geometries, can be a critical issue due to the correspondence problem, as it necessitates the development of correspondence mapping between shapes. The thoracic aorta, with its high level of morphological complexity, poses a multi-scale deformation problem due to the presence of several branch vessels with varying diameters. Moreover, branch vessels exhibit significant variability in shape, making the correspondence optimization even more challenging. Consequently, existing studies have focused on developing SSMs based only on the main body of the aorta, excluding the supra-aortic vessels from the analysis. In this work, we present a novel non-rigid registration algorithm based on optimizing a differentiable distance function through a modified gradient descent approach. This strategy enables the inclusion of custom, domain-specific constraints in the objective function, which act as landmarks during the registration phase. The algorithm’s registration performance was tested and compared to an alternative Statistical Shape modeling framework, and subsequently used for the development of a comprehensive SSM of the thoracic aorta, including the supra-aortic vessels. The developed SSM was further evaluated against the alternative framework in terms of generalisation, specificity, and compactness to assess its effectiveness.

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Feasibility of a longitudinal statistical atlas model to study aortic growth in congenital heart disease

Cited by 8 publications

References 18 publications

Accelerated Cardiac Aging in Patients With Congenital Heart Disease

Accelerated Cardiac Aging in Patients With Congenital Heart Disease

Isolating the Effect of Arch Architecture on Aortic Hemodynamics Late After Coarctation Repair: A Computational Study

Enabling supra-aortic vessels inclusion in statistical shape models of the aorta: a novel non-rigid registration method

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