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<meta name="DC.Title" content="Rest versus Exercise Hemodynamics for Middle Cerebral Artery Aneurysms: A Computational Study" />
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<meta name="DC.Date" content="2010-02-01" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Exercise is an accepted method of improving cardiovascular health; however, the impact of increases in blood flow and heart rate on a cerebral aneurysms is unknown. This study was performed to simulate the changes in hemodynamic conditions within an intracranial aneurysm when a patient exercises.

MATERIALS AND METHODS: Rotational 3D digital subtraction angiograms were used to reconstruct patient-specific geometries of 3 aneurysms located at the bifurcation of the middle cerebral artery. CFD was used to solve for transient flow fields during simulated rest and exercise conditions. Inlet conditions were set by using published transcranial Doppler sonography data for the middle cerebral artery. Velocity fields were analyzed and postprocessed to provide physiologically relevant metrics.

RESULTS: Overall flow patterns were not significantly altered during exercise. Across subjects, during the exercise simulation, time-averaged WSS increased by a mean of 20% (range, 4%–34%), the RRT of a particle in the near-wall flow decreased by a mean of 28% (range, 13%–40%), and time-averaged pressure on the aneurysm wall did not change significantly. In 2 of the aneurysms, there was a 3-fold order-of-magnitude spatial difference in RRT between the aneurysm and surrounding vasculature.

CONCLUSIONS: WSS did not increase significantly during simulated moderate aerobic exercise. While the reduction in RRT during exercise was small in comparison with spatial differences, there may be potential benefits associated with decreased RRT (ie, improved replenishment of nutrients to cells within the aneurysmal tissue).

AR
:   aspect ratio
bpm
:   beats per minute
CFD
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EC
:   endothelial cell
max
:   maximum
min
:   minimum
MMP
:   matrix metalloproteinase
OSI
:   oscillatory shear index
PC-MRA
:   phase-contrast MR angiography
PI
:   pulsatility index
Re
:   Reynolds number
RRT
:   relative residence time
SIMPLEC
:   semi-implicit method for pressure-linked equations consistent
T
:   time period
V
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WSS
:   wall shear stress" />
<meta name="DC.Contributor" content="T.J. Bowker" />
<meta name="DC.Contributor" content="P.N. Watton" />
<meta name="DC.Contributor" content="P.E. Summers" />
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<meta name="DC.Contributor" content="Y. Ventikos" />
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<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Exercise is an accepted method of improving cardiovascular health; however, the impact of increases in blood flow and heart rate on a cerebral aneurysms is unknown. This study was performed to simulate the changes in hemodynamic conditions within an intracranial aneurysm when a patient exercises.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Rotational 3D digital subtraction angiograms were used to reconstruct patient-specific geometries of 3 aneurysms located at the bifurcation of the middle cerebral artery. CFD was used to solve for transient flow fields during simulated rest and exercise conditions. Inlet conditions were set by using published transcranial Doppler sonography data for the middle cerebral artery. Velocity fields were analyzed and postprocessed to provide physiologically relevant metrics.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Overall flow patterns were not significantly altered during exercise. Across subjects, during the exercise simulation, time-averaged WSS increased by a mean of 20% (range, 4%–34%), the RRT of a particle in the near-wall flow decreased by a mean of 28% (range, 13%–40%), and time-averaged pressure on the aneurysm wall did not change significantly. In 2 of the aneurysms, there was a 3-fold order-of-magnitude spatial difference in RRT between the aneurysm and surrounding vasculature.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;WSS did not increase significantly during simulated moderate aerobic exercise. While the reduction in RRT during exercise was small in comparison with spatial differences, there may be potential benefits associated with decreased RRT (ie, improved replenishment of nutrients to cells within the aneurysmal tissue).&lt;/p&gt;" />
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<meta name="twitter:title" content="Rest versus Exercise Hemodynamics for Middle Cerebral Artery Aneurysms: A Computational Study" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Exercise is an accepted method of improving cardiovascular health; however, the impact of increases in blood flow and heart rate on a cerebral aneurysms is unknown. This study was performed to simulate the changes in hemodynamic conditions within an intracranial aneurysm when a patient exercises.

MATERIALS AND METHODS: Rotational 3D digital subtraction angiograms were used to reconstruct patient-specific geometries of 3 aneurysms located at the bifurcation of the middle cerebral artery. CFD was used to solve for transient flow fields during simulated rest and exercise conditions. Inlet conditions were set by using published transcranial Doppler sonography data for the middle cerebral artery. Velocity fields were analyzed and postprocessed to provide physiologically relevant metrics.

RESULTS: Overall flow patterns were not significantly altered during exercise. Across subjects, during the exercise simulation, time-averaged WSS increased by a mean of 20% (range, 4%–34%), the RRT of a particle in the near-wall flow decreased by a mean of 28% (range, 13%–40%), and time-averaged pressure on the aneurysm wall did not change significantly. In 2 of the aneurysms, there was a 3-fold order-of-magnitude spatial difference in RRT between the aneurysm and surrounding vasculature.

CONCLUSIONS: WSS did not increase significantly during simulated moderate aerobic exercise. While the reduction in RRT during exercise was small in comparison with spatial differences, there may be potential benefits associated with decreased RRT (ie, improved replenishment of nutrients to cells within the aneurysmal tissue).

AR
:   aspect ratio
bpm
:   beats per minute
CFD
:   computational fluid dynamics
EC
:   endothelial cell
max
:   maximum
min
:   minimum
MMP
:   matrix metalloproteinase
OSI
:   oscillatory shear index
PC-MRA
:   phase-contrast MR angiography
PI
:   pulsatility index
Re
:   Reynolds number
RRT
:   relative residence time
SIMPLEC
:   semi-implicit method for pressure-linked equations consistent
T
:   time period
V
:   velocity
WSS
:   wall shear stress" />
<meta name="og-title" property="og:title" content="Rest versus Exercise Hemodynamics for Middle Cerebral Artery Aneurysms: A Computational Study" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/31/2/317" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Exercise is an accepted method of improving cardiovascular health; however, the impact of increases in blood flow and heart rate on a cerebral aneurysms is unknown. This study was performed to simulate the changes in hemodynamic conditions within an intracranial aneurysm when a patient exercises.

MATERIALS AND METHODS: Rotational 3D digital subtraction angiograms were used to reconstruct patient-specific geometries of 3 aneurysms located at the bifurcation of the middle cerebral artery. CFD was used to solve for transient flow fields during simulated rest and exercise conditions. Inlet conditions were set by using published transcranial Doppler sonography data for the middle cerebral artery. Velocity fields were analyzed and postprocessed to provide physiologically relevant metrics.

RESULTS: Overall flow patterns were not significantly altered during exercise. Across subjects, during the exercise simulation, time-averaged WSS increased by a mean of 20% (range, 4%–34%), the RRT of a particle in the near-wall flow decreased by a mean of 28% (range, 13%–40%), and time-averaged pressure on the aneurysm wall did not change significantly. In 2 of the aneurysms, there was a 3-fold order-of-magnitude spatial difference in RRT between the aneurysm and surrounding vasculature.

CONCLUSIONS: WSS did not increase significantly during simulated moderate aerobic exercise. While the reduction in RRT during exercise was small in comparison with spatial differences, there may be potential benefits associated with decreased RRT (ie, improved replenishment of nutrients to cells within the aneurysmal tissue).

AR
:   aspect ratio
bpm
:   beats per minute
CFD
:   computational fluid dynamics
EC
:   endothelial cell
max
:   maximum
min
:   minimum
MMP
:   matrix metalloproteinase
OSI
:   oscillatory shear index
PC-MRA
:   phase-contrast MR angiography
PI
:   pulsatility index
Re
:   Reynolds number
RRT
:   relative residence time
SIMPLEC
:   semi-implicit method for pressure-linked equations consistent
T
:   time period
V
:   velocity
WSS
:   wall shear stress" />
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      <h1 class="highwire-cite-title" id="page-title">Rest versus Exercise Hemodynamics for Middle Cerebral Artery Aneurysms: A Computational Study</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">T.J. Bowker</span>, <span class="highwire-citation-author" data-delta="1">P.N. Watton</span>, <span class="highwire-citation-author" data-delta="2">P.E. Summers</span>, <span class="highwire-citation-author" data-delta="3">J.V. Byrne</span> and <span class="highwire-citation-author" data-delta="4">Y. Ventikos</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">February 2010,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">317-323; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A1797 </span></div>
  
  
  
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<p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> Exercise is an accepted method of improving cardiovascular health; however, the impact of increases in blood flow and heart rate on a cerebral aneurysms is unknown. This study was performed to simulate the changes in hemodynamic conditions within an intracranial aneurysm when a patient exercises.</p>
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<p id="p-2"><strong>MATERIALS AND METHODS:</strong> Rotational 3D digital subtraction angiograms were used to reconstruct patient-specific geometries of 3 aneurysms located at the bifurcation of the middle cerebral artery. CFD was used to solve for transient flow fields during simulated rest and exercise conditions. Inlet conditions were set by using published transcranial Doppler sonography data for the middle cerebral artery. Velocity fields were analyzed and postprocessed to provide physiologically relevant metrics.</p>
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<p id="p-3"><strong>RESULTS:</strong> Overall flow patterns were not significantly altered during exercise. Across subjects, during the exercise simulation, time-averaged WSS increased by a mean of 20% (range, 4%–34%), the RRT of a particle in the near-wall flow decreased by a mean of 28% (range, 13%–40%), and time-averaged pressure on the aneurysm wall did not change significantly. In 2 of the aneurysms, there was a 3-fold order-of-magnitude spatial difference in RRT between the aneurysm and surrounding vasculature.</p>
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<p id="p-4"><strong>CONCLUSIONS:</strong> WSS did not increase significantly during simulated moderate aerobic exercise. While the reduction in RRT during exercise was small in comparison with spatial differences, there may be potential benefits associated with decreased RRT (ie, improved replenishment of nutrients to cells within the aneurysmal tissue).</p>
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</div><div class="section glossary" id="glossary-1"><h2>Abbreviations</h2><dl id="def-list-1"><dt id="def-item-1">AR<span class="def-item-dt-sep"></span></dt><dd>aspect ratio<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">bpm<span class="def-item-dt-sep"></span></dt><dd>beats per minute<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">CFD<span class="def-item-dt-sep"></span></dt><dd>computational fluid dynamics<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">EC<span class="def-item-dt-sep"></span></dt><dd>endothelial cell<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">max<span class="def-item-dt-sep"></span></dt><dd>maximum<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">min<span class="def-item-dt-sep"></span></dt><dd>minimum<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">MMP<span class="def-item-dt-sep"></span></dt><dd>matrix metalloproteinase<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">OSI<span class="def-item-dt-sep"></span></dt><dd>oscillatory shear index<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">PC-MRA<span class="def-item-dt-sep"></span></dt><dd>phase-contrast MR angiography<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">PI<span class="def-item-dt-sep"></span></dt><dd>pulsatility index<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">Re<span class="def-item-dt-sep"></span></dt><dd>Reynolds number<span class="def-item-dd-sep"></span></dd><dt id="def-item-12">RRT<span class="def-item-dt-sep"></span></dt><dd>relative residence time<span class="def-item-dd-sep"></span></dd><dt id="def-item-13">SIMPLEC<span class="def-item-dt-sep"></span></dt><dd>semi-implicit method for pressure-linked equations consistent<span class="def-item-dd-sep"></span></dd><dt id="def-item-14">T<span class="def-item-dt-sep"></span></dt><dd>time period<span class="def-item-dd-sep"></span></dd><dt id="def-item-15">V<span class="def-item-dt-sep"></span></dt><dd>velocity<span class="def-item-dd-sep"></span></dd><dt id="def-item-16">WSS<span class="def-item-dt-sep"></span></dt><dd>wall shear stress</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">Copyright © American Society of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/31/2/317.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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