Mathematical model for qualitative assessment of blood pump-induced thrombosis and stroke risk

IF 4.6 2区工程技术 Q1 ENGINEERING, MECHANICAL

Acta Mechanica Sinica Pub Date : 2025-08-27 DOI:10.1007/s10409-024-24616-x

Yuan Li (, ), Yifeng Xi (, ), Xiaofei Wang (, ), Zengsheng Chen (, )

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Abstract

To guide clinical treatment and optimize blood pump design, a mathematical model was developed to evaluate thrombosis and stroke risks induced by blood pumps. Incorporating platelet receptor synthesis/shedding and von Willebrand factor (vWF) unfolding/degradation under shear stress, the model assessed hemorrhagic stroke risk based on shear stress-impaired platelet-vWF binding and thrombosis risk through shear stress-enhanced platelet-vWF interactions leading to hypercoagulability and blood stagnation. The model was validated using three blood pumps—HeartWare, HeartMate II, and HeartMate 3—showing consistency with clinical evidence. Thrombosis risk ranked as HeartMate II > HeartWare > HeartMate 3, primarily due to blood stagnation and shear stress-induced hypercoagulability. Hemorrhagic and ischemic stroke risks followed the ranking HeartWare > HeartMate II > HeartMate 3, with ischemic stroke regions overlapping shear stress and thrombosis-prone regions. Reducing narrow clearances and stagnation regions and avoiding regions of overlapping high shear stress and prolonged residence time can enhance hemocompatibility. The model accurately identified high-risk regions for thrombosis and stroke, providing insights for optimizing blood pump design and clinical strategies.

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定性评价血泵致血栓和脑卒中危险性的数学模型

为了指导临床治疗和优化血泵设计，建立了血泵诱发血栓和脑卒中风险的数学模型。该模型结合了剪切应力下血小板受体的合成/脱落和血管性血友病因子（vWF）的展开/降解，基于剪切应力损伤血小板-vWF结合的出血性卒中风险和剪切应力增强的血小板-vWF相互作用导致的血栓形成风险，从而导致高凝性和血液停滞。该模型使用三种血泵（heartware、HeartMate II和HeartMate 3）进行验证，显示出与临床证据的一致性。血栓形成风险被评为HeartMate II和HeartMate 3，主要是由于血液停滞和剪切应力引起的高凝。出血性和缺血性卒中风险紧随HeartMate II和HeartMate 3的排名，缺血性卒中区域重叠剪切应力和血栓形成易发区域。减少狭窄的间隙和停滞区，避免重叠的高剪切应力区和延长的停留时间可以增强血液相容性。该模型准确地识别了血栓和中风的高危区域，为优化血泵设计和临床策略提供了见解。

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来源期刊

Acta Mechanica Sinica 物理-工程：机械

CiteScore

5.60

自引率

20.00%

发文量

1807

审稿时长

4 months

期刊介绍： Acta Mechanica Sinica, sponsored by the Chinese Society of Theoretical and Applied Mechanics, promotes scientific exchanges and collaboration among Chinese scientists in China and abroad. It features high quality, original papers in all aspects of mechanics and mechanical sciences. Not only does the journal explore the classical subdivisions of theoretical and applied mechanics such as solid and fluid mechanics, it also explores recently emerging areas such as biomechanics and nanomechanics. In addition, the journal investigates analytical, computational, and experimental progresses in all areas of mechanics. Lastly, it encourages research in interdisciplinary subjects, serving as a bridge between mechanics and other branches of engineering and the sciences. In addition to research papers, Acta Mechanica Sinica publishes reviews, notes, experimental techniques, scientific events, and other special topics of interest. Related subjects » Classical Continuum Physics - Computational Intelligence and Complexity - Mechanics