International Journal for Numerical Methods in Biomedical Engineering最新文献

{"title":"Personalized Hemodynamic Analysis Based on Multimodal Medical Data and a Cardiovascular Heat Transfer Model","authors":"Yongtao Liu,&nbsp;Huimin Chen,&nbsp;Xiaoling Ding,&nbsp;Jian Yao,&nbsp;Ying He","doi":"10.1002/cnm.70149","DOIUrl":"10.1002/cnm.70149","url":null,"abstract":"<div>\u0000 \u0000 <p>Non-invasive measurement of basic physiological parameters, such as blood flow and temperature, has long been crucial for daily healthcare and the early screening of cardiovascular diseases. This study aims to integrate multimodal human data with a one-dimensional arterial tree model and a lumped-parameter tissue heat transfer model to assess personalized cardiovascular hemodynamics. By matching the measured radial pressure and flow velocity waveforms of the subjects, we obtained personalized peripheral impedance and pulse wave velocities, and first predicted personalized central aortic pressure for validation of the one-dimensional (1D) cardiovascular model. The 1D cardiovascular model was further coupled with a lumped-parameter heat transfer model to investigate the interplay between blood flow and skin temperature. Skin blood perfusion and tissue layer thickness in the facial and upper limb regions were predicted based on the integrated thermo–blood flow model and the measured skin temperatures of the subject's nose tip and fingertip. We finally explored variations in cardiovascular blood flow under local heating and drowsy conditions using the developed model, based on the measured peripheral skin temperatures. The results demonstrate that the coupled cardiovascular–tissue heat transfer model effectively simulates the subjects' blood flow waveforms and skin temperature, supporting the use of non-invasive pulse wave collection devices to predict and calibrate central aortic pressure. This approach enhances our understanding of the mechanisms by which skin temperature reflects peripheral blood flow dynamics.</p>\u0000 </div>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"42 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanistic Interpretation of Beat-to-Beat Cardiovascular Variability in Hypertension Using a Closed-Loop Cardiovascular Model","authors":"Jia Hui Ooi,&nbsp;Ahmadreza Argha,&nbsp;Choon-Hian Goh,&nbsp;Maw Pin Tan,&nbsp;Nigel H. Lovell,&nbsp;Einly Lim","doi":"10.1002/cnm.70148","DOIUrl":"10.1002/cnm.70148","url":null,"abstract":"<div>\u0000 \u0000 <p>Beat-to-beat heart rate variability (HRV) and blood pressure variability (BPV) are gaining attention as noninvasive markers of autonomic dysfunction, particularly, for improving hypertension management. However, interpretation is complicated by coexisting autonomic dysregulation and vascular mechanical alterations in hypertension. This study used a numerical model to disentangle these contributions, which cannot be isolated in vivo. A closed-loop mathematical model was developed to simulate cardiovascular variability during head-up tilt (HUT), incorporating four heart chambers, systemic and pulmonary circulations, and short-term autonomic regulation mechanisms via arterial and cardiopulmonary reflexes. Beat-to-beat heart rate and blood pressure fluctuations were simulated by introducing central autonomic noise into sympathetic efferent pathways and incorporating respiratory-induced intrathoracic pressure variations. Three hypertension-related alterations—elevated peripheral resistance, reduced arterial compliance, and enhanced left ventricular contractility—were simulated individually. Elevated vascular resistance suppressed both HRV and BPV via baroreflex saturation. Reduced arterial compliance increased BPV due to impaired pressure buffering but reduced HRV through diminished reflex feedback. Enhanced ventricular contractility amplified both HRV and BPV via stronger baroreflex-driven oscillations and greater pulsatile pressure transmission. Generally, HRV was influenced by autonomic efferent fluctuations, respiratory vagal modulation, and baroreflex-mediated feedback to pressure changes from respiration and orthostatic stress. BPV was more directly governed by mechanical fluctuations in stroke volume. HRV and BPV patterns emerge from interactions between mechanical and reflex mechanisms that modulate the transmission of underlying variability into measurable signals. This modeling framework offers mechanistic insights into beat-to-beat cardiovascular variability in hypertension and may support more accurate clinical interpretation.</p>\u0000 </div>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"42 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Statistical Shape Modeling Approach for the Derivation of a Data-Driven Geometry-Aware Lumped Arterial Stenosis Model","authors":"P. L. J. Hilhorst,&nbsp;S. C. F. P. M. Verstraeten,&nbsp;K. Zając,&nbsp;R. Ganesan,&nbsp;M. van 't Veer,&nbsp;F. N. van de Vosse,&nbsp;W. Huberts","doi":"10.1002/cnm.70138","DOIUrl":"10.1002/cnm.70138","url":null,"abstract":"<p>Existing lumped arterial stenosis models struggle to accurately capture the pressure and flow relationship of complex lesion morphologies, thereby limiting their ability to accurately evaluate lesions. To overcome these limitations, we introduce a geometry-informed, data-driven lumped stenosis model that incorporates realistic lesion shapes using statistical shape modeling (SSM). By generating a large dataset of synthetic coronary stenoses, hence focusing on epicardial lesions, and evaluating them through high-fidelity 3D computational fluid dynamics (CFD), we derived reference pressure drops across a diverse range of lesion geometries and flow regimes. These CFD-derived pressures and flows, along with their corresponding shape coefficients, were used to train a lumped parameter model capable of rapidly estimating trans-lesional pressure drops. Remarkably, only five shape modes were necessary to effectively describe the geometric variability, underscoring the efficiency of the approach. Compared to a conventional lumped model, our approach significantly improved pressure drop prediction accuracy, especially in the case of irregular stenosis morphologies. Integration of the new data-driven lumped stenosis model within a 1D pulse wave propagation framework was also successful, aligning simulated pressure and flow waveforms much closer with high-fidelity CFD-coupled results. In turn, the estimation of the fractional flow reserve, a clinically validated index of lesion-specific ischemia, also improved by 18% compared to a conventional lumped model. Although only validated using synthetic lesion data, the model's architecture allows easy integration of additional shape features and lesion-specific parameters, paving the way for future validation on patient-derived geometries.</p>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"42 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12876559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Clinically Compatible Method for Generating Preoperative Finite Element Models to Simulate Facial Appearance and Movements in Orthognathic Surgery","authors":"Marie-Charlotte Picard,&nbsp;Mohammad Ali Nazari,&nbsp;Pascal Perrier,&nbsp;Georges Bettega,&nbsp;Rodolphe Lartizien,&nbsp;Michel Rochette,&nbsp;Yohan Payan","doi":"10.1002/cnm.70144","DOIUrl":"10.1002/cnm.70144","url":null,"abstract":"<p>This study proposes an innovative method for generating patient-specific 3D models of the facial soft tissue, which can be integrated into clinical routine to predict the consequences of orthognathic surgery. This surgery, which impacts both facial aesthetics and functionality, requires precise tools tailored to each patient. To this end, a 3D face model has been developed, integrating anatomically precise bone structures (mandible and maxilla) and soft tissues (skin, fat, and muscles). This reference model is then fitted to each patient's anatomy using a nearly automatic method. This process requires only a manual selection of 34 landmarks to be performed in the clinical setting. The remainder of the patient-specific 3D model generation is fully automated from the patient's CT imaging data. Finally, a proof of concept is presented, featuring Finite Element simulations performed with Ansys APDL software, including orthognathic surgery and then muscle contractions applied to a patient-specific 3D model generated by the nearly automatic method.</p>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"42 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12873870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards Personalised Assessment of Abdominal Aortic Aneurysm Structural Integrity","authors":"Mostafa Jamshidian,&nbsp;Adam Wittek,&nbsp;Saeideh Sekhavat,&nbsp;Hozan Mufty,&nbsp;Geert Maleux,&nbsp;Inge Fourneau,&nbsp;Elke R. Gizewski,&nbsp;Eva Gassner,&nbsp;Alexander Loizides,&nbsp;Maximilian Lutz,&nbsp;Florian K. Enzmann,&nbsp;Donatien Le Liepvre,&nbsp;Florian Bernard,&nbsp;Ludovic Minvielle,&nbsp;Antoine Fondanèche,&nbsp;Karol Miller","doi":"10.1002/cnm.70140","DOIUrl":"10.1002/cnm.70140","url":null,"abstract":"<p>Abdominal aortic aneurysm (AAA) is a life-threatening condition characterized by the progressive dilation of the aorta, which can lead to rupture if undetected or untreated. Stress-based rupture risk estimation using computational biomechanics has been widely studied; however, it requires wall strength data that cannot be measured in humans in vivo. To overcome this limitation, the goal of this study is to present a new method for biomechanical assessment of AAA via simultaneous consideration of tension and strain in AAA wall. We present a patient-specific, non-invasive method for assessing the structural integrity of the AAA wall using only time-resolved 3D computed tomography angiography (4D-CTA) images and blood pressure data. The proposed approach integrates wall strain (throughout the cardiac cycle) and wall tension analysis to compute a novel index, the Relative Structural Integrity Index (RSII), which quantifies local wall stiffness independently of wall thickness, wall material properties, and blood pressure measurement conditions. We applied our method to 20 patients from three different hospitals to extract visual RSII maps over the AAA wall of each individual patient and to compare the RSII values between aneurysmal and non-aneurysmal aortas in one patient. Our results primarily show similar RSII values across all patients, indicating the consistency of the method. Additionally, we observed patterns consistent with experimental findings reported in the literature: AAA walls exhibited higher stiffness than healthy aortic walls, while localized low-stiffness zones in the AAA wall were predominantly found in the most dilated regions.</p>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"42 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12866937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Path Planning for Cannula Flexible Needle Based on Function Family of the Mechanical Bending Model","authors":"He Zhang,&nbsp;Yan-Jiang Zhao,&nbsp;Yong-De Zhang,&nbsp;Lei Wang,&nbsp;Jian-Wei Xiao,&nbsp;Ye-Xin Jin","doi":"10.1002/cnm.70141","DOIUrl":"10.1002/cnm.70141","url":null,"abstract":"<div>\u0000 \u0000 <p>As a kind of the flexible needle, a cannula flexible needle consists of a flexible cannula and a flexible stylet, which can achieve variable-curvature paths through changing the stylet extension lengths out of the cannula, and has the advantages in the path correction and the insertion flexibility compared to the traditional flexible needles. The current path planning is mainly based on the over-idealized wheel-based kinematic models. However, these kinematic models cannot accurately express the bending of the flexible needle and cause the major insertion errors. In this article, a bending model was proposed for predicting the large bending of the cannula flexible needle based on the large bending theory. The relationship between the different stylet extension lengths and the discretization lengths of the mechanical bending model was formulated through the experimental data, and then a function family was established to depict the needle bending relative to the stylet extension length. Based on these, a path planning algorithm for the cannula flexible needle was proposed based on the improved Rapidly-exploring Random Trees in the environments with obstacles. The comparisons between the proposed algorithm and the path planning algorithm based on the wheel-based model were conducted by simulations. The simulation results showed that the proposed path planning algorithm was overall superior to the others not only in terms of the searching speed but also the total insertion length. Then, a series of insertion experiments and the error analysis were performed for the two planned paths. The results were with the mean errors of 0.77 and 0.91 mm, the root mean square errors of 0.85 and 1.13 mm, and the maximum errors of 1.2 and 1.5 mm, for the path-1 and the path-2, respectively. The experimental results met the clinical requirements for the ordinary surgery which proved the effectiveness and the accuracy of the proposed path planning algorithm.</p>\u0000 </div>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"42 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FlexiScale: A Hybrid Marker-Based Scaling Method for Geometrically and Biomechanically Accurate Lower Limb Musculoskeletal Models","authors":"Jinghao Xu,&nbsp;Zhihao Tang,&nbsp;Pengfei Xia,&nbsp;Rui Xu,&nbsp;Zhongmin Jin,&nbsp;Junyan Li","doi":"10.1002/cnm.70142","DOIUrl":"10.1002/cnm.70142","url":null,"abstract":"<div>\u0000 \u0000 <p>Subject-specific musculoskeletal (MSK) models with individualized anthropometric features are essential for accurate biomechanical analysis, given the considerable anatomical and mechanical variability across individuals. Marker-based scaling provides a noninvasive, efficient, and cost-effective strategy for personalizing generic MSK models, yet its reliability and accuracy remain insufficiently validated. This study proposes a hybrid scaling approach (FlexiScale), which combines segment-wise linear scaling with global nonlinear morphing based on radial basis function (RBF) interpolation. This method enables simultaneous adjustment of relative segment orientations and overall skeletal geometry. To comprehensively evaluate its performance, two simpler baseline models were also constructed, including a uniform linear scaling model and a segmental linear scaling model. A reliability analysis was conducted by comparing knee joint contact forces predicted by the three scaling models with in vivo measurements obtained from an instrumented knee prosthesis under identical gait conditions. Furthermore, an accuracy validation was performed by comparing joint contact forces and muscle forces predicted by each scaling model against those derived from medical image–based subject-specific models across three daily activities (level walking, stair ascent, and stair descent) in both male and female subjects. Compared to conventional linear methods, FlexiScale consistently produced the most accurate and reliable geometric and biomechanical predictions across tasks and subjects. These findings demonstrate that the proposed hybrid approach can generate geometrically and biomechanically more accurate and robust MSK models than conventional linear scaling methods, even without medical imaging, thereby supporting subject-specific assessments and large-scale applications in clinical and research settings.</p>\u0000 </div>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"42 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanics-Oriented Coil Size Selection for an Internal Carotid Aneurysm With Fluid–Structure Interaction","authors":"Jiakun Han,&nbsp;Na Zhao,&nbsp;Wei Li,&nbsp;Shiwei Zhao","doi":"10.1002/cnm.70139","DOIUrl":"10.1002/cnm.70139","url":null,"abstract":"<div>\u0000 \u0000 <p>The coil intervention is a common aneurysm treatment strategy, but the effect of coil size on aneurysm hemodynamics and mechanics is not fully understood. In this paper, how different sizes of coils affect the hemodynamic and mechanical properties of a real internal carotid artery (ICA) aneurysm was investigated. A fluid–structure interaction (FSI) method based on the Arbitrary Lagrangian–Eulerian (ALE) approach was used to consider non-Newtonian blood flow, linear elastic arterial wall and simulations. It is indicated that with the increase of coil size, the hemodynamic parameters related to aneurysm such as wall shear stress (WSS), time-averaged WSS (TAWSS) and oscillatory shear index (OSI) decreased significantly. However, too large coils will compress the parent artery, produce high TAWSS areas in adjacent branches, and cause stress concentration on the aneurysm wall. Moreover, both the average displacement and von Mises stress of the aneurysm dome initially decrease and then increase with coil size. The appropriate size of the coil is beneficial to minimize displacement and stress by reducing blood flow velocity and vortices. The effects of different coil sizes were predicted by computational fluid dynamics (CFD), and the individualized treatment plan was adjusted according to the aneurysm morphology and hemodynamic characteristics. Our results provide a new theoretical basis for interventional therapy and help to promote the transformation of coil intervention from empirical filling to mechanics-oriented precision treatment.</p>\u0000 </div>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"42 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A One-Dimensional (1D) Computational Fluid Dynamics Study of Fontan-Associated Liver Disease (FALD)","authors":"Yaqi Li,&nbsp;Justin D. Weigand,&nbsp;Charles Puelz,&nbsp;Mette S. Olufsen,&nbsp;Alyssa Taylor-Lapole","doi":"10.1002/cnm.70128","DOIUrl":"10.1002/cnm.70128","url":null,"abstract":"<p>Fontan-associated liver disease (FALD) is a disorder arising from hemodynamic changes and venous congestion in the liver. This disease is prominent in patients with hypoplastic left heart syndrome (HLHS). Although HLHS patients typically survive into adulthood, they have reduced cardiac output due to their univentricular physiology (i.e., a Fontan circuit). As a result, they have insufficient blood delivery to the liver. In comparison, patients with double outlet right ventricle (DORV), also having a univentricular circuit, have a lower incidence of FALD. In this study, we use a patient-specific, one-dimensional computational fluid dynamics (1D-CFD) model to predict hemodynamics in the liver of an HLHS patient and compare the predictions with an age- and size-matched single-ventricle Fontan DORV control patient. Additionally, we simulate FALD conditions in the HLHS patient to predict hemodynamic changes across various stages of disease progression. Our results show that the HLHS patient has higher hepatic arterial pressure compared to the DORV patient. This difference is exacerbated as FALD conditions progress. HLHS patients also have higher average portal pressures than DORV patients. The wall shear stress (WSS) is higher in the hepatic network for the simulated FALD patients. WSS is slightly decreased in the portal network for the HLHS patients, consistent with the development of portal hypertension. Perfusion analysis gives insight into regions of liver tissue at risk for fibrosis development, showing increasing pressures and reduced flow throughout the liver tissue fed by the portal vein under FALD conditions. Our results provide insight into the specific hemodynamic changes in Fontan circulation that can cause FALD.</p>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"42 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cnm.70128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multiscale Computational Model of Endothelial-Immune Cell Interactions Regulated by Dynamic Wall Shear Stress","authors":"Yu-Yuan Zhang,&nbsp;Yi-Teng Wang,&nbsp;Yong-Jiang Li,&nbsp;Yan Qiu,&nbsp;Dong Chen,&nbsp;Kai-Rong Qin","doi":"10.1002/cnm.70137","DOIUrl":"10.1002/cnm.70137","url":null,"abstract":"<div>\u0000 \u0000 <p>Atherosclerotic plaque formation alters local vascular geometry, leading to disturbed blood flow patterns. These geometric irregularities produce spatial heterogeneity in wall shear stress (WSS), which plays a critical role in endothelial dysfunction and early immune cell recruitment during atherogenesis. However, the dynamic effect of spatial heterogeneity of wall shear stress on endothelial-immune interactions remains unclear. A multiscale computational model that integrates hemodynamics, endothelial cell phenotype transitions, and immune responses was developed. The model is used to investigate endothelial cell (EC) phenotype transitions and immune cell dynamics under varying damage threshold (<i>D</i>_NO) conditions. Low-shear stress regions were found to expand with increasing <i>D</i>_NO. Nitric oxide (NO) production was decreased, leading to accelerated EC activation and death. Monocyte Chemoattractant Protein-1 (MCP-1) expression was elevated, and monocyte recruitment and differentiation were enhanced, resulting in a higher proportion of pro-inflammatory M1 macrophages. The model reproduced experimental observations and provided robust predictions under different <i>D</i>_NO scenarios. These results indicate that dynamic WSS drives EC state transitions and regulates immune cell recruitment and differentiation, providing a framework for studying vascular inflammation. Spatially heterogeneous WSS induces local NO depletion, which accelerates EC activation and death in low-shear stress regions, explaining focal endothelial dysfunction. EC injury further increases MCP-1 production, enhances monocyte recruitment, and promotes macrophage polarization toward a pro-inflammatory phenotype, demonstrating the ability of the model to capture flow-dependent vascular immune dynamics and inflammatory lesion development. This work provides mechanistic insight into the interplay between mechanical forces and vascular immune responses and may guide strategies for preventing endothelial injury and promoting anti-inflammatory therapy.</p>\u0000 </div>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"42 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}