Cardiovascular Engineering and Technology最新文献

{"title":"Development of a Novel Holistic Assessment Strategy of TAVI-Induced Flow Restoration via Dimensionality Reduction Techniques.","authors":"Tianai Wang, Tobias Zeus, Christine Quast, Ayse Sedef Ceylan, Kathrin Klein, Malte Kelm, Francesca Dell'Agnello, Simona Celi, Ulrich Steinseifer, Michael Neidlin","doi":"10.1007/s13239-026-00840-2","DOIUrl":"10.1007/s13239-026-00840-2","url":null,"abstract":"<p><strong>Purpose: </strong>Restoration of physiological aortic hemodynamics is a crucial therapeutic target after transcatheter aortic valve implantation (TAVI). However, quantifying this restoration is challenging, particularly using conventional markers. This study presents a novel, unsupervised approach based on proper orthogonal decomposition (POD), suitable for holistic characterization of patient-specific aortic flow field and their association with procedural outcome.</p><p><strong>Material and methods: </strong>Patients (n = 8) with severe aortic valve stenosis (AS) undergoing TAVI were studied. Three metrics were evaluated: patient-specific composite cardiovascular stress signature, pre-procedural free hemoglobin levels and degree of flow restoration. Flow restoration was quantified using POD-based similarity measures (Euclidean distances and Dynamic Time Warping), and compared with conventional hemodynamic markers, i.e. shear stresses, helicity and turbulence production. Unsupervised clustering was applied to explore agreement with biochemical patterns and clinical outcomes.</p><p><strong>Results: </strong>POD identified coherent flow structures and enabled quantification of restoration relative to healthy references. POD-based markers provided more clinically interpretable groupings than conventional measures in this cohort. Patients with low restoration exhibited more pathological composite cardiovascular stress signatures and adverse outcomes during short-term follow-up.</p><p><strong>Conclusion: </strong>POD-based flow analysis provides a holistic and interpretable quantification of post-TAVI aortic hemodynamics. In the given cohort, the method showed agreement with biochemical patterns and clinical outcomes, highlighting its potential to complement conventional hemodynamic and procedural assessment.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"439-456"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943830","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 Vein Attempt? Experimental Models for Arteriovenous Fistula Research.","authors":"Nasir A Shah, Calvin D Li, Shannon D Thomas, Ramon L Varcoe, Jelena Rnjak-Kovacina, Carmine Gentile, Zoltan H Endre, Tracie J Barber, Jonathan H Erlich, Blake J Cochran","doi":"10.1007/s13239-026-00838-w","DOIUrl":"10.1007/s13239-026-00838-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic kidney disease (CKD) affects more than 10% of adults worldwide and is associated with rising mortality and increasing demand for hemodialysis. Hemodialysis requires durable vascular access, with surgically created arteriovenous fistulas (AVFs) being the preferred modality. However, up to 60% of AVFs fail to mature in time for clinical use, whereas others develop excessively high flow that can drive adverse cardiac remodeling and heart failure. These problems reflect incomplete understanding of the biological and biomechanical processes that govern AVF maturation and failure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To summarize the experimental models currently used to study AVF maturation and failure-including animal models, computational approaches and in vitro flow systems-and to compare their respective strengths, limitations and complementary roles in vascular access research. AVF maturation depends on coordinated arterial and venous remodeling in response to abrupt hemodynamic changes after anastomosis. Altered wall shear stress, pressure and cyclic strain activate endothelial and vascular smooth muscle signaling pathways that promote vasodilation, outward remodeling, matrix turnover and wall thickening. When these adaptive responses are blunted or dysregulated, neointimal hyperplasia, stenosis and access failure ensue. These biomechanical stimuli act within a pro-inflammatory, pro-oxidant uremic milieu, in which circulating toxins impair endothelial function, enhance oxidative stress and bias remodeling towards maladaptation. A broad spectrum of experimental platforms has been developed to interrogate these processes: animal models that recapitulate whole-organism physiology, computational models, including computational fluid dynamics and emerging fluid-structure interaction simulations, that resolve local hemodynamics and wall mechanics; conventional in vitro systems for controlled mechanobiology studies; and emerging microfluidic and macrofluidic devices that impose defined shear waveforms in physiologically relevant geometries. Each model captures selected spatial, temporal or biochemical dimensions of AVF biology, but each is constrained by trade-offs in scalability, fidelity, throughput or translational relevance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;AVF maturation and failure arise from tightly coupled biomechanical and biological interactions, shaped by hemodynamic forces and uremia-related vascular dysfunction. No single experimental platform can encompass this complexity. Progress will depend on systematic comparison of available models and their deliberate integration into a coherent multimodal framework, in which insights from animal studies, computational simulations and in vitro flow systems are used in a complementary manner. Such an approach is essential to identify predictive biomarkers, clarify mechanisms of maladaptive remodeling and guide the rational design of targeted interventions to improve ","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"502-518"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846042","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":"Functional Cardiac Biomaterials: Insights into Constructing a Vascularized Myocardial Tissue Surrogate.","authors":"Suresh Kumar Saravanan, Ramya Ramadoss, Pavithra Velmurugan, Veni Subramanyam, Balasubramanian Moovarkumudalvan","doi":"10.1007/s13239-026-00852-y","DOIUrl":"https://doi.org/10.1007/s13239-026-00852-y","url":null,"abstract":"<p><strong>Purpose: </strong>Myocardial infarction is a pathological condition caused by impaired blood flow to the heart and is recognized as a leading contributor to cardiovascular diseases. The treatment options for myocardial infarction are currently limited, emphasizing the necessity to develop tissue engineering strategies. Nevertheless, scaffold-based techniques suffer from a number of limitations including issues of compatibility of biomaterials, immune rejection, and scarring. This review provides elaborates existing techniques and requirements for developing effective vascularized constructs for cardiac repair.</p><p><strong>Methods: </strong>PubMed, Scopus, Web of Science, and CrossRef databases were searched for related scientific literature on the subject according to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). 93 relevant articles were selected.</p><p><strong>Results: </strong>Cardiac patches, injectable scaffolds, hydrogels, cell sheets, and decellularized constructs are studied to be effective solutions for myocardial repair. Literature survey reveals that vascular integration and construct survival might been hanced by endothelial progenitor cells, prevascularization, 3D bioprinting, nanotechnology, and engineered exosomes.</p><p><strong>Conclusions: </strong>Biomimetic constructs for effective myocardial regeneration require appropriate biomaterials, growth factors, functional cells, and a stable vascular network.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632661","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":"Mind the Movement: The Biomechanical Impact of Head Motion on Carotid Arteries Following Stent Implantation.","authors":"Shuhao Dai, Zhenmin Fan, Xianghao Zhang, Xia Ye, Xiaoyan Deng, Zhixiang Zhang","doi":"10.1007/s13239-026-00851-z","DOIUrl":"https://doi.org/10.1007/s13239-026-00851-z","url":null,"abstract":"<p><strong>Purpose: </strong>Physiological head motion is common in daily activities after carotid artery stenting (CAS) and may alter the local biomechanical environment of the treated artery. This study aimed to investigate the effects of different head movements on arterial wall stress after CAS and to explore the potential mechanical role of neointima formation.</p><p><strong>Methods: </strong>A carotid bifurcation model with an implanted stent was developed, and numerical simulations were performed to evaluate biomechanical changes under different head-motion conditions, including forward/backward bending, left/right bending, and left/right turning. Additional models with neointima formation were constructed to assess its influence on stress redistribution in the stented artery.</p><p><strong>Results: </strong>Head bending induced increased stress concentration in the arterial bending region and at the distal end of the stented segment. Head turning produced elevated stress mainly near the proximal end of the stented segment. Neointima formation did not substantially alter the stress distribution in the motion-deformed regions near the stent ends, but it partially reduced high-stress areas within the relatively less-deformed stented segment.</p><p><strong>Conclusion: </strong>Under the modeled conditions, head motion increased local mechanical loading near the stent edges and arterial bending regions after CAS. Neointima formation may locally attenuate stress within the stented segment but does not eliminate motion-induced stress concentrations. These findings provide a biomechanical basis for further investigation of motion-related vascular responses after CAS.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622651","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":"Morphological Stability of Intracranial Aneurysms and the Contour Neurovascular System: A Longitudinal Analysis.","authors":"Lena Iam Spitz, Jana Korte, Franziska Gaidzik, Naomi Larsen, Daniel Behme, Bernhard Preim, Sylvia Saalfeld","doi":"10.1007/s13239-026-00847-9","DOIUrl":"https://doi.org/10.1007/s13239-026-00847-9","url":null,"abstract":"<p><strong>Purpose: </strong>The Contour Neurovascular System (CNS) is a novel intrasaccular flow disruptor for the endovascular treatment of wide-necked aneurysms. While more longitudinal studies are needed to fully assess its efficacy, initial study results over the past few years have been promising. However, no studies have yet assessed the CNS's robustness to deformation over time, and few have assessed its effect on the morphology of intracranial aneurysms.</p><p><strong>Methods: </strong>Thirteen IAs were retrospectively analyzed using co-registered 3D meshes from serial imaging (2-5 scans per patient, up to 26 months of follow-up). Morphological parameters of the ostium and CNS were compared across defined time points. Intra-patient variance was also assessed through scans taken on the same day, and morphology was correlated with treatment outcome.</p><p><strong>Results: </strong>Significant postprocedural changes were observed in the ostium's ellipticity index (EI; <math><mi>Δ</mi></math> = -0.07 ±0.06, p = 0.01, d = -1.18) and neck circularity index (NCI; <math><mi>Δ</mi></math> = +0.04 ±0.04, p = 0.04, d = 0.90). No statistically significant long-term changes were detected for either the ostium or CNS. Most variations were within intra-patient variance, and many measured deformations were below imaging resolution (0.16-0.47 mm). No correlation was found between recurrence and morphology.</p><p><strong>Conclusion: </strong>Only immediate postprocedural shape changes of the ostium were significant. No measurable long-term deformation of the CNS or ostium was observed. The CNS appears morphologically stable, though larger, high-resolution studies are needed to confirm these findings.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438997","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":"An Intelligent IoT-Compatible Arrhythmia Detection System Using a Hybrid Vision Transformer-LSTM Framework.","authors":"S Selva Birunda, V Vaissnave, K Abirami","doi":"10.1007/s13239-026-00849-7","DOIUrl":"https://doi.org/10.1007/s13239-026-00849-7","url":null,"abstract":"<p><strong>Background: </strong>In electrocardiogram (ECG) signal classification, advanced IoT-compatible systems and medical signal processing solutions have become feasible due to the rapid growth of the Internet of Things (IoT). However, it is challenging to detect and classify arrhythmias because of the complex nature and large volumes of ECG data.</p><p><strong>Objective: </strong>This article proposes a hybrid deep learning (DL) approach by combining long short-term memory (LSTM)and a Vision Transformer (ViT) for the automatic arrhythmia classifi cation from ECG signals.</p><p><strong>Objective: </strong>This article proposes a hybrid deep learning (DL) approach by combining long short-term memory (LSTM)and a Vision Transformer (ViT) for the automatic arrhythmia classifi cation from ECG signals.</p><p><strong>Methods: </strong>Initially, the proposed framework gathers the data from the MIT-BIH database for training. Then, preprocessing strategies such as min-max normalization and signal-to-spectrogram conversion using the Stockwell transform are applied. Then, the imbalance problem in the collected dataset is rectifi ed by applying the K-Mean scentered Adaptive Synthetic Sampling (KMADASYN) technique. Afterward, the proposed framework employs the Hybrid Optimized ViT with Long Short-Term Memory (HOVLSTM) for classification, where spatial and temporal features are extracted to achieve higher classification performance.</p><p><strong>Results: </strong>The developed model achieved a classification accuracy of 99.17%, out performing several existing ECG classification systems.</p><p><strong>Conclusion: </strong>These outcomes demonstrate that the proposed technique is suitable for IoT-compatible healthcare systems. While the IoT-compatible system does not employ data acquisition, the model is evaluated in a simulated IoT environment, demonstrating its potential for future deployment in IoT-enabled clinical decision-support systems.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413639","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":"Reducing Stent-Induced Blooming Artifacts Using Virtual Monoenergetic Imaging Reconstructions in a Superficial Femoral Artery Phantom: An In-Vitro Study.","authors":"Lisa Rutten, Lennart van de Velde, Cornelis H Slump, Jasper Martens, Kartik Jain, Michel Versluis, Michel M P J Reijnen","doi":"10.1007/s13239-026-00848-8","DOIUrl":"https://doi.org/10.1007/s13239-026-00848-8","url":null,"abstract":"<p><strong>Purpose: </strong>Spectral computed tomography derived virtual monoenergetic imaging (VMI) reconstructions have been shown to reduce stent-induced blooming artifacts thus minimizing in-stent lumen underestimation. We have investigated the use of VMI reconstructions to reduce the blooming artifact for stent markers, single and double stent configurations.</p><p><strong>Methods: </strong>Two partially overlapping covered stents were deployed in a superficial femoral artery phantom. A conventional and twelve VMI reconstructions (40-100 keV and 120-200 keV with 10 and 20 keV increments, respectively) were created. Contrast-to-noise ratio, signal-to-noise ratio, attenuation difference between native and in-stent vessel lumen and full width at half maximum (FWHM) of the stent peaks were evaluated. The in-stent lumen diameter was measured, and the stent evaluated using a 5-point scale by three interventional radiologists.</p><p><strong>Results: </strong>The 80-100 keV VMI reconstructions for the single stent configuration and the 140 keV VMI reconstruction for the other configurations resulted in the smallest lumen underestimation and best quality score on blooming. The underestimation was reduced from 21.5-29.1% for the conventional reconstruction to 14.1-18.6% for the optimal VMI reconstructions. No significant differences were observed in FWHM between the conventional reconstruction and the 50-200 keV VMI reconstructions.</p><p><strong>Conclusions: </strong>VMI was found to minimize stent-induced blooming artifacts and improve in-stent lumen assessment. More stent material requires higher-energy VMI reconstructions to reduce blooming. The absence of significant differences in quantitative parameters suggests that the number of pixels affected by the blooming artifact is not reduced using VMI reconstructions.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406880","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 Trends Analysis and Scoping Review: Minimal Invasive Extracorporeal Circulation.","authors":"Doğuş Hemşinli, Sedat Ozan Karakişi, Hülya Kılıç","doi":"10.1007/s13239-026-00845-x","DOIUrl":"https://doi.org/10.1007/s13239-026-00845-x","url":null,"abstract":"<p><strong>Purpose: </strong>The minimal invasive extracorporeal circulation (MiECC) was developed as abiocompatible alternative to conventional cardiopulmonary bypass (cCPB), intending to mitigate haemodilution, lessen the systemic inflammatory response, and enhance organ protection. AQ2 Although the evidence base has grown over the past 30 years, there has been no systematic mappingof the evolution of research activity and its results.</p><p><strong>Methods: </strong>The objectives are to perform a detailed analysis of the temporal, geographical, methodological, and clinical trends within MiECC research published between 1990 and 2025. Studies involving original human clinical data (randomized controlled trials, cohort studies, observational reports, methodological or protocol papers) that reported perioperative or clinical outcomes of MiECC were included. Exclusion criteria comprised reviews, meta-analyses, editorials, letters, guidelines, animal studies, and conference abstracts lacking full text. A comprehensive search of PubMed/MEDLINE, Web of Science, Scopus, and Cochrane databases was conducted up to September 2025 to gather evidence. Reference lists of included articles and relevant reviews were also screened. Data were extracted on publication year, country, sample size, study design, surgical procedure, and reported outcomes. Two reviewers independently charted the data, and discrepancies were resolved by a third reviewer.</p><p><strong>Results: </strong>A total of 151 studies were identified, of which 128 met eligibility criteria. Publication activity increased substantially after 2002 and peaked in 2021, with major contributions from European centres (Germany, Italy, Switzerland, Greece, and the Netherlands). Methodological/protocol papers and Randomize Controlled Trials (RCT) predominated (respectively, n = 37, n = 36). Most studies focused on coronary artery bypass grafting (CABG), while valve surgery and paediatric populations were underrepresented. Reported outcomes shifted over time: early studies emphasised transfusion and inflammatory markers, whereas more recent investigations increasingly examined renal function, neurological complications, and survival. Subgroup analyses suggested notable benefits in elderly patients, those with renal dysfunction, and individuals with low ejection fraction (EF).</p><p><strong>Conclusion: </strong>MiECC research has progressed from feasibility series to large multicentre trials, generating evidence for reduced transfusion requirements, attenuated inflammatory response, and better organ protection, though no clear mortality benefit has been demonstrated.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334383","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":"Auxetic Stents as a Next Generation Solution for Vascular Diseases-A Review.","authors":"Khanish Gupta, Kusum Meena, S H Chandrashekhara","doi":"10.1007/s13239-026-00846-w","DOIUrl":"https://doi.org/10.1007/s13239-026-00846-w","url":null,"abstract":"<p><strong>Objective: </strong>Vascular diseases, particularly atherosclerosis, represent a leading cause of global morbidity and mortality. Endovascular stenting has emerged as a cornerstone of therapy to restore vessel patency, yet conventional stents remain obstructed by significant clinical limitations, including in-stent restenosis, thrombosis, and mechanical failure. These adverse outcomes are intrinsically linked to their fundamental structural design, which is characterized by a positive Poisson's ratio, leading to foreshortening and a biomechanical mismatch with the native vasculature.</p><p><strong>Methods: </strong>This review critically examines auxetic stents as a next-generation solution, engineered with a structure possessing a negative Poisson's ratio. This unique property allows them to expand axially upon radial deployment, thereby eliminating foreshortening, enhancing conformability to tortuous vessels, and distributing mechanical stress more uniformly onto the arterial wall.</p><p><strong>Results: </strong>This paper synthesizes the robust body of in-silico/bench-top evidence from computational modeling and in-vitro experimentation that validates these superior biomechanical characteristics. Furthermore, it explores the profound and favorable biological implications, arguing that the optimized mechanical environment and improved hemodynamics are hypothesized to attenuate the primary triggers for neointimal hyperplasia and foster rapid, complete endothelialization.</p><p><strong>Conclusion: </strong>The review concludes by outlining the translational pathway, including challenges in structure integration and discussing the vast future horizons for auxetic structured stents in complex peripheral, carotid, and non-vascular applications. Auxetic design represents a paradigm shift from material-centric iteration to structure-driven innovation, holding the promise to significantly improve the long-term safety and efficacy of endovascular stent implants.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304101","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":"Shape and Scale in Quantifying Aortic Morphology Evolution and Chronicity.","authors":"Joseph A Pugar, David Jiang, Junsung Kim, Luka Pocivavsek","doi":"10.1007/s13239-026-00827-z","DOIUrl":"10.1007/s13239-026-00827-z","url":null,"abstract":"<p><strong>Purpose: </strong>Decision-making in thoracic aortic disease primarily relies on diameter thresholds that compress rich three-dimensional morphology into a single length scale. Intrinsic shape measures have been shown to complement diameter, but their utility depends critically on the observation scale imposed during quantification. We aim to identify scales at which a size-invariant shape descriptor, specifically the normalized fluctuation in total integrated Gaussian curvature <math> <mover><mrow><mi>δ</mi> <mi>K</mi></mrow> <mo>~</mo></mover> </math> , most robustly captures thoracic aortic disease state and to relate the tuned <math> <mover><mrow><mi>δ</mi> <mi>K</mi></mrow> <mo>~</mo></mover> </math> signal to clinically relevant markers of chronicity in aortic dissection.</p><p><strong>Methods: </strong>We construct a scale space of aortic surface representations from CTA images via a factorial sweep across smoothing intensity, mesh density, and mesh partitioning (coarse-graining) size. For each construction we compute <math> <mover><mrow><mi>δ</mi> <mi>K</mi></mrow> <mo>~</mo></mover> </math> , quantify signal robustness and predictive clinical value, and identify a \"stable zone\" of scales where performance stabilizes. We then model clinical progression using Gaussian Process Regression and relate <math> <mover><mrow><mi>δ</mi> <mi>K</mi></mrow> <mo>~</mo></mover> </math> to markers of aortic chronicity in dissection, testing whether <math> <mover><mrow><mi>δ</mi> <mi>K</mi></mrow> <mo>~</mo></mover> </math> behaves as a proxy for phase transitions in disease progression.</p><p><strong>Results: </strong>A reproducible stable zone emerges in which centimeter-scale partitioning consistently maximizes the informativeness of <math> <mover><mrow><mi>δ</mi> <mi>K</mi></mrow> <mo>~</mo></mover> </math> while remaining resilient to smoothing, meshing, and acquisition (CT resolution) variability. Within this zone, <math> <mover><mrow><mi>δ</mi> <mi>K</mi></mrow> <mo>~</mo></mover> </math> augments preoperative risk stratification and, when coupled with Gaussian Process Regression, delineates a nonstationary regime consistent with progressive remodeling in dissection, suggesting linkage to chronicity beyond diameter alone.</p><p><strong>Conclusion: </strong>Optimizing scale space yields a tuned, size-invariant shape signal that is both robust and clinically interpretable. The observed association between <math> <mover><mrow><mi>δ</mi> <mi>K</mi></mrow> <mo>~</mo></mover> </math> and chronicity supports its use as a complementary marker to diameter and motivates prospective validation of shape-aware, curvature-based decision tools.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"343-356"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582760","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}