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Hemodynamic Abnormalities in the Aorta of Turner Syndrome Girls

Congenital abnormalities in girls and women with Turner syndrome (TS), alongside an underlying predisposition to obesity and hypertension, contribute to an increased risk of cardiovascular disease and ultimately reduced life expectancy. We observe that children with TS present a greater variance in...

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Autores principales: Johnston, Lauren, Allen, Ruth, Hall Barrientos, Pauline, Mason, Avril, Kazakidi, Asimina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203817/
https://www.ncbi.nlm.nih.gov/pubmed/34141729
http://dx.doi.org/10.3389/fcvm.2021.670841
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author Johnston, Lauren
Allen, Ruth
Hall Barrientos, Pauline
Mason, Avril
Kazakidi, Asimina
author_facet Johnston, Lauren
Allen, Ruth
Hall Barrientos, Pauline
Mason, Avril
Kazakidi, Asimina
author_sort Johnston, Lauren
collection PubMed
description Congenital abnormalities in girls and women with Turner syndrome (TS), alongside an underlying predisposition to obesity and hypertension, contribute to an increased risk of cardiovascular disease and ultimately reduced life expectancy. We observe that children with TS present a greater variance in aortic arch morphology than their healthy counterparts, and hypothesize that their hemodynamics is also different. In this study, computational fluid dynamic (CFD) simulations were performed for four TS girls, and three age-matched healthy girls, using patient-specific inlet boundary conditions, obtained from phase-contrast MRI data. The visualization of multidirectional blood flow revealed an increase in vortical flow in the arch, supra-aortic vessels, and descending aorta, and a correlation between the presence of aortic abnormalities and disturbed flow. Compared to the relatively homogeneous pattern of time-averaged wall shear stress (TAWSS) on the healthy aortae, a highly heterogeneous distribution with elevated TAWSS values was observed in the TS geometries. Visualization of further shear stress parameters, such as oscillatory shear index (OSI), normalized relative residence time (RRTn), and transverse WSS (transWSS), revealed dissimilar heterogeneity in the oscillatory and multidirectional nature of the aortic flow. Taking into account the young age of our TS cohort (average age 13 ± 2 years) and their obesity level (75% were obese or overweight), which is believed to accelerate the initiation and progression of endothelial dysfunction, these findings may be an indication of atherosclerotic disease manifesting earlier in life in TS patients. Age, obesity and aortic morphology may, therefore, play a key role in assessing cardiovascular risk in TS children.
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spelling pubmed-82038172021-06-16 Hemodynamic Abnormalities in the Aorta of Turner Syndrome Girls Johnston, Lauren Allen, Ruth Hall Barrientos, Pauline Mason, Avril Kazakidi, Asimina Front Cardiovasc Med Cardiovascular Medicine Congenital abnormalities in girls and women with Turner syndrome (TS), alongside an underlying predisposition to obesity and hypertension, contribute to an increased risk of cardiovascular disease and ultimately reduced life expectancy. We observe that children with TS present a greater variance in aortic arch morphology than their healthy counterparts, and hypothesize that their hemodynamics is also different. In this study, computational fluid dynamic (CFD) simulations were performed for four TS girls, and three age-matched healthy girls, using patient-specific inlet boundary conditions, obtained from phase-contrast MRI data. The visualization of multidirectional blood flow revealed an increase in vortical flow in the arch, supra-aortic vessels, and descending aorta, and a correlation between the presence of aortic abnormalities and disturbed flow. Compared to the relatively homogeneous pattern of time-averaged wall shear stress (TAWSS) on the healthy aortae, a highly heterogeneous distribution with elevated TAWSS values was observed in the TS geometries. Visualization of further shear stress parameters, such as oscillatory shear index (OSI), normalized relative residence time (RRTn), and transverse WSS (transWSS), revealed dissimilar heterogeneity in the oscillatory and multidirectional nature of the aortic flow. Taking into account the young age of our TS cohort (average age 13 ± 2 years) and their obesity level (75% were obese or overweight), which is believed to accelerate the initiation and progression of endothelial dysfunction, these findings may be an indication of atherosclerotic disease manifesting earlier in life in TS patients. Age, obesity and aortic morphology may, therefore, play a key role in assessing cardiovascular risk in TS children. Frontiers Media S.A. 2021-06-01 /pmc/articles/PMC8203817/ /pubmed/34141729 http://dx.doi.org/10.3389/fcvm.2021.670841 Text en Copyright © 2021 Johnston, Allen, Hall Barrientos, Mason and Kazakidi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Johnston, Lauren
Allen, Ruth
Hall Barrientos, Pauline
Mason, Avril
Kazakidi, Asimina
Hemodynamic Abnormalities in the Aorta of Turner Syndrome Girls
title Hemodynamic Abnormalities in the Aorta of Turner Syndrome Girls
title_full Hemodynamic Abnormalities in the Aorta of Turner Syndrome Girls
title_fullStr Hemodynamic Abnormalities in the Aorta of Turner Syndrome Girls
title_full_unstemmed Hemodynamic Abnormalities in the Aorta of Turner Syndrome Girls
title_short Hemodynamic Abnormalities in the Aorta of Turner Syndrome Girls
title_sort hemodynamic abnormalities in the aorta of turner syndrome girls
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203817/
https://www.ncbi.nlm.nih.gov/pubmed/34141729
http://dx.doi.org/10.3389/fcvm.2021.670841
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