The Role of Elevated Wall Shear Stress in Progression of Pulmonary Vein Stenosis: Evidence from Two Case Studies
Pulmonary vein stenosis is a serious condition characterized by restriction or blockage due to fibrotic tissue ingrowth that develops in the pulmonary veins of infants or children. It is often progressive and can lead to severe pulmonary hypertension and death. Efforts to halt or reverse disease pro...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Children |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9067/8/9/729 |
| _version_ | 1797519844875173888 |
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| author | Peter E. Hammer Kerry McEnaney Ryan Callahan Christopher W. Baird David M. Hoganson Kathy J. Jenkins |
| author_facet | Peter E. Hammer Kerry McEnaney Ryan Callahan Christopher W. Baird David M. Hoganson Kathy J. Jenkins |
| author_sort | Peter E. Hammer |
| collection | DOAJ |
| description | Pulmonary vein stenosis is a serious condition characterized by restriction or blockage due to fibrotic tissue ingrowth that develops in the pulmonary veins of infants or children. It is often progressive and can lead to severe pulmonary hypertension and death. Efforts to halt or reverse disease progression include surgery and catheter-based balloon dilation and stent implantation. Its cause and mechanism of progression are unknown. In this pilot study, we propose and explore the hypothesis that elevated wall shear stress at discrete pulmonary venous sites triggers stenosis. To assess this theory, we retrospectively analyzed cardiac catheterization, lung scan, and X-ray computed tomography data to estimate wall shear stress in the pulmonary veins at multiple time points during disease progression in two patients. Results are consistent with the existence of a level of elevated wall shear stress above which the disease is progressive and below which progression is halted. The analysis also suggests the possibility of predicting the target lumen size necessary in a given vein to reduce wall shear stress to normal levels and remove the trigger for stenosis progression. |
| first_indexed | 2024-03-10T07:48:33Z |
| format | Article |
| id | doaj.art-91c51f7c432f42259f7f250c9a1d02ae |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T07:48:33Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-91c51f7c432f42259f7f250c9a1d02ae2023-11-22T12:29:08ZengMDPI AGChildren2227-90672021-08-018972910.3390/children8090729The Role of Elevated Wall Shear Stress in Progression of Pulmonary Vein Stenosis: Evidence from Two Case StudiesPeter E. Hammer0Kerry McEnaney1Ryan Callahan2Christopher W. Baird3David M. Hoganson4Kathy J. Jenkins5Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA 02115, USADepartment of Cardiology, Boston Children’s Hospital, Boston, MA 02115, USADepartment of Cardiology, Boston Children’s Hospital, Boston, MA 02115, USADepartment of Cardiac Surgery, Boston Children’s Hospital, Boston, MA 02115, USADepartment of Cardiac Surgery, Boston Children’s Hospital, Boston, MA 02115, USADepartment of Cardiology, Boston Children’s Hospital, Boston, MA 02115, USAPulmonary vein stenosis is a serious condition characterized by restriction or blockage due to fibrotic tissue ingrowth that develops in the pulmonary veins of infants or children. It is often progressive and can lead to severe pulmonary hypertension and death. Efforts to halt or reverse disease progression include surgery and catheter-based balloon dilation and stent implantation. Its cause and mechanism of progression are unknown. In this pilot study, we propose and explore the hypothesis that elevated wall shear stress at discrete pulmonary venous sites triggers stenosis. To assess this theory, we retrospectively analyzed cardiac catheterization, lung scan, and X-ray computed tomography data to estimate wall shear stress in the pulmonary veins at multiple time points during disease progression in two patients. Results are consistent with the existence of a level of elevated wall shear stress above which the disease is progressive and below which progression is halted. The analysis also suggests the possibility of predicting the target lumen size necessary in a given vein to reduce wall shear stress to normal levels and remove the trigger for stenosis progression.https://www.mdpi.com/2227-9067/8/9/729pulmonary vein stenosiswall shear stressneointimal hyperplasia |
| spellingShingle | Peter E. Hammer Kerry McEnaney Ryan Callahan Christopher W. Baird David M. Hoganson Kathy J. Jenkins The Role of Elevated Wall Shear Stress in Progression of Pulmonary Vein Stenosis: Evidence from Two Case Studies Children pulmonary vein stenosis wall shear stress neointimal hyperplasia |
| title | The Role of Elevated Wall Shear Stress in Progression of Pulmonary Vein Stenosis: Evidence from Two Case Studies |
| title_full | The Role of Elevated Wall Shear Stress in Progression of Pulmonary Vein Stenosis: Evidence from Two Case Studies |
| title_fullStr | The Role of Elevated Wall Shear Stress in Progression of Pulmonary Vein Stenosis: Evidence from Two Case Studies |
| title_full_unstemmed | The Role of Elevated Wall Shear Stress in Progression of Pulmonary Vein Stenosis: Evidence from Two Case Studies |
| title_short | The Role of Elevated Wall Shear Stress in Progression of Pulmonary Vein Stenosis: Evidence from Two Case Studies |
| title_sort | role of elevated wall shear stress in progression of pulmonary vein stenosis evidence from two case studies |
| topic | pulmonary vein stenosis wall shear stress neointimal hyperplasia |
| url | https://www.mdpi.com/2227-9067/8/9/729 |
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