Bridging vascular physiology and computer modelling to predict functional decline and cardiovascular event risk in patients with blood flow limitations

Peripheral artery disease (PAD) is characterized by narrowing of the peripheral arteries that affects the lower extremities. Patients have impairments in delivering oxygen to their leg muscles during walking, which restricts functional independence. PAD patients are also at increased risk of cardiovascular events, including death. Disturbed patterns of blood flow, or shear stress play a major role in progressive narrowing of the arteries. We will look at whether mean shear and patterns of shear stress (antegrade, retrograde, and oscillatory shear) using ultrasound methods are linked with muscle oxygenation during a walking test, an indicator of functional capacity. Using these measurements, the goal of this project is to model severity of vascular impairment in patients and link this with functional limitations and cardiovascular event occurrence. This is particularly important to investigate in women as they tend to exhibit non-classical symptoms of cardiovascular disease related to the non-obstructive nature of disease progression. This can lead to worse outcomes, in part, due to delayed detection and treatment. Developing a computational model to predict functional decline and cardiovascular event occurrence would aid in more accurate stratification of patients into risk category and timely intervention to improve disease trajectory.