Key result
A numerical fluid structure interaction model revealed that a threefold increase in aortic wall stiffness and leaflet thickness causes a marked drop in coronary peak velocity.
Why the study?
Does aortic root stiffening and calcific aortic stenosis affect coronary perfusion in a fluid structure interaction model?
Does aortic root stiffening and calcific aortic stenosis affect coronary perfusion in a fluid structure interaction model?
Numerical modeling suggests that significant aortic stiffening and calcific aortic stenosis can markedly reduce coronary perfusion, highlighting the potential benefit of therapies that improve aortic compliance.
May warrant coronary perfusion assessment in aortic stiffening; leaves open clinical validation in patients.
In some pathological conditions like aortic stiffening and calcific aortic stenosis (CAS), the microstructure of the aortic root and the aortic valve leaflets are altered in response to stress resulting in changes in tissue thickness, stiffness, or both. This aortic stiffening and CAS are thought to affect coronary blood flow. The goal of the present paper was to include the flow in the coronary ostia in the previous fluid structure interaction model we have developed and to analyze the effect of diseased tissues (aortic root stiffening and CAS) on coronary perfusion. Results revealed a significant impact on the coronary perfusion due to a moderate increase in the aortic wall stiffness and CAS (increase of the aortic valve leaflets thickness). A marked drop of coronary peak velocity occurred when the values of leaflet thickness and aortic wall stiffness were above a certain threshold, corresponding to a threefold of their normal value. Consequently, mild and prophylactic treatments such as smoking cessation, exercise, or diet, which have been proven to increase the aortic compliance, may significantly improve the coronary perfusion.
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Nobari et al. (2012) studied Aortic stiffening and calcific aortic stenosis. Aortic wall stiffness and leaflet thickness increase (numerical model) vs. Normal values was evaluated on Coronary perfusion and peak velocity. A numerical fluid structure interaction model revealed that a threefold increase in aortic wall stiffness and leaflet thickness causes a marked drop in coronary peak velocity.
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