Key result
Hemodynamic analysis of a patient-specific coronary model suggested that plaque is likely to form in locations with disturbed flow characterized by low WSS and high RRT or high WSS and low RRT.
Computational fluid dynamics modeling demonstrates that local hemodynamic parameters (wall shear stress and relative resident time) are associated with locations prone to coronary plaque formation, and FFR correlates better with blood flow rate than anatomic stenosis severity.
Supports hemodynamic plaque prediction in models; hypothesis-generating and should not yet change practice.
Local hemodynamic parameters, such as wall shear stress (WSS), oscillatory shear index and relative resident time (RRT), have been linked to coronary plaque initiation and progression. In this study, a left coronary artery tree model was reconstructed from computed tomography angiography images of a patient with multiple stenoses. The geometry of the coronary artery tree model was virtually restored by eliminating the lesions, essentially re-creating the virtually healthy artery anatomy. Using numerical simulations, flow characteristics and hemodynamic parameter distributions in the stenosed and virtually healthy models were investigated. In the virtually healthy artery model, disturbed flows were found at four locations, prone to initialization of plaque formation. Low WSS and high RRT were exhibited in three of the four locations, and high WSS and low RRT were exhibited in the fourth. These findings suggest that coronary plaque is more likely to form in locations with disturbed flow conditions characterized by low WSS and high RRT or high WSS and low RRT. In addition, clinical index of fractional flow reserve was found to significantly correlate with blood flow rate, rather than anatomic parameters, such as diameter stenosis, which implied the importance of hemodynamic environment in stenosis formation.
No takes yet. Share an insight, caveat, or question.
Zhang et al. (2015) studied Coronary artery disease with multiple stenoses (n=1). Stenosed coronary artery model vs. Virtually healthy artery model was evaluated on Hemodynamic parameter distributions (wall shear stress and relative resident time). Hemodynamic analysis of a patient-specific coronary model suggested that plaque is likely to form in locations with disturbed flow characterized by low WSS and high RRT or high WSS and low RRT.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: