Key result
Proximally skewed eccentric plaques with large positive curvature produce the highest wall shear stress.
Why the study?
Plaque rupture is a leading mechanism underlying acute myocardial infarction and is associated with elevated wall shear stress and wall shear stress gradient, motivating an investigation into the effects of plaque morphology and vascular curvature on coronary hemodynamics.
Does variation in plaque morphology (percent area stenosis, eccentricity, longitudinal skewness) and vascular curvature alter local wall shear stress (WSS) and wall shear stress gradient (WSSG) in idealized coronary artery models?
Does variation in plaque morphology (percent area stenosis, eccentricity, longitudinal skewness) and vascular curvature alter local wall shear stress (WSS) and wall shear stress gradient (WSSG) in idealized coronary artery models?
This computational fluid dynamics study demonstrates that coronary plaque morphology (stenosis severity, eccentricity, and longitudinal skewness) and vascular curvature interact nonlinearly and asymmetrically to determine local wall shear stress and wall shear stress gradients, underscoring the need to account for both factors when evaluating hemodynamic plaque vulnerability.
Answers are grounded in this paper and cite their sources.
Integrating plaque skewness and curvature may refine WSS-based rupture models; extends idealized simulations but leaves open patient-specific validation.
Plaque rupture is a leading mechanism underlying acute myocardial infarction and has been associated with elevated wall shear stress (WSS) and wall shear stress gradient (WSSG). This study uses a parametric computational fluid dynamics (CFD) approach to investigate the effects of plaque morphology and vascular curvature on coronary hemodynamics. Idealized coronary artery geometries containing atherosclerotic plaques were modeled using OpenFOAM. The parameters included percent area stenosis, plaque longitudinal skewness, eccentricity, and vascular curvature. The incompressible Navier–Stokes equations were solved using a non-Newtonian blood viscosity model and pulsatile flow boundary conditions. WSS and WSSG were then evaluated from the resulting flow fields. For concentric plaques, increasing vascular curvature produced approximately linear increases in both WSS and WSSG, with symmetric responses at positive and negative curvature angles. In contrast, eccentric plaques exhibited asymmetric and nonmonotonic responses to vascular curvature. At an eccentricity of 0.2, the lowest peak WSS and WSSG occurred at a curvature angle of -15 degrees. Proximally skewed eccentric plaques combined with large positive curvature angles produced the highest WSS and WSSG. These findings demonstrate that plaque morphology and vascular geometry interact to strongly influence local coronary hemodynamics, highlighting the importance of accounting for both factors when assessing hemodynamic conditions associated with plaque vulnerability.
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Huang et al. (2026) studied Coronary atherosclerosis. Parametric variations in plaque morphology (percent area stenosis, eccentricity, longitudinal skewness) and vascular curvature vs. Baseline longitudinally symmetric, concentric plaque with zero curvature and 80% area stenosis was evaluated on Maximum wall shear stress (WSS) and wall shear stress gradient (WSSG). Proximally skewed eccentric plaques combined with large positive curvature angles produced the highest wall shear stress and wall shear stress gradient, whereas at 0.2 eccentricity, the lowest peak values occurred at a -15° curvature angle.
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