Key result
LCx bifurcation angles near ~40° create the most plaque-prone hemodynamic conditions.
Why the study?
The left circumflex bifurcation angle affects flow distribution and reverse flow in the left coronary system, but its effect on hemodynamic indices remained unclear.
Does varying the left circumflex (LCx) bifurcation angle between 20° and 80° alter hemodynamic indices (TAWSS, OSI, and helicity) and plaque-prone regions in an idealized left coronary bifurcation model?
Does varying the left circumflex (LCx) bifurcation angle between 20° and 80° alter hemodynamic indices (TAWSS, OSI, and helicity) and plaque-prone regions in an idealized left coronary bifurcation model?
Computational fluid dynamics simulations suggest that a medium left circumflex bifurcation angle (~40°) maximizes oscillatory shear index and may be more prone to atherosclerotic plaque development than higher angles.
Answers are grounded in this paper and cite their sources.
LCx BA may modulate coronary plaque hemodynamics; leaves open clinical relevance for atherosclerosis risk or interventions.
Coronary atherosclerosis preferentially develops at bifurcations due to complex flow, and bifurcation angle (BA) strongly influences local hemodynamics. The left circumflex (LCx) BA affects flow distribution and reverse flow in the left coronary system, but its effect on hemodynamic indices remains unclear. We numerically investigated the effect of the LCx BA on plaque-prone regions using three hemodynamic indices: time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and helicity. The analysis was conducted using an idealized left coronary bifurcation model with a fixed left anterior descending (LAD) angle of 40° and systematically varied LCx angles (20°–80°) under physiologic pulsatile flow conditions. A P2P1 finite element method has been used to solve the 3-D unsteady incompressible Navier-Stokes equations based on the constitutive equation of a non-Newtonian model. We found that the area of low TAWSS has a maximum plateau for low BAs (< 40°) because stronger reverse flows with higher BAs enhance the wash-out near the bifurcating region of the LCx. This phenomenon has been supported by confirming the existing fact that stronger reverse flow with a higher BA is closely related to a higher helicity due to the higher BA. The present simulations also reveal that the temporal variation of the size of the reverse flow reaches a maximum near the medium BA (∼40°), leading to the maximum OSI value. Based on the simulation results of the present model, it can be said that a medium BA of the LCx (∼40°) is more plaque-prone than a higher BA.
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Vo et al. (2026) studied Coronary atherosclerosis at left coronary bifurcations. Varying left circumflex (LCx) bifurcation angles (20°–80°) was evaluated on Hemodynamic indices: time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and helicity. Varying LCx bifurcation angles (20°–80°) in a computational model showed maximum low TAWSS area at <40° and maximum OSI near a medium angle (~40°), making ~40° more plaque-prone than higher angles.
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