Hemodynamically non-significant coronary artery stenosis: a predictive model

Coronary artery disease (CAD), which is characterized by the presence of coronary artery stenosis, is the frequent cause of death worldwide. The aim of this study was to assess hemodynamic effect due to the presence of non critical coronary stenoses. The computational fluid dynamics (CFD) was used to carry out numerical simulations, investigating the hemodynamic parameters. Twenty-four stenotic coronary arteries, with different non-significant stenosis severities, were reconstructed from frames of coronary angiographies of patients. The results show the distribution of the wall shear stress (WSS) in coronary vessels, and will be used to develop a predictive model to obtain shear stress value knowing stenosis area and length. These models demonstrate that the assessment of WSS parameters may be useful to further refine risk stratification of patients having not clinically significant coronary artery stenosis.

[1]  M. Caruso,et al.  Computational analysis of aortic hemodynamics during total and partial extracorporeal membrane oxygenation and intra-aortic balloon pump support. , 2016, Acta of bioengineering and biomechanics.

[2]  Gionata Fragomeni,et al.  Influence of IABP-Induced Abdominal Occlusions on Aortic Hemodynamics: A Patient-Specific Computational Evaluation , 2017, ASAIO journal.

[3]  K. Prasad,et al.  Textbook of Angiology , 2000, Springer New York.

[4]  Zhonghua Sun,et al.  Hemodynamic impacts of left coronary stenosis: a patient-specific analysis. , 2013, Acta of bioengineering and biomechanics.

[5]  David A. Steinman,et al.  Image-Based Computational Fluid Dynamics Modeling in Realistic Arterial Geometries , 2002, Annals of Biomedical Engineering.

[6]  M. Gavaises,et al.  Derivation of flow related risk indices for stenosed left anterior descending coronary arteries with the use of computer simulations. , 2016, Medical engineering & physics.

[7]  Zhonghua Sun,et al.  Computational Fluid Dynamics Analysis of the Effect of Plaques in the Left Coronary Artery , 2012, Comput. Math. Methods Medicine.

[8]  Hui Meng,et al.  High Wall Shear Stress and Spatial Gradients in Vascular Pathology: A Review , 2012, Annals of Biomedical Engineering.

[9]  Ciro Indolfi,et al.  Computational analysis of stenosis geometry effects on right coronary hemodynamics , 2015, 2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[10]  M. Caruso,et al.  A numerical analysis of the aortic blood flow pattern during pulsed cardiopulmonary bypass , 2015, Computer methods in biomechanics and biomedical engineering.

[11]  Michael C. McDaniel,et al.  Coronary Artery Wall Shear Stress Is Associated With Progression and Transformation of Atherosclerotic Plaque and Arterial Remodeling in Patients With Coronary Artery Disease , 2011, Circulation.

[12]  V. Fuster,et al.  Coronary plaque disruption. , 1995, Circulation.

[13]  G. Louridas,et al.  Wall shear stress in normal left coronary artery tree. , 2006, Journal of biomechanics.

[14]  Jan G. Korvink,et al.  Patient Specific Hemodynamics: Combined 4D Flow-Sensitive MRI and CFD , 2011 .

[15]  P. Eshtehardi,et al.  Protective or destructive: High wall shear stress and atherosclerosis. , 2016, Atherosclerosis.

[16]  M. Jaff.  Vascular Medicine: A Companion to Braunwald's Heart Disease , 2006 .

[17]  F. Boyle,et al.  Numerical prediction of the effect of aortic Left Ventricular Assist Device outflow-graft anastomosis location , 2016 .