The relative effects of arterial curvature and lumen diameter on wall shear stress distributions in human right coronary arteries

This study looks at blood flow in four different human right coronary arteries (RCAs), which have been reconstructed from bi-plane angiograms. A generalized power-law model of blood viscosity is used to study the blood flow at a particular point in the cardiac cycle. Large differences are found in the wall shear stress magnitude (WSS) distributions in the four arteries, leading to the conclusion that it is not possible to make generalizations based on the study of a single artery. The pattern of WSS is found to be related to the geometry of a particular artery, that is, lumen diameter and arterial curvature as well as a combination of these two factors. There is a strong correlation between WSS and reciprocal radius and a weaker correlation between high curvature and extremes of WSS, with high WSS on the 'inside' of a bend and low WSS on the 'outside' of a bend. This is in contrast to the situation for a simple curved tube with constant radius where the inverse is observed. For each artery, a region proximal to the acute margin is identified where low WSS is found and where WSS is lower on the 'inner' wall of the RCA than on the 'outer' wall. This region is one where several studies have found that the human RCA preferentially exhibits atherogenesis.

[1]  D. L. Fry.  Acute Vascular Endothelial Changes Associated with Increased Blood Velocity Gradients , 1968, Circulation research.

[2]  M. H. Friedman.  Some atherosclerosis may be a consequence of the normal adaptive vascular response to shear. , 1990, Atherosclerosis.

[3]  D. Ku,et al.  Pulsatile Flow and Atherosclerosis in the Human Carotid Bifurcation: Positive Correlation between Plaque Location and Low and Oscillating Shear Stress , 1985, Arteriosclerosis.

[4]  R. Nerem,et al.  A numerical calculation of flow in a curved tube model of the left main coronary artery. , 1991, Journal of biomechanics.

[5]  A. Qiao,et al.  Numerical study of nonlinear pulsatile flow in S-shaped curved arteries. , 2004, Medical engineering & physics.

[6]  Sergio Waxman,et al.  Determination of in vivo velocity and endothelial shear stress patterns with phasic flow in human coronary arteries: a methodology to predict progression of coronary atherosclerosis. , 2002, American heart journal.

[7]  R. Bouzerar,et al.  Blood flow patterns in an anatomically realistic coronary vessel: influence of three different reconstruction methods. , 2002, Journal of biomechanics.

[8]  S. Alper,et al.  Hemodynamic shear stress and its role in atherosclerosis. , 1999, JAMA.

[9]  Hui Zhu,et al.  Relationship Between the Dynamic Geometry and Wall Thickness of a Human Coronary Artery , 2003, Arteriosclerosis, thrombosis, and vascular biology.

[10]  Ahmed Hassanein,et al.  Multiphase hemodynamic simulation of pulsatile flow in a coronary artery. , 2006, Journal of biomechanics.

[11]  K. Johnston,et al.  Distribution of intimal and medial thickening in the human right coronary artery: a study of 17 RCAs. , 2001, Atherosclerosis.

[12]  C. Ross Ethier,et al.  Effects of Cardiac Motion on Right Coronary Artery Hemodynamics , 2003, Annals of Biomedical Engineering.

[13]  S. Corney,et al.  Construction of realistic branched, three-dimensional arteries suitable for computational modelling of flow , 2004, Medical and Biological Engineering and Computing.

[14]  T. Tokushima,et al.  Phasic coronary artery flow velocity determined by Doppler flowmeter catheter in aortic stenosis and aortic regurgitation. , 1988, The American journal of cardiology.

[15]  R. Nerem.  Vascular fluid mechanics, the arterial wall, and atherosclerosis. , 1992, Journal of biomechanical engineering.

[16]  Barbara M. Johnston,et al.  Non-Newtonian blood flow in human right coronary arteries: steady state simulations. , 2004, Journal of biomechanics.

[17]  Barbara M. Johnston,et al.  Non-Newtonian blood flow in human right coronary arteries: transient simulations. , 2006, Journal of biomechanics.

[18]  K. Johnston,et al.  Velocity and wall shear stress patterns in the human right coronary artery. , 1999, Journal of biomechanical engineering.

[19]  T. Karino,et al.  Flow patterns and spatial distribution of atherosclerotic lesions in human coronary arteries. , 1990, Circulation research.

[20]  D. Steinman,et al.  Simulation of non-Newtonian blood flow in an end-to-side anastomosis. , 1994, Biorheology.

[21]  C. R. Ethier,et al.  Factors Influencing Blood Flow Patterns in the Human Right Coronary Artery , 2001, Annals of Biomedical Engineering.

[22]  R. Schroter,et al.  Atheroma and arterial wall shear - Observation, correlation and proposal of a shear dependent mass transfer mechanism for atherogenesis , 1971, Proceedings of the Royal Society of London. Series B. Biological Sciences.

[23]  C. Caro.  Vascular fluid dynamics and vascular biology and disease , 2001 .

[24]  P. Serruys,et al.  Evaluation of endothelial shear stress and 3D geometry as factors determining the development of atherosclerosis and remodeling in human coronary arteries in vivo. Combining 3D reconstruction from angiography and IVUS (ANGUS) with computational fluid dynamics. , 1997, Arteriosclerosis, thrombosis, and vascular biology.

[25]  Don P. Giddens,et al.  Response of Arteries to Near-Wall Fluid Dynamic Behavior , 1990 .

[26]  S. Corney,et al.  Cyclic flow patterns in human coronary arteries , 2001, Computers in Cardiology 2001. Vol.28 (Cat. No.01CH37287).

[27]  Nikos Stergiopulos,et al.  Shear stress, vascular remodeling and neointimal formation. , 2003, Journal of biomechanics.