Impact of coronary tortuosity on coronary pressure: numerical simulation study.
BACKGROUND
Coronary tortuosity (CT) is a common coronary angiographic finding. Whether CT leads to an apparent reduction in coronary pressure distal to the tortuous segment of the coronary artery is still unknown. The purpose of this study is to determine the impact of CT on coronary pressure distribution by numerical simulation.


METHODS
21 idealized models were created to investigate the influence of coronary tortuosity angle (CTA) and coronary tortuosity number (CTN) on coronary pressure distribution. A 2D incompressible Newtonian flow was assumed and the computational simulation was performed using finite volume method. CTA of 30°, 60°, 90°, 120° and CTN of 0, 1, 2, 3, 4, 5 were discussed under both steady and pulsatile conditions, and the changes of outlet pressure and inlet velocity during the cardiac cycle were considered.


RESULTS
Coronary pressure distribution was affected both by CTA and CTN. We found that the pressure drop between the start and the end of the CT segment decreased with CTA, and the length of the CT segment also declined with CTA. An increase in CTN resulted in an increase in the pressure drop.


CONCLUSIONS
Compared to no-CT, CT can results in more decrease of coronary blood pressure in dependence on the severity of tortuosity and severe CT may cause myocardial ischemia.
Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Yang
Y
Li
Zhengtao
Z
Shi
Yan
Y
Cai
Yi
Y
Feng
Genshan
G
Ma
Chengxing
C
Shen
Zhiyong
Z
Li
Naifeng
N
Liu
D000792:Angiography / Q000379:methods; D062186:Arterial Pressure; D001158:Arteries / Q000002:abnormalities / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure; D003198:Computer Simulation; D003326:Coronary Circulation / Q000502:physiology; D003331:Coronary Vessels / Q000502:physiology* / Q000503:physiopathology; D006321:Heart / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology*; D008955:Models, Cardiovascular; D008962:Models, Theoretical; D017202:Myocardial Ischemia / Q000473:pathology; D011312:Pressure; D012873:Skin Diseases, Genetic / Q000503:physiopathology*; D054079:Vascular Malformations / Q000503:physiopathology*