Computational Fluid Dynamics Simulations of Hemodynamics in Plaque Erosion.
OBJECTIVE
We investigated whether local hemodynamics were associated with sites of plaque erosion and hypothesized that patients with plaque erosion have locally elevated WSS magnitude in regions where erosion has occurred.


METHODS
We generated 3D, patient-specific models of coronary arteries from biplane angiographic images in 3 human patients with plaque erosion diagnosed by optical coherence tomography (OCT). Using computational fluid dynamics, we simulated pulsatile blood flow and calculated both wall shear stress (WSS) and oscillatory shear index (OSI). We also investigated anatomic features of plaque erosion sites by examining branching and local curvature in x-ray angiograms of barium-perfused autopsy hearts.


RESULTS
Neither high nor low magnitudes of mean WSS were associated with sites of plaque erosion. OSI and local curvature were also not associated with erosion. Anatomically, 8 of 13 hearts had a nearby bifurcation upstream of the site of plaque erosion.


CONCLUSIONS
This study provides preliminary evidence that neither hemodynamics nor anatomy are predictors of plaque erosion, based upon a very unique dataset. Our sample sizes are small, but this dataset suggests that high magnitudes of wall shear stress, one potential mechanism for inducing plaque erosion, are not necessary for erosion to occur.
Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, GA 30332, USA.
Ian C
IC
Campbell
Lucas H
LH
Timmins
Don P
DP
Giddens
Renu
R
Virmani
Alessandro
A
Veneziani
S Tanveer
ST
Rab
Habib
H
Samady
Michael C
MC
McDaniel
Aloke V
AV
Finn
W Robert
WR
Taylor
John N
JN
Oshinski
Computational fluid dynamics; atherosclerosis; endothelium; plaque erosion; wall shear stress