title: Hemodynamic analysis of patient-specific coronary artery tree.
abstract: Local hemodynamic parameters, such as wall shear stress (WSS), oscillatory shear index and relative resident time (RRT), have been linked to coronary plaque initiation and progression. In this study, a left coronary artery tree model was reconstructed from computed tomography angiography images of a patient with multiple stenoses. The geometry of the coronary artery tree model was virtually restored by eliminating the lesions, essentially re-creating the virtually healthy artery anatomy. Using numerical simulations, flow characteristics and hemodynamic parameter distributions in the stenosed and virtually healthy models were investigated. In the virtually healthy artery model, disturbed flows were found at four locations, prone to initialization of plaque formation. Low WSS and high RRT were exhibited in three of the four locations, and high WSS and low RRT were exhibited in the fourth. These findings suggest that coronary plaque is more likely to form in locations with disturbed flow conditions characterized by low WSS and high RRT or high WSS and low RRT. In addition, clinical index of fractional flow reserve was found to significantly correlate with blood flow rate, rather than anatomic parameters, such as diameter stenosis, which implied the importance of hemodynamic environment in stenosis formation.
authors: National Heart Center Singapore, 5 Hospital Drive, 169609, Singapore; Duke-NUS Graduate Medical School, Singapore, 8 College Road, 169857, Singapore.
authors: Jun-Mei
authors: JM
authors: Zhang
authors: Tong
authors: T
authors: Luo
authors: Swee Yaw
authors: SY
authors: Tan
authors: Aileen Mae
authors: AM
authors: Lomarda
authors: Aaron Sung Lung
authors: AS
authors: Wong
authors: Felix Yung Jih
authors: FY
authors: Keng
authors: John Carson
authors: JC
authors: Allen
authors: Yunlong
authors: Y
authors: Huo
authors: Boyang
authors: B
authors: Su
authors: Xiaodan
authors: X
authors: Zhao
authors: Min
authors: M
authors: Wan
authors: Ghassan S
authors: GS
authors: Kassab
authors: Ru San
authors: RS
authors: Tan
authors: Liang
authors: L
authors: Zhong
mesh_terms: D000792:Angiography / Q000379:methods; D001783:Blood Flow Velocity / Q000502:physiology; D023921:Coronary Stenosis / Q000503:physiopathology; D003331:Coronary Vessels / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D058226:Plaque, Atherosclerotic / Q000503:physiopathology; D013314:Stress, Mechanical
keywords: coronary artery; hemodynamic parameter; hemodynamics; numerical simulation; stenosis