The Impact of the Geometric Characteristics on the Hemodynamics in the Stenotic Coronary Artery.
The alterations of the hemodynamics in the coronary arteries, which result from patient-specific geometric significances are complex. The effect of the stenosis on the blood flow alteration had been wildly reported, but the combinational contribution from geometric factors required a comprehensive investigation to provide patient-specific information for diagnosis and assisting in the decision on the further treatment strategies. In the present study, we investigated the correlation between hemodynamic parameters and individual geometric factors in the patient-specific coronary arteries. Computational fluid dynamic simulations were performed on 22 patient-specific 3-dimensional coronary artery models that were reconstructed based on computed tomography angiography images. Our results showed that the increasing severity of the stenosis is associated with the increased maximum wall shear stress at the stenosis region (r = 0.752, P < 0.001). In contrast, the length of the recirculation zone has a moderate association with the curvature of the lesion segment (r = 0.505, P = 0.019) and the length of the lesions (r = 0.527, P = 0.064). Moreover, bifurcation in the coronary arteries is significantly correlated with the occurrence of recirculation, whereas the severity of distal stenosis demonstrated an effect on the alteration of the flow in the upstream bifurcation. These findings could serve as an indication for treatment planning and assist in prognosis evaluation.
Department of Cardiology, Shenzhen Sun Yat-Sen cardiovascular hospital, Shenzhen 518112, China.
Changnong
C
Peng
Department of Cardiology, Shenzhen Sun Yat-Sen cardiovascular hospital, Shenzhen 518112, China.
Xiaoqing
X
Wang
Department of Cardiology, Shenzhen Sun Yat-Sen cardiovascular hospital, Shenzhen 518112, China.
Zhanchao
Z
Xian
Research center for biomedical information technology, Shenzhen institute of advance technology, Chinese academic of science, Shenzhen 518055, China.
Xin
X
Liu
Institutes of Clinical Anatomy, Southern Medical University, Guangzhou 510515, China.
Wenhua
W
Huang
Institutes of Clinical Anatomy, Southern Medical University, Guangzhou 510515, China.
Pengcheng
P
Xu
Institutes of Clinical Anatomy, Southern Medical University, Guangzhou 510515, China.
Jinyang
J
Wang
D000368:Aged; D001783:Blood Flow Velocity; D003198:Computer Simulation; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D013314:Stress, Mechanical