The Impact of the Geometric Characteristics on the Hemodynamics in the Stenotic Coronary Artery

• Published in: PloS one 2016-06, Vol.11 (6), p.e0157490-e0157490
• Main Authors: Peng, Changnong, Wang, Xiaoqing, Xian, Zhanchao, Liu, Xin, Huang, Wenhua, Xu, Pengcheng, Wang, Jinyang
• Format: Article
• Language: English
• Subjects: Accuracy; Aged; Angiography; Arteries; Bifurcations; Biology and Life Sciences; Blood flow; Blood Flow Velocity; Cardiology; Cardiovascular disease; Circulatory system; Clinical outcomes; Computed tomography; Computer applications; Computer Simulation; Coronary Angiography; Coronary artery; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - pathology; Coronary Stenosis - physiopathology; Coronary vessels; Coronary Vessels - diagnostic imaging; Coronary Vessels - pathology; Coronary Vessels - physiopathology; Correlation analysis; Curvature; Female; Flow velocity; Fluid-structure interaction; Fractional Flow Reserve, Myocardial; Heart attacks; Heart surgery; Hemodynamics; Hospitals; Humans; Image Processing, Computer-Assisted; Image reconstruction; Intervention; Ischemia; Lesions; Male; Medical imaging; Medicine and Health Sciences; Middle Aged; Models, Cardiovascular; Patients; Physical Sciences; Shear stress; Stenosis; Stents; Stress, Mechanical; Studies; Three dimensional models; Wall shear stresses
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0157490

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.