Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University, GPO Box, U1987, Perth, Western Australia 6845, Australia.
Phys Med. 2013 Sep;29(5):447-52. doi: 10.1016/j.ejmp.2013.02.001. Epub 2013 Mar 1.
This study investigates the hemodynamic changes to various types of coronary stenosis in the left coronary artery bifurcation, based on a patient-specific analysis. Twenty two patients with left coronary artery disease were included in this study. All stenoses involving the left coronary artery bifurcation were classified into four types, according to their locations: A) left circumflex (LCx) and left anterior descending (LAD), B) LCx only, C) left main stem only, and D) LAD only. Computational fluid dynamics (CFD) was performed to analyze the flow and wall shear stress (WSS) changes in all reconstructed left coronary geometries. Our results showed that the flow velocity and WSS were significantly increased at stenotic locations. High WSS was found at >70% lumen stenosis, which ranged from 2.5 Pa to 3.5 Pa. This study demonstrates that in patients with more than 50% stenosis in the left coronary artery bifurcation, WSS plays an important role in providing information about the extent of coronary atherosclerosis in the left coronary artery branch.
本研究基于患者个体分析,探讨了左冠状动脉分叉处不同类型的冠状动脉狭窄的血液动力学变化。本研究纳入了 22 名左冠状动脉疾病患者。所有涉及左冠状动脉分叉处的狭窄均根据其位置分为以下四种类型:A)回旋支(LCx)和前降支(LAD)、B)仅 LCx、C)仅左主干、D)仅 LAD。通过计算流体动力学(CFD)分析所有重建的左冠状动脉几何形状的流量和壁面剪切应力(WSS)变化。我们的结果表明,狭窄部位的血流速度和 WSS 显著增加。在>70%管腔狭窄处发现了高 WSS,范围为 2.5 Pa 至 3.5 Pa。本研究表明,在左冠状动脉分叉处有>50%狭窄的患者中,WSS 在提供左冠状动脉分支中冠状动脉粥样硬化程度的信息方面发挥着重要作用。