Peng Changnong, Wang Xiaoqing, Xian Zhanchao, Liu Xin, Huang Wenhua, Xu Pengcheng, Wang Jinyang
Department of Cardiology, Shenzhen Sun Yat-Sen cardiovascular hospital, Shenzhen 518112, China.
Research center for biomedical information technology, Shenzhen institute of advance technology, Chinese academic of science, Shenzhen 518055, China.
PLoS One. 2016 Jun 16;11(6):e0157490. doi: 10.1371/journal.pone.0157490. eCollection 2016.
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.
由患者特异性几何特征导致的冠状动脉血流动力学改变是复杂的。狭窄对血流改变的影响已有大量报道,但几何因素的综合作用需要进行全面研究,以便为诊断提供患者特异性信息并辅助制定进一步的治疗策略。在本研究中,我们调查了患者特异性冠状动脉中血流动力学参数与个体几何因素之间的相关性。对基于计算机断层扫描血管造影图像重建的22个患者特异性三维冠状动脉模型进行了计算流体动力学模拟。我们的结果表明,狭窄严重程度的增加与狭窄区域最大壁面切应力的增加相关(r = 0.752,P < 0.001)。相比之下,再循环区的长度与病变段的曲率(r = 0.505,P = 0.019)和病变长度(r = 0.527,P = 0.064)有中等程度的关联。此外,冠状动脉分叉与再循环的发生显著相关,而远端狭窄的严重程度对上游分叉处的血流改变有影响。这些发现可为治疗规划提供参考并辅助预后评估。