Yang Yang, Liu Xin, Xia Yufa, Liu Xin, Wu Wanqing, Xiong Huahua, Zhang Heye, Xu Lin, Wong Kelvin K L, Ouyang Hanbin, Huang Wenhua
School of Basic Medical Science, Southern Medical University, Guangzhou, Guangdong, China.
Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangzhou, Guangdong, China.
Sci Rep. 2017 Nov 13;7(1):15452. doi: 10.1038/s41598-017-15620-1.
Cardiovascular disease has been the major cause of death worldwide. Although the initiation and progression mechanism of the atherosclerosis are similar, the stenotic characteristics and the corresponding medical decisions are different between individuals. In the present study, we performed anatomic and hemodynamic analysis on 8 left coronary arterial trees with 10 identified stenoses. A novel boundary condition method had been implemented for fast computational fluid dynamics simulations and patient-specific three-dimensional printed models had been built for visualizations. Our results suggested that the multiple spatial characteristics (curvature of the culprit vessel multiplied by an angle of the culprit's vessel to the upstream parent branch) could be an index of hemodynamics significance (r = -0.673, P-value = 0.033). and reduction of the maximum velocity from stenosis to downstream was found correlated to the FFRCT (r = 0.480, p = 0.160). In addition, 3D printed models could provide accurate replicas of the patient-specific left coronary arterial trees compare to virtual 3D models (r = 0.987, P-value < 0.001). Therefore, the visualization of the 3D printed models could help understand the spatial distribution of the stenoses and the hand-held experience could potentially benefit the educating and preparing of medical strategies.
心血管疾病一直是全球主要的死亡原因。尽管动脉粥样硬化的起始和进展机制相似，但个体之间的狭窄特征和相应的医疗决策却有所不同。在本研究中，我们对8个左冠状动脉树进行了解剖和血流动力学分析，其中有10处已确定的狭窄。一种新颖的边界条件方法已被用于快速计算流体动力学模拟，并且已经构建了针对患者的三维打印模型用于可视化。我们的结果表明，多个空间特征（罪犯血管的曲率乘以罪犯血管与上游母支的夹角）可能是血流动力学意义的一个指标（r = -0.673，P值 = 0.033）。并且发现从狭窄处到下游的最大速度降低与FFRCT相关（r = 0.480，p = 0.160）。此外，与虚拟三维模型相比，三维打印模型可以提供针对患者的左冠状动脉树的精确复制品（r = 0.987，P值 < 0.001）。因此，三维打印模型的可视化有助于理解狭窄的空间分布，并且手持体验可能对医疗策略的教育和准备有潜在益处。
