Institute of Science and Innovation in Mechanical and Industrial Engineering (INEGI), Engineering Faculty, University of Porto, Rua Dr. Roberto Frias s/n, 4200 - 465, Porto, Portugal.
Cardiovascular R&D Unit, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
Med Biol Eng Comput. 2019 Mar;57(3):715-729. doi: 10.1007/s11517-018-1904-2. Epub 2018 Oct 24.
The hemodynamics conditioned by coronary geometry may play an important role in the creation of a pro-atherogenic environment in specific locations of the coronary tree. The aim of this study is to identify how several geometric parameters of the left coronary artery - cross-section areas, proximal left anterior descending artery length, angles between the branches and the septum, curvature and tortuosity - can be related with hemodynamic descriptors, using a computational fluid-structure interaction method. It is widely accepted that the hemodynamic indicators play an important role in identifying possible pro-atherogenic locations. A statistical study, using Pearson correlation coefficient and P value, was performed for a population study of 8 normal human left coronary arteries presenting right-dominant circulation. Within the study cases, arteries with high caliber (r = 0.88), high angles (r = 0.49), (r = 0.57) and (r = 0.52), and high tortuosity (r = 0.63) were correlated with a hemodynamic behavior propitious to plaque formation in the left anterior descending artery. In contrast, high proximal left anterior descending artery length (r = -0.41), high angle (r = -0.59), high tortuosity (r = -0.56) and (r = -0.55) and high curvature of LMS (r = -0.60) and LCx (r = -0.56) can lead to non-favorable hemodynamic conditions for atheroma formation. Graphical abstract.
冠状动脉几何形状所决定的血液动力学可能在冠状动脉树特定部位的促动脉粥样硬化环境的形成中发挥重要作用。本研究的目的是使用计算流体-结构相互作用方法来确定左冠状动脉的几个几何参数-横截面积、左前降支近段长度、分支与间隔之间的角度、曲率和扭曲度-如何与血液动力学描述符相关。人们普遍认为,血液动力学指标在识别可能的促动脉粥样硬化部位方面发挥着重要作用。对具有右优势循环的 8 例正常人类左冠状动脉的人群研究进行了统计学研究,使用 Pearson 相关系数和 P 值。在研究病例中,具有大口径(r=0.88)、大角度(r=0.49)、(r=0.57)和(r=0.52)以及高扭曲度(r=0.63)的动脉与左前降支有利于斑块形成的血液动力学行为相关。相比之下,具有较长的左前降支近段长度(r=-0.41)、大角度(r=-0.59)、高扭曲度(r=-0.56)和(r=-0.55)以及较高的 LMS(r=-0.60)和 LCx(r=-0.56)的曲率会导致动脉粥样硬化形成的非有利血液动力学条件。示意图。