Nguyen Thach, Ngo Khiem, Vu Tri Loc, Nguyen Hien Q, Pham Dat H, Kodenchery Mihas, Zuin Marco, Rigatelli Gianluca, Nanjundappa Aravinda, Gibson Michael
Cardiovascular Research Laboratories, Methodist Hospital, Merrillville, IN 46410, USA.
School of Medicine, Tan Tao University, Duc Hoa 82000, Long An, Vietnam.
Diagnostics (Basel). 2024 Jun 17;14(12):1282. doi: 10.3390/diagnostics14121282.
In the study of coronary artery disease (CAD), the mechanism of plaque formation and development is still an important subject for investigation. A limitation of current coronary angiography (CAG) is that it can only show static images of the narrowing of arterial channels without identifying the mechanism of the disease or predicting its progression or regression. To address this limitation, the CAG technique has been modified. The new approach emphasizes identifying and analyzing blood flow patterns, employing methodologies akin to those used by hydraulic engineers for fluid or gas movement through domestic or industrial pipes and pumps. With the new technique, various flow patterns and arterial phenomena-such as laminar, turbulent, antegrade, retrograde, and recirculating flow and potentially water hammer shock and vortex formation-are identified, recorded, and classified. These phenomena are then correlated with the presence of lesions at different locations within the coronary vasculature. The formation and growth of these lesions are explained from the perspective of fluid mechanics. As the pathophysiology of CAD and other cardiovascular conditions becomes clearer, new medical, surgical, and interventional treatments could be developed to reverse abnormal coronary flow dynamics and restore laminar flow, leading to improved clinical outcomes.
在冠状动脉疾病(CAD)的研究中,斑块形成和发展的机制仍然是一个重要的研究课题。当前冠状动脉造影(CAG)的一个局限性在于,它只能显示动脉通道狭窄的静态图像,而无法识别疾病机制或预测其进展或消退。为了解决这一局限性,CAG技术已被改进。新方法强调识别和分析血流模式,采用类似于水利工程师用于流体或气体在家庭或工业管道及泵中流动的方法。通过新技术,识别、记录并分类了各种血流模式和动脉现象,如层流、湍流、顺行、逆行和再循环血流,以及潜在的水锤冲击和涡流形成。然后将这些现象与冠状动脉血管系统内不同位置的病变存在情况相关联。从流体力学的角度解释了这些病变的形成和生长。随着CAD和其他心血管疾病的病理生理学变得更加清晰,可以开发新的医学、外科和介入治疗方法来逆转异常的冠状动脉血流动力学并恢复层流,从而改善临床结果。