Lee B K, Kwon H M, Kim D, Yoon Y W, Seo J K, Kim I J, Roh H W, Suh S H, Yoo S S, Kim H S
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 1998 Apr;39(2):166-74. doi: 10.3349/ymj.1998.39.2.166.
The objectives of this investigation were to evaluate biomechanical factors in the atherosclerotic process using human in vivo hemodynamic parameters and computed numerical simulation qualitatively and quantitatively. The three-dimensional spatial patterns of steady and pulsatile flows in the left coronary artery were simulated, using a finite volume method. Coronary angiogram and Doppler ultrasound measurement of the proximal left coronary flow velocity were performed in humans. Inlet wave velocity distribution obtained from in vivo data of the intravascular Doppler study allowed for input of in vitro numerical simulation. Hemodynamic variables, such as flow velocity, pressure and shear stress of the left anterior descending coronary bifurcation site were calculated. We found that there were spatial fluctuation of flow-velocity and recirculation areas at the curved outer wall of the left anterior descending coronary artery, which were due to the differences of flow-velocity and shear stress, especially during the declaration phase of pulsatile flow. This study suggests that rheologic properties may be a part of the atherogenic process in the coronary bifurcated and curved areas.
本研究的目的是使用人体体内血流动力学参数和计算机数值模拟，定性和定量地评估动脉粥样硬化过程中的生物力学因素。采用有限体积法模拟了左冠状动脉中稳定流和脉动流的三维空间模式。在人体中进行了冠状动脉造影和左冠状动脉近端血流速度的多普勒超声测量。从血管内多普勒研究的体内数据获得的入口波速度分布允许输入体外数值模拟。计算了左前降支冠状动脉分叉部位的血流动力学变量，如流速､压力和剪切应力。我们发现，在左前降支冠状动脉的弯曲外壁处存在流速的空间波动和回流区域，这是由于流速和剪切应力的差异所致，尤其是在脉动流的舒张期。本研究表明，流变学特性可能是冠状动脉分叉和弯曲区域动脉粥样硬化形成过程的一部分。
