Authors: M Malvè A M Gharib S K Yazdani G Finet M A Martínez R Pettigrew J Ohayon
Publish Date: 2014/07/02
Volume: 43, Issue: 1, Pages: 82-93
Abstract
The purpose of the present study was to determine whether in vivo bifurcation geometric factors would permit prediction of the risk of atherosclerosis It is worldwide accepted that low or oscillatory wall shear stress WSS is a robust hemodynamic factor in the development of atherosclerotic plaque and has a strong correlation with the local site of plaque deposition However it still remains unclear how coronary bifurcation geometries are correlated with such hemodynamic forces Computational fluid dynamics simulations were performed on left main LM coronary bifurcation geometries derived from CT of eight patients without significant atherosclerosis WSS amplitudes were accurately quantified at two high risk zones of atherosclerosis namely at proximal left anterior descending artery LAD and at proximal left circumflex artery LCx and also at three high WSS concentration sites near the bifurcation Statistical analysis was used to highlight relationships between WSS amplitudes calculated at these five zones of interest and various geometric factors The tortuosity index of the LMLAD segment appears to be an emergent geometric factor in determining the low WSS amplitude at proximal LAD Strong correlations were found between the high WSS amplitudes calculated at the endothelial regions close to the flow divider This study not only demonstrated that CT imaging studies of local risk factor for atherosclerosis could be clinically performed but also showed that tortuosity of LMLAD coronary branch could be used as a surrogate marker for the onset of atherosclerosis
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