Relative Residence Time Can Account for Half of the Anatomical Variation in Fatty Streak Prevalence Within the Right Coronary Artery

IF 3 2区 医学 Q3 ENGINEERING, BIOMEDICAL
Pratik Kandangwa, Kevin Cheng, Miten Patel, Spencer J. Sherwin, Ranil de Silva, Peter D. Weinberg
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Abstract

Purpose

The patchy anatomical distribution of atherosclerosis has been attributed to variation in haemodynamic wall shear stress (WSS). The consensus is that low WSS and a high Oscillatory Shear Index (OSI) trigger the disease. We found that atherosclerosis at aortic branch sites correlates threefold better with transverse WSS (transWSS), a metric which quantifies multidirectional near-wall flow. Coronary artery disease has greater clinical significance than aortic disease but computation of WSS metrics is complicated by the substantial vessel motion occurring during each cardiac cycle. Here we present the first comparison of the distribution of atherosclerosis with WSS metrics computed for moving coronary arteries.

Methods

Maps of WSS metrics were computed using dynamic geometries reconstructed from angiograms of ten non-stenosed human right coronary arteries (RCAs). They were compared with maps of fatty streak prevalence derived from a previous study of 1852 RCAs.

Results

Time average WSS (TAWSS), OSI, transWSS and the cross-flow index (CFI), a non-dimensional form of the transWSS, gave non-significant or significant but low spatial correlations with lesion prevalence. The highest correlation coefficient (0.71) was for the relative residence time (RRT), a metric that decreases with TAWSS and increases with OSI. The coefficient was not changed if RRT was calculated using CFI, which captures multidirectional WSS only, rather than OSI, which encompasses both multidirectional and oscillatory WSS.

Conclusion

Contrary to our earlier findings in the aorta, low WSS in combination with highly multidirectional flow correlates best with lesion location in the RCA, explaining approximately half of its anatomical variation.

Abstract Image

相对停留时间可解释右冠状动脉内脂肪条纹发生率的一半解剖学差异
目的 动脉粥样硬化的斑块状解剖分布是由于血流动力学壁剪切应力(WSS)的变化造成的。目前的共识是,低 WSS 和高振荡剪切指数(OSI)会诱发动脉粥样硬化。我们发现,主动脉分支部位的动脉粥样硬化与横向壁剪应力(transWSS)的相关性要好三倍,而横向壁剪应力是一种量化多向近壁流动的指标。冠状动脉疾病的临床意义大于主动脉疾病,但由于每个心动周期中都会发生大量的血管运动,因此计算 WSS 指标非常复杂。在此,我们首次将动脉粥样硬化的分布情况与移动冠状动脉的 WSS 指标进行了比较。方法使用从 10 条未闭合的人体右冠状动脉(RCA)血管造影中重建的动态几何图形计算 WSS 指标图。结果时间平均 WSS(TAWSS)、OSI、反向 WSS 和横流指数(CFI,反向 WSS 的一种非维度形式)与病变发生率的空间相关性不显著或显著但较低。相关系数最高(0.71)的是相对停留时间(RRT),该指标随 TAWSS 的降低而降低,随 OSI 的升高而升高。结论与我们之前在主动脉中的发现相反,低 WSS 与高度多向流结合与 RCA 病变位置的相关性最好,约占其解剖变化的一半。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Biomedical Engineering
Annals of Biomedical Engineering 工程技术-工程:生物医学
CiteScore
7.50
自引率
15.80%
发文量
212
审稿时长
3 months
期刊介绍: Annals of Biomedical Engineering is an official journal of the Biomedical Engineering Society, publishing original articles in the major fields of bioengineering and biomedical engineering. The Annals is an interdisciplinary and international journal with the aim to highlight integrated approaches to the solutions of biological and biomedical problems.
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