Impact of asymmetric stenosis and heart rate on the left coronary artery hemodynamics in elderly patients: a 3D computational study.

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Asif Equbal, Paragmoni Kalita, Farhin Iqbal
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引用次数: 0

Abstract

The left coronary main (LCM) artery and its branches, particularly the left anterior descending (LAD) artery, are highly prone to atherosclerosis, especially as arterial stiffness increases with age. Irregularities in arterial geometry further contribute to the development of asymmetric plaques, underscoring the importance of three-dimensional (3D) hemodynamic studies, which remain limited in literature. Moreover, no existing research explores how hemodynamic variables change with different heart rates in the presence of asymmetric plaque in LAD, which is essential for assessing the disease severity and progression. To address this gap, our study conducts a 3D numerical analysis of the hemodynamic effects of heart rate (HR) and degree of stenosis (DOS) with asymmetric plaques in the LAD branch. The hemodynamic parameters - primary velocityVp, time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and relative residence time (RRT) - are analyzed to correlate HR and DOS with disease progression and severity. Analysis based on all these hemodynamic variables reveals that the atheroprone regions on the outer lateral walls expand as the DOS increases for a given HR. Conversely, such regions shrink in size as the HR increases for fixed DOS. While the inner lateral walls are safe in terms of OSI and RRT, they remain atheroprone due to alarmingly low TAWSS, especially at 75% DOS. At 45% DOS, TAWSS exceeds the upper-critical limit of 15 Pa at 120 beats per minute (bpm), making the branch thrombosis-prone. At 60% and 75% DOS, the thrombosis threshold is crossed at 100 bpm and at 75 bpm, respectively. Based on the threshold values, TAWSS is found to be a more conservative marker for assessing cardiovascular risks associated with these plaques compared to OSI and RRT.

不对称狭窄和心率对老年患者左冠状动脉血流动力学的影响:3D计算研究。
左冠状动脉主干(LCM)及其分支,特别是左前降支(LAD)动脉,极易发生动脉粥样硬化,特别是随着年龄的增长,动脉硬度增加。动脉几何形状的不规则进一步促进了不对称斑块的发展,强调了三维(3D)血流动力学研究的重要性,这在文献中仍然有限。此外,尚无研究探讨不对称斑块存在时血流动力学变量随不同心率的变化,而不对称斑块是评估疾病严重程度和进展所必需的。为了解决这一空白,我们的研究对LAD分支不对称斑块对心率(HR)和狭窄程度(DOS)的血流动力学影响进行了三维数值分析。血流动力学参数-主要流速,时间平均壁剪切应力(TAWSS),振荡剪切指数(OSI)和相对停留时间(RRT) -分析HR和DOS与疾病进展和严重程度的相关性。基于所有这些血流动力学变量的分析表明,对于给定HR,外侧壁的动脉粥样硬化区随着DOS的增加而扩大。相反,对于固定DOS,这些区域的大小随着HR的增加而缩小。虽然内侧壁在OSI和RRT方面是安全的,但由于TAWSS低得惊人,特别是在75% DOS时,它们仍然是动脉粥样硬化性的。在45% DOS时,TAWSS在每分钟120次(bpm)时超过15 Pa的上临界值,使分支容易血栓形成。在60%和75% DOS时,血栓形成阈值分别在100 bpm和75 bpm时越过。基于阈值,与OSI和RRT相比,TAWSS是评估与这些斑块相关的心血管风险的更保守的标志物。
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
Biomedical Physics & Engineering Express
Biomedical Physics & Engineering Express RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
2.80
自引率
0.00%
发文量
153
期刊介绍: BPEX is an inclusive, international, multidisciplinary journal devoted to publishing new research on any application of physics and/or engineering in medicine and/or biology. Characterized by a broad geographical coverage and a fast-track peer-review process, relevant topics include all aspects of biophysics, medical physics and biomedical engineering. Papers that are almost entirely clinical or biological in their focus are not suitable. The journal has an emphasis on publishing interdisciplinary work and bringing research fields together, encompassing experimental, theoretical and computational work.
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