Wall shear stress on LDL accumulation in human RCAs

Johannes V Soulis1, Dimitrios K Fytanidis, Vassilios C Papaioannou

  • 1Fluid Mechanics Division, Faculty of Engineering, Demokrition University of Thrace, Vas. Sofias 12, 67100 Xanthi, Greece. jvsoulis@med.auth.gr

Insights

This study reveals that low wall shear stress (WSS) in arteries correlates with elevated low-density lipoprotein (LDL) concentrations, a key factor in atherosclerosis development. Understanding this relationship is crucial for predicting disease progression.

Area of Science:

  • Cardiovascular Science
  • Biomedical Engineering
  • Computational Fluid Dynamics

Background:

  • Atherosclerosis development is linked to blood flow patterns and molecule transport in the cardiovascular system.
  • Specific arterial regions with altered hemodynamics and high lipoprotein concentrations are prone to atherosclerosis.
  • The arterial wall's semi-permeable nature and its dependence on wall shear stress are critical factors.

Purpose of the Study:

  • To computationally model low-density lipoprotein (LDL) transport in diseased human coronary arteries.
  • To investigate the relationship between wall shear stress (WSS) and LDL concentration at the arterial wall.
  • To assess the impact of shear-dependent endothelial permeability on LDL transport.

Main Methods:

  • Utilized image-based 3D reconstructions of six diseased human right coronary arteries (RCAs) from angiography and IVUS.
  • Employed numerical simulations coupling fluid dynamics and transport equations with realistic boundary conditions.
  • Incorporated the Kedem-Katchalsky equation to model endothelial water infiltration and solute dynamics.

Main Results:

  • Luminal surface LDL concentration was found to be flow-dependent and varied with arterial geometry.
  • A medium correlation (Pearson) was observed between low WSS and elevated LDL concentrations.
  • Shear-dependent water infiltration significantly impacted LDL elevation, with area-averaged normalized LDL concentration increasing by 9.6% compared to constant infiltration.

Conclusions:

  • Low WSS is a significant factor in elevated LDL concentrations at the arterial wall, contributing to atherosclerosis.
  • Computational fluid dynamics models incorporating LDL transport must consider shear-dependent endothelial permeability for accurate predictions.
  • The water infiltration velocity at the vessel wall is a primary driver of LDL concentration elevation.

Related Concept Videos

Atherosclerosis I: Introduction01:30

Atherosclerosis I: Introduction

Atherosclerosis is a progressive disorder characterized by the buildup of plaques on the arterial inner wall, causing them to narrow and harden over time. These plaques comprise lipids, calcium, blood components, carbohydrates, and fibrous tissue. The process primarily affects the intima of large and medium-sized arteries, reducing blood flow in any artery.Etiology and risk factorsThe cause of atherosclerosis is multifactorial, involving a complex interplay among endothelial injury, lipid...
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
Inflammation01:38

Inflammation

Overview
Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
Cholesterol: Significance and Regulation01:29

Cholesterol: Significance and Regulation

Although not a source of energy, cholesterol plays a significant role as a foundational structure for bile salts, steroid hormones, and vitamin D, as well as being a crucial component of plasma membranes. Approximately 15% of blood cholesterol is derived from our diet, with the remainder synthesized from acetyl CoA by the liver and intestines. Cholesterol is eliminated from the body through its conversion into bile salts, which are eventually discarded in the feces.
Considering cholesterol and...