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Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
Correlations of coronary plaque wall thickness with wall pressure and wall pressure gradient: a representative case
Biyue Liu1, Jie Zheng, Richard Bach
1Department of Mathematics, Monmouth University, West Long Branch, NJ 07764, USA. bliu@monmouth.edu
Insights
Atherosclerosis plaque thickness negatively correlates with blood wall pressure (WP) and positively with wall pressure gradient (WPG). This study highlights the under-studied impact of blood pressure on plaque progression.
Area of Science:
- Cardiovascular research
- Biomedical engineering
- Medical physics
Background:
- Hemodynamic stresses at the blood-arterial wall interface include wall shear stress (WSS) and wall pressure (WP).
- While WSS in atherosclerosis is well-studied, the impact of WP on plaque progression remains under-investigated.
Purpose of the Study:
- To investigate the correlation between plaque wall thickness (WT) and hemodynamic factors, specifically wall pressure (WP) and wall pressure gradient (WPG).
- To analyze the relationship between these factors in a human atherosclerotic coronary artery.
Main Methods:
- Simulated pulsatile blood flow using a 3D mathematical model of a human coronary artery reconstructed from IVUS data.
- Treated blood as an incompressible, viscous, non-Newtonian fluid.
- Performed Pearson correlation analysis on averaged WT, WP, and WPG data across different arterial segments and slices.
Main Results:
- A significant negative correlation was found between WT and WP (r = -0.81, p < 0.0001) using slice-averaged analysis.
- A significant positive correlation was observed between WT and WPG (r = 0.45, p = 0.002) using slice-averaged analysis.
- Similar correlation coefficients were found for systolic and diastolic pressure conditions.
Conclusions:
- Plaque wall thickness demonstrates a strong negative linear relationship with wall pressure and a positive relationship with the wall pressure gradient.
- These findings suggest that blood pressure plays a significant role in atherosclerotic plaque development.
- Further large-scale patient studies are recommended to validate these results.
Background:
There are two major hemodynamic stresses imposed at the blood arterial wall interface by flowing blood: the wall shear stress (WSS) acting tangentially to the wall, and the wall pressure (WP) acting normally to the wall. The role of flow wall shear stress in atherosclerosis progression has been under intensive investigation, while the impact of blood pressure on plaque progression has been under-studied.
Method:
The correlations of wall thickness (WT) with wall pressure (WP, blood pressure on the lumen wall) and spatial wall pressure gradient (WPG) in a human atherosclerotic right coronary artery were studied. The pulsatile blood flow was simulated using a three dimensional mathematical model. The blood was treated as an incompressible viscous non-Newtonian fluid. The geometry of the artery was re-constructed using an in vivo intravascular ultrasound (IVUS) 44-slice dataset obtained from a patient with consent obtained. The WT, the WP and the WPG were averaged on each slice, respectively, and Pearson correlation analysis was performed on slice averaged base. Each slice was then divided into 8 segments and averaged vessel WT, WP and WPG were collected from all 352 segments for correlation analysis. Each slice was also divided into 2 segments (inner semi-wall of bend and outer semi-wall of bend) and the correlation analysis was performed on the 88 segments.
Results:
Under mean pressure, the Pearson coefficient for correlation between WT and WP was r = - 0.52 (p < 0.0001) by 2-segment analysis and r = - 0.81 (p < 0.0001) by slice averaged analysis, respectively. The Pearson coefficient for correlation between WT and WPG was r = 0.30 (p = 0.004) by 2-segment analysis and r = 0.45 (p = 0.002) by slice averaged analysis, respectively. The r-values corresponding to systole and diastole pressure conditions were similar.
Conclusions:
Results from this representative case report indicated that plaque wall thickness correlated negatively with wall pressure (r = -0.81 by slice) and positively with wall pressure gradient (r = 0.45). The slice averaged WT has a strong linear relationship with the slice averaged WP. Large-scale patient studies are needed to further confirm our findings.
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