The effect of aortic wall and aortic leaflet stiffening on coronary hemodynamic: a fluid-structure interaction study

Area of Science:

• Cardiovascular research
• Biomedical engineering
• Pathophysiology

Background:

• Aortic valve pathologies, such as aortic sclerosis, are clinically observed to influence coronary blood flow.
• Simultaneous structural and hemodynamic changes in the aortic valve and coronary arteries are noted in patients with regional aortic valve pathologies.

Purpose of the Study:

• To investigate the link between local aortic valve pathology and the initiation or progression of coronary artery disease.
• To elucidate the mechanisms by which aortic valve abnormalities affect coronary hemodynamics.

Main Methods:

• Computational modeling and simulation of aortic valve and coronary artery interactions.
• Analysis of the impact of aortic wall and leaflet stiffness and thickness on coronary flow dynamics.

Main Results:

• Increased aortic wall or leaflet stiffness and thickness significantly alter coronary flow, velocity profiles, and shear stress.
• A fractional flow reserve cutoff of 0.75 was observed when leaflet thickness and aortic wall stiffness were approximately double and triple normal values, respectively.
• Observed variations in coronary velocity profiles and wall shear stress suggest a potential pathway for coronary artery disease initiation.

Conclusions:

• Local aortic valve pathologies can have a considerable impact on coronary hemodynamics.
• Altered shear stress and flow patterns in coronary arteries due to aortic valve changes may contribute to the development of coronary artery disease.