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Haemodynamic analysis of the effect of different types of plaques in the left coronary artery
Thanapong Chaichana1, Zhonghua Sun, James Jewkes
1Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University, Perth, Western Australia 6845, Australia.
Insights
This study examined how different coronary plaque configurations affect blood flow dynamics in the left coronary bifurcation. Plaques involving all three branches or located in the left circumflex artery caused the most significant hemodynamic changes.
Area of Science:
- Cardiovascular physiology
- Biomedical engineering
- Medical imaging
Background:
- Coronary plaque composition influences blood parameters.
- Hemodynamic variations due to plaque configuration remain understudied.
- Understanding plaque effects on coronary blood flow is crucial for atherosclerosis research.
Purpose of the Study:
- To investigate the hemodynamic effects of various plaque configurations in the left coronary bifurcation.
- To analyze how different plaque types and locations impact coronary blood flow dynamics.
- To provide insights into the relationship between plaque distribution and hemodynamic alterations.
Main Methods:
- Simulated eight types of plaque configurations in the left main stem, left anterior descending, and left circumflex arteries.
- Utilized computational fluid dynamics (CFD) to model realistic cardiac hemodynamics.
- Calculated and compared velocity, wall shear stress (WSS), and pressure gradient (PSG) across cardiac cycles for each configuration.
Main Results:
- The plaque configuration involving all three left coronary branches exhibited the highest velocity and pressure gradient (PSG).
- Plaques in the left circumflex branch induced highly significant changes in velocity, WSS, and PSG (p<0.001).
- Specific plaque locations and configurations markedly alter coronary hemodynamic parameters.
Conclusions:
- The study offers insights into plaque distribution at the left coronary bifurcation and its hemodynamic consequences.
- Findings enhance the understanding of atherosclerosis by correlating plaque morphology with blood flow alterations.
- This research can inform future diagnostic and therapeutic strategies for coronary artery disease.
Purpose:
Coronary plaque has been shown to directly affect the blood parameters, however, haemodynamic variations based on the plaque configuration has not been studied. In this study we investigate the haemodynamic effects of various types of plaques in the left coronary bifurcation.
Methods:
Eight types of plaque configurations were simulated and located in various positions in the left main stem, the left anterior descending and left circumflex to produce a >50% narrowing of the coronary lumen. We analyse and characterise haemodynamic effects caused by each type of plaque. Computational fluid dynamics was performed to simulate realistic physiological conditions that reveal the in vivo cardiac haemodynamics. Velocity, wall shear stress (WSS) and pressure gradient (PSG) in the left coronary artery were calculated and compared in all plaque configurations during cardiac cycles.
Results:
Our results showed that the highest velocity and PSG were found in the type of plaque configuration which involved all of the three left coronary branches. Plaques located in the left circumflex branch resulted in highly significant changes of the velocity, WSS and PSG (p<0.001) when compared to the other types of plaque configurations.
Conclusion:
Our analysis provides an insight into the distribution of plaque at the left bifurcation, and corresponding haemodynamic effects, thus, improving our understanding of atherosclerosis.
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