Hemodynamic analysis of patient-specific coronary artery tree

Area of Science:

• Cardiovascular Research
• Biomedical Engineering
• Medical Imaging

Background:

• Local hemodynamic parameters like wall shear stress (WSS), oscillatory shear index, and relative resident time (RRT) are associated with coronary plaque development.
• Understanding the interplay between hemodynamics and plaque initiation is critical for cardiovascular disease research.

Purpose of the Study:

• To investigate blood flow characteristics and hemodynamic parameter distributions in both stenosed and virtually healthy coronary artery models.
• To identify specific hemodynamic conditions that promote coronary plaque initiation and progression.

Main Methods:

• Reconstruction of a left coronary artery tree model from computed tomography angiography images.
• Virtual restoration of the artery model to a healthy state by removing stenotic lesions.
• Numerical simulations to analyze flow patterns and hemodynamic parameters in both models.

Main Results:

• Disturbed blood flow was identified at four locations in the healthy artery model, correlating with plaque formation sites.
• Low WSS with high RRT, or high WSS with low RRT, were characteristic of these disturbed flow regions.
• Fractional flow reserve correlated significantly with blood flow rate, highlighting the importance of hemodynamic factors over anatomical stenosis.

Conclusions:

• Coronary plaque initiation is strongly associated with specific disturbed flow conditions (low WSS/high RRT or high WSS/low RRT).
• The hemodynamic environment plays a significant role in coronary stenosis formation, independent of anatomical measures alone.