Effects of Vessel Tortuosity on Coronary Hemodynamics: An Idealized and Patient-Specific Computational Study

Area of Science:

• Cardiovascular physiology
• Biomedical engineering
• Computational fluid dynamics

Background:

• Coronary artery tortuosity's effect on hemodynamics is understudied due to undefined metrics and lack of patient-specific complete coronary tree analyses.
• Existing research lacks a comprehensive understanding of how tortuosity influences coronary blood flow parameters.

Purpose of the Study:

• To investigate the impact of coronary artery tortuosity on hemodynamics using computational modeling.
• To analyze pressure drop, wall shear stress, and helical flow strength in relation to tortuosity.
• To compare findings from idealized versus patient-specific coronary geometries.

Main Methods:

• Utilized a computational approach to simulate blood flow in both idealized and patient-specific coronary artery models.
• Quantified coronary flow parameters including pressure drop, wall shear stress, and helicity intensity.
• Incorporated patient-specific geometric data, including heart shape-induced curvature.

Main Results:

• Increased tortuosity correlated with decreased perfusion pressure in overall analysis.
• Patient-specific models showed higher physiological wall shear stress with increased tortuosity.
• A strong correlation was found between tortuosity and helicity intensity, with helical flow increasing wall shear stress.

Conclusions:

• Accurate coronary tortuosity assessment requires patient-specific models accounting for all geometric factors.
• Helicity intensity may serve as a universal parameter for describing tortuosity and its health impacts.
• Increased tortuosity may reduce perfusion pressure but offer atherosclerosis protection via elevated wall shear stress.