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Updated: Dec 28, 2025
Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
The impact of helical flow on coronary atherosclerotic plaque development
Giuseppe De Nisco1, Ayla Hoogendoorn2, Claudio Chiastra1
1PoliTo(BIO)Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129, Turin, Italy.
Insights
Helical flow (HF) in coronary arteries protects against atherosclerotic plaque growth. Higher HF intensity correlates with lower wall thickness increase, suggesting HF as a potential atherosclerosis risk marker.
Area of Science:
- Cardiovascular research
- Biomedical engineering
- Medical imaging
Background:
- Atherosclerosis is linked to near-wall hemodynamics and wall shear stress (WSS).
- The role of coronary intravascular helical flow (HF) in atherosclerosis is understudied.
- Physiological HF patterns may influence plaque development.
Purpose of the Study:
- To investigate the impact of HF on coronary plaque initiation and progression.
- To demonstrate the atheroprotective nature of HF in coronary arteries.
- To correlate HF patterns with changes in arterial wall thickness.
Main Methods:
- Coronary arteries of hypercholesterolemic mini-pigs were imaged using CCTA and IVUS over 9.4 months.
- Computational fluid dynamic simulations were performed using baseline geometries and in vivo blood flow data.
- Local wall thickness (WT) changes were assessed and compared with computed HF and WSS descriptors.
Main Results:
- HF intensity showed a strong positive association with WSS magnitude (p < 0.001).
- Coronary segments with high baseline HF intensity exhibited significantly lower WT growth (p < 0.05).
- Regions with higher HF intensity were protected against atherosclerotic WT increase.
Conclusions:
- HF plays a significant physiological role in coronary arteries.
- HF demonstrates an atheroprotective effect against atherosclerotic WT growth.
- In vivo measurement of coronary HF could serve as a novel atherosclerosis risk marker.
Background And Aims:
Atherosclerosis has been associated with near-wall hemodynamics and wall shear stress (WSS). However, the role of coronary intravascular hemodynamics, in particular of the helical flow (HF) patterns that physiologically develop in those arteries, is rarely considered. The purpose of this study was to assess how HF affects coronary plaque initiation and progression, definitively demonstrating its atheroprotective nature.
Methods:
The three main coronary arteries of five adult hypercholesterolemic mini-pigs on a high fat diet were imaged by computed coronary tomography angiography (CCTA) and intravascular ultrasound (IVUS) at 3 (T1, baseline) and 9.4 ± 1.9 (T2) months follow-up. The baseline geometries of imaged coronary arteries (n = 15) were reconstructed, and combined with pig-specific boundary conditions (based on in vivo Doppler blood flow measurements) to perform computational fluid dynamic simulations. Local wall thickness (WT) was measured on IVUS images at T1 and T2, and its temporal changes were assessed. Descriptors of HF and WSS nature were computed for each model, and statistically compared to WT data.
Results:
HF intensity was strongly positively associated with WSS magnitude (p < 0.001). Overall, coronary segments exposed to high baseline levels of HF intensity exhibited a significantly lower WT growth (p < 0.05), compared to regions with either mid or low HF intensity.
Conclusions:
This study confirms the physiological significance of HF in coronary arteries, revealing its protective role against atherosclerotic WT growth and its potential in predicting regions undergoing WT development. These findings support future in vivo measurement of coronary HF as atherosclerotic risk marker, overcoming current limitations of in vivo WSS assessment.
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