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Accuracy of vascular tortuosity measures using computational modelling.

Vishesh Kashyap¹, Ramtin Gharleghi², Darson D Li³

¹Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, USA.

Scientific Reports

|January 18, 2022

Summary

The average absolute curvature best measures coronary artery tortuosity and its link to low wall shear stress (WSS). This finding helps clarify the relationship between vessel shape and cardiovascular health.

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Area of Science:

Cardiovascular research
Biomedical engineering
Medical imaging analysis

Background:

Coronary artery tortuosity is linked to low wall shear stress (WSS), a factor in cardiovascular disease.
Previous studies have yielded ambiguous findings due to varied tortuosity metrics used.
A standardized metric is needed to accurately assess the relationship between coronary artery shape and WSS.

Purpose of the Study:

To identify the most reliable tortuosity metric that correlates with low time-averaged WSS (TAWSS).
To establish a benchmark metric for future research on coronary artery tortuosity and hemodynamics.

Main Methods:

Utilized Computed Tomography Coronary Angiogram (CTCA) data from 127 patients without coronary artery disease.
Applied four tortuosity metrics: tortuosity index, average absolute curvature, RMS curvature, and average squared-derivative curvature.
Modeled TAWSS using computational fluid dynamics (CFD) and correlated metrics with areas of low TAWSS (<0.4 Pa).

Main Results:

Curvature-based tortuosity measures showed stronger correlations with low TAWSS than non-curvature-based measures.
Average absolute curvature demonstrated the highest coefficient of determination (p < 0.001) across all analyzed coronary branches.
The widely used tortuosity index showed no significant correlation with low TAWSS (p = 0.86).

Conclusions:

Average absolute curvature is recommended as the preferred metric for quantifying coronary artery tortuosity in relation to TAWSS.
This standardized approach can improve the understanding of hemodynamics in non-diseased coronary arteries.
Accurate tortuosity assessment may aid in identifying individuals at higher risk for cardiovascular disease.