The Influence of Aortic Valve Disease on Coronary Hemodynamics: A Computational Model-Based Study

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Xuanyu Li1, Sergey Simakov2, Youjun Liu3

  • 1Department of Engineering Mechanics, School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, Shanghai 200240, China.

Bioengineering (Basel, Switzerland)
|June 28, 2023
PubMed

Insights

Aortic valve stenosis (AS) may worsen coronary artery disease (CAD) by altering blood flow dynamics in coronary arteries. Aortic valve regurgitation (AR) had the opposite effect, highlighting distinct impacts of aortic valve disease on coronary artery health.

Area of Science:

  • Cardiovascular Medicine
  • Biomedical Engineering
  • Computational Fluid Dynamics

Background:

  • Aortic valve disease (AVD) and coronary artery disease (CAD) frequently coexist.
  • The precise relationship and hemodynamic mechanisms linking AVD and CAD remain unclear.

Purpose of the Study:

  • To develop a multi-scale modeling method to quantify the hemodynamic impact of aortic valve stenosis (AS) and aortic valve regurgitation (AR) on coronary arteries.
  • To investigate how AS and AR influence coronary artery hemodynamics, specifically wall shear stress and oscillatory shear index.

Main Methods:

  • A 0-3D multi-scale modeling approach was employed, integrating aortic valve dynamics, coronary artery hemodynamics, and systemic circulation.
  • Simulations were performed on patient-specific left anterior descending coronary arteries (LADs) under control, AS, and AR conditions.

Main Results:

  • Aortic valve stenosis significantly increased the space-averaged oscillatory shear index (SA-OSI) in LADs.
  • Aortic valve regurgitation led to a decrease in SA-OSI compared to the control condition.
  • AS primarily increased OSI by augmenting low-frequency components of the coronary flow waveform.

Conclusions:

  • Aortic valve stenosis may elevate the risk or progression of CAD by creating an unfavorable hemodynamic environment in coronary arteries.
  • The findings provide a mathematical tool for understanding AVD-CAD interactions and suggest AS as a potential contributor to CAD progression.

Keywords:
aortic valve diseasecoronary artery diseasehemodynamicsmulti-scale modeling

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