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Updated: Sep 12, 2025
Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
High-intensity helical flow: a double-edged sword in coronary artery haemodynamics
Chi Shen1, Mingzi Zhang1,2, Hamed Keramati1
1School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, New South Wales, Australia.
Insights
Helical flow in coronary arteries influences blood flow patterns. This study reveals helical flow can both reduce protective low shear stress and increase harmful high shear stress, impacting atherosclerosis development and plaque vulnerability.
Area of Science:
- Cardiovascular Science
- Biomedical Engineering
- Hemodynamics
Background:
- The role of helical blood flow in human coronary arteries is not fully understood.
- Helical flow's impact on atherosclerosis and cardiovascular events requires further investigation.
Purpose of the Study:
- To investigate the effects of helical flow and hemodynamic descriptors in patient-specific coronary arteries.
- To analyze the relationship between helical flow intensity and endothelial shear stress in stenosed and non-stenosed arteries.
Main Methods:
- Utilized the Automated Segmentation of Coronary Arteries (ASOCA) dataset.
- Analyzed 39 patient-specific left coronary artery trees (20 non-stenosed, 19 stenosed).
- Correlated absolute helical flow intensity (h2) with time-averaged endothelial shear stress (TAESS).
Main Results:
- Higher helical flow intensity (h2) correlated with increased TAESS in all segments, irrespective of stenosis.
- In stenosed arteries, high h2 regions were associated with reduced areas of low TAESS (<0.5 Pa) and increased areas of high TAESS (>4.71 Pa).
- Helical flow's influence on TAESS patterns was significant in both non-stenosed and stenosed coronary arteries.
Conclusions:
- Helical flow in coronary arteries is not uniformly protective against atherosclerosis.
- It can mitigate low TAESS linked to plaque development but also exacerbate high TAESS associated with plaque vulnerability and acute events.
- Findings redefine the understanding of helical blood flow's role in cardiovascular atherosclerotic disease.
Abstract:
The role of helical flow in human coronary arteries remains uncertain, yet its understanding promises unprecedented insights into atherosclerotic processes. In this study, we investigated the effects of helical flow and key haemodynamic descriptors in 39 patient-specific left coronary artery trees of the Automated Segmentation of Coronary Arteries (ASOCA) dataset: 20 non-stenosed and 19 stenosed. Absolute helical flow intensity h 2 correlated with higher time-averaged endothelial shear stress in all vessel segments regardless of stenoses ( ). In stenosed cases, this correlation was so prominent that the vessel area exposed to adversely low time-averaged endothelial shear stress reduced (less than 0.5 Pa ), and simultaneously, areas of adversely high time-averaged endothelial shear stress increased (greater than 4.71 Pa, ) coinciding with high h 2 regions. This suggests that helical flow in coronaries is not always protective, as previously thought, because it not only mitigates low time-averaged endothelial shear stress associated with long-term plaque development and restenosis but also exacerbates adversely high time-averaged endothelial shear stress linked to increased plaque vulnerability and even acute events. Our findings redefined the current understanding of the role of helical blood flow in cardiovascular atherosclerotic disease processes.
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