Blood flow patterns in patients with mild/moderate coronary serial stenosis: A Pilot study

Area of Science:

• Cardiovascular Medicine
• Biomedical Engineering
• Fluid Dynamics

Background:

• Coronary stenosis evaluation often overlooks flow disorders, particularly from serial plaques.
• Discrepancies between initial assessments and patient outcomes in mild/moderate stenosis are common.
• Understanding coronary blood flow patterns is crucial for risk stratification.

Purpose of the Study:

• To characterize coronary blood flow patterns in patients with varying clinical outcomes.
• To investigate the correlation between abnormal flow patterns and adverse events in coronary stenosis.
• To identify novel indicators for high-risk patients with mild/moderate coronary serial stenosis.

Main Methods:

• Established patient-specific coronary tree models from CT images.
• Quantified abnormal flow patterns using reverse zone volume and coefficients of variation.
• Analyzed Wall Shear Stress (WSS) topological skeleton to correlate flow with clinical outcomes.

Main Results:

• The adverse event (AE) group showed significantly more chaotic blood flow patterns.
• AE group exhibited higher cumulative reverse zone volume and coefficients of variation during the cardiac cycle.
• WSS vector analysis revealed spatiotemporal variations within reverse zones, linking flow abnormalities to outcomes.

Conclusions:

• Abnormal coronary blood flow patterns, especially chaotic flow and high reverse zone volume, are associated with adverse events.
• These flow characteristics may indicate plaque development and hemodynamic stress.
• Quantifying flow patterns offers a potential method for identifying high-risk patients with mild/moderate coronary serial stenosis.