Primary stenosis progression versus secondary stenosis formation in the left coronary bifurcation: a mechanical point of view

Jahromi, R ; Sharif University of Technology | 2019

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  1. Type of Document: Article
  2. DOI: 10.1016/j.bbe.2018.11.006
  3. Publisher: Elsevier Sp. z o.o , 2019
  4. Abstract:
  5. Biomechanical forces and hemodynamic factors influence the blood flow and the endothelial cells (ECs) morphology. These factors behave differently beyond the coronary artery stenosis. In the present study, unsteady blood flow in the left coronary artery (LCA) and its atherosclerotic bifurcating vessels, left anterior descending (LAD) and left circumflex (LCX) arteries, were numerically simulated to investigate the risk of plaque length development and secondary plaque formation in the post-stenotic areas. Using fluid–structure interaction (FSI) model, compliance of arterial wall and vessel curvature variations due to cardiac motion were considered. The arteries included plaques at the beginning of the bifurcation. Stenosis degree varied from 40% to 70% based on diameter reduction. Healthy coronary artery was also reconstructed to compare with the atherosclerotic arteries. Circumferential and longitudinal strains of ECs as well as wall shear stress (WSS) were computed in different locations downstream of the stenosis. It was concluded that the most critical regions experiencing low circumferential strain and low WSS were located proximal to the plaque throat, and the effects of these parameters intensified by stenosis degree. The results proposed that primary plaque length progression is more probable than secondary plaque formation distal to the stenosis when the stenosis degree increases. © 2018 Nalecz Institute of Biocybernetics and Biomedical Engineering of the Polish Academy of Sciences
  6. Keywords:
  7. Coronary arteries ; Fluid–structure interaction ; Stenosis ; Strain ; Wall shear stress ; Aortic bifurcation ; Artery wall ; Biomedical engineering ; Cell count ; Clinical observation ; Comparative study ; Coronary artery atherosclerosis ; Coronary artery obstruction ; Disease course ; Endothelium cell ; Heart cycle ; Heart movement ; Left coronary artery ; Priority journal ; Shear stress ; Simulation ; Systolic blood pressure
  8. Source: Biocybernetics and Biomedical Engineering ; Volume 39, Issue 1 , 2019 , Pages 188-198 ; 02085216 (ISSN)
  9. URL: https://www.sciencedirect.com/science/article/abs/pii/S0208521618302730