Hemodynamic analysis of patient‐specific coronary artery tree

JM Zhang, T Luo, SY Tan, AM Lomarda… - … journal for numerical …, 2015 - Wiley Online Library
JM Zhang, T Luo, SY Tan, AM Lomarda, ASL Wong, FYJ Keng, JC Allen, Y Huo, B Su
International journal for numerical methods in biomedical engineering, 2015Wiley Online Library
Local hemodynamic parameters, such as wall shear stress (WSS), oscillatory shear index
and relative resident time (RRT), have been linked to coronary plaque initiation and
progression. In this study, a left coronary artery tree model was reconstructed from computed
tomography angiography images of a patient with multiple stenoses. The geometry of the
coronary artery tree model was virtually restored by eliminating the lesions, essentially re‐
creating the virtually healthy artery anatomy. Using numerical simulations, flow …
Summary
Local hemodynamic parameters, such as wall shear stress (WSS), oscillatory shear index and relative resident time (RRT), have been linked to coronary plaque initiation and progression. In this study, a left coronary artery tree model was reconstructed from computed tomography angiography images of a patient with multiple stenoses. The geometry of the coronary artery tree model was virtually restored by eliminating the lesions, essentially re‐creating the virtually healthy artery anatomy. Using numerical simulations, flow characteristics and hemodynamic parameter distributions in the stenosed and virtually healthy models were investigated. In the virtually healthy artery model, disturbed flows were found at four locations, prone to initialization of plaque formation. Low WSS and high RRT were exhibited in three of the four locations, and high WSS and low RRT were exhibited in the fourth. These findings suggest that coronary plaque is more likely to form in locations with disturbed flow conditions characterized by low WSS and high RRT or high WSS and low RRT. In addition, clinical index of fractional flow reserve was found to significantly correlate with blood flow rate, rather than anatomic parameters, such as diameter stenosis, which implied the importance of hemodynamic environment in stenosis formation. Copyright © 2015 John Wiley & Sons, Ltd.
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