scholarly journals Effect of compliance and hematocrit on wall shear stress in a model of the entire coronary arterial tree

2009 ◽  
Vol 107 (2) ◽  
pp. 500-505 ◽  
Author(s):  
Yunlong Huo ◽  
Ghassan S. Kassab

A hemodynamic analysis is implemented in the entire coronary arterial tree of diastolically arrested, vasodilated pig heart that takes into account vessel compliance and blood viscosity in each vessel of a large-scale simulation involving millions of vessels. The feed hematocrit (Hct) is varied at the inlet of the coronary arterial tree, and the Fahraeus-Lindqvist effect and phase separation are considered throughout the vasculature. The major findings are as follows: 1) vessel compliance is the major determinant of nonlinearity of the pressure-flow relation, and 2) changes in Hct influence wall shear stress (WSS) in epicardial coronary arteries more significantly than in transmural and perfusion arterioles because of the Fahraeus-Lindqvist effect. The present study predicts the flow rate as a second-order polynomial function of inlet pressure due to vessel compliance. WSS in epicardial coronary arteries increases >15% with an increase of feed Hct from 45% to 60% and decreases >15% with a decrease of feed Hct from 45% to 30%, whereas WSS in small arterioles is not affected as feed Hct changes in this range. These findings have important implications for acute Hct changes under vasodilated conditions.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yu-Fang Hsieh ◽  
Chih-Kuo Lee ◽  
Weichung Wang ◽  
Yu-Cheng Huang ◽  
Wen-Jeng Lee ◽  
...  

AbstractThis study aims to apply a CCTA-derived territory-based patient-specific estimation of boundary conditions for coronary artery fractional flow reserve (FFR) and wall shear stress (WSS) simulation. The non-invasive simulation can help diagnose the significance of coronary stenosis and the likelihood of myocardial ischemia. FFR is often regarded as the gold standard to evaluate the functional significance of stenosis in coronary arteries. In another aspect, proximal wall shear stress ($$\mathrm{{WSS}_{prox}}$$ WSS prox ) can also be an indicator of plaque vulnerability. During the simulation process, the mass flow rate of the blood in coronary arteries is one of the most important boundary conditions. This study utilized the myocardium territory to estimate and allocate the mass flow rate. 20 patients are included in this study. From the knowledge of anatomical information of coronary arteries and the myocardium, the territory-based FFR and the $$\mathrm{{WSS}_{prox}}$$ WSS prox can both be derived from fluid dynamics simulations. Applying the threshold of distinguishing between significant and non-significant stenosis, the territory-based method can reach the accuracy, sensitivity, and specificity of 0.88, 0.90, and 0.80, respectively. For significantly stenotic cases ($$\mathrm{FFR}_{m}$$ FFR m $$\le$$ ≤ 0.80), the vessels usually have higher wall shear stress in the proximal region of the lesion.


Author(s):  
Karol Calò ◽  
Giuseppe De Nisco ◽  
Diego Gallo ◽  
Claudio Chiastra ◽  
Ayla Hoogendoorn ◽  
...  

Atherosclerosis at the early stage in coronary arteries has been associated with low cycle-average wall shear stress magnitude. However, parallel to the identification of an established active role for low wall shear stress in the onset/progression of the atherosclerotic disease, a weak association between lesions localization and low/oscillatory wall shear stress has been observed. In the attempt to fully identify the wall shear stress phenotype triggering early atherosclerosis in coronary arteries, this exploratory study aims at enriching the characterization of wall shear stress emerging features combining correlation-based analysis and complex networks theory with computational hemodynamics. The final goal is the characterization of the spatiotemporal and topological heterogeneity of wall shear stress waveforms along the cardiac cycle. In detail, here time-histories of wall shear stress magnitude and wall shear stress projection along the main flow direction and orthogonal to it (a measure of wall shear stress multidirectionality) are analyzed in a representative dataset of 10 left anterior descending pig coronary artery computational hemodynamics models. Among the main findings, we report that the proposed analysis quantitatively demonstrates that the model-specific inlet flow-rate shapes wall shear stress time-histories. Moreover, it emerges that a combined effect of low wall shear stress magnitude and of the shape of the wall shear stress–based descriptors time-histories could trigger atherosclerosis at its earliest stage. The findings of this work suggest for new experiments to provide a clearer determination of the wall shear stress phenotype which is at the basis of the so-called arterial hemodynamic risk hypothesis in coronary arteries.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E M J Hartman ◽  
A M Kok ◽  
A Hoogendoorn ◽  
F J H Gijsen ◽  
A F W Steen ◽  
...  

Abstract Introduction Local wall shear stress (WSS) metrics, high local lipid levels (as detected by near-infrared spectroscopy (NIRS)), as well as systemic lipid levels, have been individually associated with atherosclerotic disease progression. However, a possible synergistic effect remains to be elucidated. This study is the first study to combine WSS metrics with NIRS-detected local lipid content to investigate a potential synergistic effect on plaque progression in human coronary arteries. Methods The IMPACT study is a prospective, single centre study investigating the relation between atherosclerotic plaque progression and WSS in human coronary arteries. Patients with ACS treated with PCI were included. At baseline and after 1-year follow-up, patients underwent near-infrared spectroscopy intravascular ultrasound (NIRS-IVUS) imaging and intravascular doppler flow measurements of at least one non-culprit coronary artery. After one month, a CT angiography was made. CT derived centreline combined with IVUS lumen contours resulted in a 3D reconstruction of the vessel. The following WSS metrics were computed using computational fluid dynamics applying the vessel specific invasive flow measurements: time-average wall shear stress (TAWSS), relative residence time (RRT), cross-flow index, oscillatory shear index and transverse wall shear stress. Low TAWSS is known as pro atherogenic, in contrast to all the other shear stress metrics, at which a high magnitude is pro-atherogenic. The arteries were divided into 1.5mm/45° sectors. Based on NIRS-IVUS, wall thickness change over time was determined and NIRS positive sectors detected. Furthermore, per vessel the shear stress was divided into tertiles (low, intermediate, high). To investigate the synergistic effect of local lipids on shear stress related plaque growth, wall thickness change over time was related to the different shear stress metrics comparing the NIRS-positive with the NIRS-negative sectors. Results 15 non-culprit coronary arteries from the first 14 patients were analyzed (age 62±10 years old and 92.9% male). A total of 2219 sectors were studied (5.2%, N=130, NIRS-positive) for wall thickness changes. After studying all five shear stress metrics, we found for TAWSS and RRT that presence of lipids, as detected by NIRS, amplified the effect of shear stress on plaque progression (see figure). Sectors presenting with lipid-rich plaque, compared to NIRS-negative sectors, showed more progression when they were exposed to low TAWSS (p=0.07) or high RRT (p=0.012) and more regression in sectors exposed to high TAWSS (p=0.10) or low RRT (p=0.06). Delta wall thickness vs shear stress Conclusion We presented the first preliminary results of the IMPACT study, showing the synergistic effect of lipid rich plaque and shear stress on plaque progression. Therefore, intravascular lipid-rich plaque (NIRS) assessment has added value to shear stress profiling for the prediction of plaque growth, leading to improved risk stratification. Acknowledgement/Funding ERC starting grant 310457


2016 ◽  
Vol 11 (10) ◽  
pp. 1779-1790 ◽  
Author(s):  
Guillaume Zahnd ◽  
Jelle Schrauwen ◽  
Antonios Karanasos ◽  
Evelyn Regar ◽  
Wiro Niessen ◽  
...  

2015 ◽  
Vol 14 (Suppl 1) ◽  
pp. S2 ◽  
Author(s):  
David S Molony ◽  
Lucas H Timmins ◽  
Olivia Y Hung ◽  
Emad Rasoul-Arzrumly ◽  
Habib Samady ◽  
...  

2019 ◽  
Vol 131 (2) ◽  
pp. 442-452 ◽  
Author(s):  
Alexandra Lauric ◽  
James E. Hippelheuser ◽  
Adel M. Malek

OBJECTIVEEndothelium adapts to wall shear stress (WSS) and is functionally sensitive to positive (aneurysmogenic) and negative (protective) spatial WSS gradients (WSSG) in regions of accelerating and decelerating flow, respectively. Positive WSSG causes endothelial migration, apoptosis, and aneurysmal extracellular remodeling. Given the association of wide branching angles with aneurysm presence, the authors evaluated the effect of bifurcation geometry on local apical hemodynamics.METHODSComputational fluid dynamics simulations were performed on parametric bifurcation models with increasing angles having: 1) symmetrical geometry (bifurcation angle 60°–180°), 2) asymmetrical geometry (daughter angles 30°/60° and 30°/90°), and 3) curved parent vessel (bifurcation angles 60°–120°), all at baseline and double flow rate. Time-dependent and time-averaged apical WSS and WSSG were analyzed. Results were validated on patient-derived models.RESULTSNarrow symmetrical bifurcations are characterized by protective negative apical WSSG, with a switch to aneurysmogenic WSSG occurring at angles ≥ 85°. Asymmetrical bifurcations develop positive WSSG on the more obtuse daughter branch. A curved parent vessel leads to positive apical WSSG on the side corresponding to the outer curve. All simulations revealed wider apical area coverage by higher WSS and positive WSSG magnitudes, with increased bifurcation angle and higher flow rate. Flow rate did not affect the angle threshold of 85°, past which positive WSSG occurs. In curved models, high flow displaced the impingement area away from the apex, in a dynamic fashion and in an angle-dependent manner.CONCLUSIONSApical shear forces and spatial gradients are highly dependent on bifurcation and inflow vessel geometry. The development of aneurysmogenic positive WSSG as a function of angular geometry provides a mechanotransductive link for the association of wide bifurcations and aneurysm development. These results suggest therapeutic strategies aimed at altering underlying unfavorable geometry and deciphering the molecular endothelial response to shear gradients in a bid to disrupt the associated aneurysmal degeneration.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Anna Starikov ◽  
Guanglei Xiong ◽  
James K Min

Introduction: The ability to detect hemodynamically significant coronary artery disease non-invasively has been a goal that has the potential to improve patient care significantly. New non-invasive approaches using coronary CT angiograms (CCTAs) have been proposed and appear to show some promise. Hypothesis: One such method is the measurement of measuring wall shear stress (WSS), the tangential force of flowing blood against the artery wall, using computational fluid dynamics (CFD). However, in order to deem this technique useful in clinical practice, the normal values must first be defined. These values have been minimally reported and are limited to the left coronary tree. Methods: We ran a CFD simulation of WSS on 3-D reconstructions of the coronary arteries derived from the CCTAs of 35 patients with either no disease or non-obstructive (< 50%) stenosis from the DeFACTO trial, a multi-center study. The resulting model was segmented according to the Society of Cardiovascular CT guidelines, separating the proximal and distal parts of each artery as well as the major side branches. The segments were composed of WSS values at hundreds of points along the vessel wall. The median value was taken as a representative of each segment. Results: The average values were calculated and varied significantly from one another, especially the proximal and distal parts of the same artery, as showing in Figure 1. Conclusions: These results establish the first known WSS distribution within all of the coronary arteries and serve as a foundation for defining a cut-off for abnormal values. Importantly, they also illuminate the variability of WSS that occurs even throughout a single artery and suggests that perhaps multiple abnormal cutoffs need to be established to evaluate WSS based on the location of the stenosis.


Author(s):  
Navid Freidoonimehr ◽  
Rey Chin ◽  
Anthony C. Zander ◽  
Maziar Arjomandi

Abstract Temporal variations of the coronary arteries during a cardiac cycle are defined as the superposition of the changes in the position, curvature, and torsion of the coronary artery axis markers and the variations in the lumen cross-sectional shape due to the distensible wall motion induced by the pulse pressure and contraction of the myocardium in a cardiac cycle. This review discusses whether the modelling the temporal variations of the coronary arteries is needed for the investigation of the hemodynamics specifically in time critical applications such as a clinical environment. The numerical modellings in the literature which model or disregard the temporal variations of the coronary arteries on the hemodynamic parameters are discussed. The results in the literature show that neglecting the effects of temporal geometric variations is expected to result in about 5\% deviation of the time-averaged pressure drop and wall shear stress values and also about 20\% deviation of the temporal variations of hemodynamic parameters, such as time-dependent wall shear stress and oscillatory shear index. This review study can be considered as a guide for the future studies to outline the conditions in which temporal variations of the coronary arteries can be neglected, while providing a reliable estimation of hemodynamic parameters.


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