Comparison of left anterior descending coronary artery hemodynamics before and after angioplasty.
Comparison of left anterior descending coronary artery hemodynamics before and after angioplasty.
复制标题
冠状动脉左前降支血管成形术前后血流动力学比较。
DOI：
10.1115/1.2132371
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Chandran,KB
中科院分区：
文献类型：
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作者：
Ramaswamy,SD;Vigmostad,SC;Wahle,A;Lai,YG;Olszewski,ME;Braddy,KC;Brennan,TMH;Rossen,JD;Sonka,M;Chandran,KB
冠状动脉疾病（CAD）的特征是动脉粥样硬化的进展，这是一个涉及斑块的起始、沉积、发展和分解的复杂病理过程。动脉中的血流力学在动脉粥样硬化斑块的目标位置和进展中发挥着关键作用。在心脏收缩和舒张期间运动的冠状动脉中，血流动力学流场与其他容易发生动脉粥样硬化的动脉部位有很大不同。在这项研究中，我们的工作重点是动脉运动和局部几何形状对左前降支（LAD）冠状动脉在临床干预治疗该疾病之前和之后的血流动力学的影响。基于血管内超声 (IVUS) 和双平面血管造影图像的融合，在干预前后的心动周期 10 个阶段重建三维 (3D) 动脉段。任意拉格朗日-欧拉公式用于计算流体动力学分析。测量到的动脉平移在干预后的收缩期间观察到更大，并且在干预前观察到更多的平面外运动，表明血管成形术后心脏收缩发生了实质性改变。与干预前相比，时间平均轴向壁剪应力的变化范围。与干预后的情况相比，干预前的流动动力学中存在显着的振荡剪切应力。
Coronary artery disease (CAD) is characterized by the progression of atherosclerosis, a complex pathological process involving the initiation, deposition, development, and breakdown of the plaque. The blood flow mechanics in arteries play a critical role in the targeted locations and progression of atherosclerotic plaque. In coronary arteries with motion during the cardiac contraction and relaxation, the hemodynamic flow field is substantially different from the other arterial sites with predilection of atherosclerosis. In this study, our efforts focused on the effects of arterial motion and local geometry on the hemodynamics of a left anterior descending (LAD) coronary artery before and after clinical intervention to treat the disease. Three-dimensional (3D) arterial segments were reconstructed at 10 phases of the cardiac cycle for both pre- and postintervention based on the fusion of intravascular ultrasound (IVUS) and biplane angiographic images. An arbitrary Lagrangian-Eulerian formulation was used for the computational fluid dynamic analysis. The measured arterial translation was observed to be larger during systole after intervention and more out-of-plane motion was observed before intervention, indicating substantial alterations in the cardiac contraction after angioplasty. The time averaged axial wall shear stress ranged frombefore intervention compared toafter intervention. Substantial oscillatory shear stress was present in the preintervention flow dynamics compared to that in the postintervention case.