FLOW PATTERNS AND SPATIAL-DISTRIBUTION OF ATHEROSCLEROTIC LESIONS IN HUMAN CORONARY-ARTERIES
FLOW PATTERNS AND SPATIAL-DISTRIBUTION OF ATHEROSCLEROTIC LESIONS IN HUMAN CORONARY-ARTERIES
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DOI：
10.1161/01.res.66.4.1045
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发表时间：
1990-04-01
影响因子：
20.1
通讯作者：
KARINO, T
中科院分区：
文献类型：
--
作者：
ASAKURA, T;KARINO, T
为探讨流体力学因素在人类动脉粥样硬化病变局部发生发展中的作用，应用血流显像法和高速摄影技术，对人左、右冠状动脉粥样硬化病变的精确解剖位置和血流模式进行了详细的研究。结果发现，左、右冠状动脉的动脉粥样硬化斑块和管壁增厚几乎都集中在主分叉和T形交界处一侧或双侧子血管的外壁，使分流管无病变，并沿弯曲段的内壁分布。当详细研究这类血管中的流型时，发现这些位置是流动缓慢或扰动的地方，形成了缓慢的回流和二次流，并且壁面剪应力很低。结果表明，与动脉粥样硬化斑块的定位和管壁增厚直接相关的主要血流动力学因素是低流速和由此产生的作用于管壁的低剪应力。
To investigate the potential role of fluid mechanical factors in the localized genesis and development of atherosclerotic lesions in humans, the exact anatomic locations of aherosclerotic lesions and the flow patterns at such sites in left and right human coronary arteries were studied in detail by flow visualization and high-speed cinemicrographic techniques using five isolated, transparent human coronary arterial trees prepared postmortem. It was found that atherosclerotic plaques and wall thickenings in left and right coronary arteries were localized almost exclusively on the outer wall of one or both daughter vessels at major difurcations and T-junctions, which left the flow-divider free of lesions, and along the inner wall of curved segments. When flow patterns in such vessels were studied in detail, it was discovered that these sites were where flow was either slow or disturbed with the formation of slow recirculation and secondary flows and where wall shear stress was low. The results indicate that the major hemodynamic factors directly related to the localization of atherosclerotic plaques and wall thickenings in the human arterial system are the low fluid velocity and the resultant low shear stress that acts on the vessel wall.