Evaluation of endothelial shear stress and 3D geometry as factors determining the development of atherosclerosis and remodeling in human coronary arteries in vivo - Combining 3D reconstruction from angiography and IVUS (ANGUS) with computational fluid dynamics
Evaluation of endothelial shear stress and 3D geometry as factors determining the development of atherosclerosis and remodeling in human coronary arteries in vivo - Combining 3D reconstruction from angiography and IVUS (ANGUS) with computational fluid dynamics
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DOI：
10.1161/01.atv.17.10.2061
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发表时间：
1997-10-01
影响因子：
8.7
通讯作者：
Slager, CJ
中科院分区：
文献类型：
--
作者：
Krams, R;Wentzel, JJ;Slager, CJ
动脉粥样硬化斑块的好发部位与剪切应力等流变学因素有关。目前，没有技术是可用的，使一个提供三维剪切应力数据在人体冠状动脉在体内。在这项研究中，我们描述了一种新的技术，使用最近开发的三维重建技术计算内皮细胞上的剪切应力与计算流体动力学。此外，我们计算了局部壁厚，曲率的主平面，并参照该平面的斑块的位置，这些结果在人体右冠状动脉在体内的剪切应力。三种流入速度值下整个容器的壁厚和剪应力值（10厘米/秒、20厘米/秒和30厘米/秒当量，雷诺数为114、229和457）的速度分别为：0.65+/-0.37毫米（n=1600）和19.6+/-1.7达因/厘米（2）; 46.1+/-8.1达因/厘米（2）和80.1+/-16.8达因/厘米（2）（n=1600）。曲率为25+/-9（m（-1）），导致Dean数为20+/-8; 46+/-16和93+/-33。选择右冠状动脉内弯处的数据，得到的壁厚值为0.90+/-0.41 mm（n=100），剪切应力为17+/-17，38+/-44和77+/-54 dyne/cm（2）（n=100），而外曲线处的壁厚值为0.37 ± 0.17 mm（n=100），剪切应力值为22 ± 17、60 ± 44和107 ± 79 dyne/cm（2）（n=100）;这些发现可以通过研究中的每个速度水平的壁厚和剪切应力之间的反比关系来调和。首次在体内人体血管中发现低切应力促进动脉粥样硬化的证据。由于该方法是非破坏性的，它允许在同一患者中重复测量，并将为动脉粥样硬化的进展提供新的见解。
The predilection sites of atherosclerotic plaques implicate theologic factors like shear stress underlying the genesis of atherosclerosis. Presently no technique is available that enables one to provide 3D shear stress data in human coronary arteries in vivo. In this study, we describe a novel technique that uses a recently developed 3D reconstruction technique to calculate shear stress on the endothelium with computational fluid dynamics. In addition, we calculated local wall thickness, the principal plane of curvature, and the location of plaque with reference to this plane, relating these results to shear stress in a human right coronary artery in vivo. Wall thickness and shear stress values for the entire vessel for three inflow-velocity values (10 cm/second, 20 cm/second, and 30 cm/second equivalents with the Reynolds numbers 114, 229, and 457) were as follows: 0.65+/-0.37 mm (n=1600) and 19.6+/-1.7 dyne/cm(2); 46.1+/-8.1 dyne/cm(2) and 80.1+/-16.8 dyne/cm(2) (n=1600). Curvature was 25+/-9 (m(-1)), resulting in Dean numbers 20+/-8; 46+/-16, and 93+/-33. Selection of data at the inner curvature of the right coronary artery provided wall thickness values of 0.90+/-0.41 mm (n=100), and shear stress was 17+/-17, 38+/-44, and 77+/-54 dyne/cm(2) (n=100), whereas wall thickness values at the outer curve were 0.37+/-0.17 mm (n=100) and shear stress values were 22+/-17, 60+/-44, and 107+/-79 dyne/cm(2) (n=100); These findings could be reconciled by an inverse relationship between wall thickness and shear stress for each velocity level under study. For the first time for human vessels in vivo, evidence is presented that low shear stress promotes atherosclerosis. As the method is nondestructive, it allows repeated measurements in the same patient and will provide new insights in the progress of atherosclerosis.