Computational Fluid Dynamics Simulations of Hemodynamics in Plaque Erosion.
Computational Fluid Dynamics Simulations of Hemodynamics in Plaque Erosion.
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DOI：
10.1007/s13239-013-0165-3
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发表时间：
2013-12
影响因子：
1.8
通讯作者：
Oshinski, John N
中科院分区：
文献类型：
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作者：
Campbell, Ian C;Timmins, Lucas H;Giddens, Don P;Virmani, Renu;Veneziani, Alessandro;Rab, S Tanveer;Samady, Habib;McDaniel, Michael C;Finn, Aloke V;Taylor, W Robert;Oshinski, John N
我们调查了局部血流动力学是否与斑块侵蚀部位有关，并假设斑块侵蚀患者在发生斑块侵蚀的区域局部WSS升高。我们从光学相干断层扫描(OCT)诊断为斑块侵蚀的3名人类患者的双平面血管造影图像中生成了针对患者的3D冠状动脉模型。应用计算流体力学模拟脉动血流，计算壁面切应力(WSS)和振荡切变指数(OSI)。我们也研究了斑块侵蚀部位的解剖学特征，通过检查x射线血管造影中的分支和局部曲率。平均WSS的高低与斑块侵蚀部位无关。OSI和局部曲率也与侵蚀无关。解剖学上，13个心脏中有8个在斑块侵蚀部位上游附近有分叉。根据一个非常独特的数据集，这项研究提供了初步证据，表明血流动力学和解剖学都不是斑块侵蚀的预测因子。我们的样本量很小，但这个数据集表明，高水平的壁面剪应力是导致斑块侵蚀的一个潜在机制，并不是发生侵蚀所必需的。
We investigated whether local hemodynamics were associated with sites of plaque erosion and hypothesized that patients with plaque erosion have locally elevated WSS magnitude in regions where erosion has occurred. We generated 3D, patient-specific models of coronary arteries from biplane angiographic images in 3 human patients with plaque erosion diagnosed by optical coherence tomography (OCT). Using computational fluid dynamics, we simulated pulsatile blood flow and calculated both wall shear stress (WSS) and oscillatory shear index (OSI). We also investigated anatomic features of plaque erosion sites by examining branching and local curvature in x-ray angiograms of barium-perfused autopsy hearts. Neither high nor low magnitudes of mean WSS were associated with sites of plaque erosion. OSI and local curvature were also not associated with erosion. Anatomically, 8 of 13 hearts had a nearby bifurcation upstream of the site of plaque erosion. This study provides preliminary evidence that neither hemodynamics nor anatomy are predictors of plaque erosion, based upon a very unique dataset. Our sample sizes are small, but this dataset suggests that high magnitudes of wall shear stress, one potential mechanism for inducing plaque erosion, are not necessary for erosion to occur.