The Association Between the Hemodynamics in Anomalous Origins of Coronary Arteries and Atherosclerosis: A Preliminary Case Study Based on Computational Fluid Dynamics

被引:0
作者
Wei, Yuhao [1 ,2 ]
Cao, Haoyao [1 ,2 ]
Zheng, Tinghui [1 ,3 ]
机构
[1] Sichuan Univ, Coll Architecture & Environm, Dept Mech & Engn, Chengdu 610065, Peoples R China
[2] Sichuan Univ Yibin Pk, Yibin Inst Ind Technol, Yibin 644000, Peoples R China
[3] Sichuan Univ, Medx Ctr Informat, Chengdu 610041, Peoples R China
来源
BIOENGINEERING-BASEL | 2024年 / 11卷 / 12期
基金
中国国家自然科学基金;
关键词
anomalous origin of coronary arteries (AOCA); atherosclerosis; hemodynamics; computational fluid dynamics;
D O I
10.3390/bioengineering11121196
中图分类号
Q81 [生物工程学(生物技术)]; Q93 [微生物学];
学科分类号
071005 ; 0836 ; 090102 ; 100705 ;
摘要
Patients with anomalous coronary artery origins (AOCA) exhibit a higher risk of atherosclerosis, where even minimal stenosis may lead to adverse cardiovascular events. However, the factors contributing to this heightened risk in AOCA patients remain unclear. This study aimed to investigate whether an AOCA patient is more prone to stenosis occurrence and its progression in view of hemodynamics. A patient whose left circumflex artery originated from the right coronary sinus with a mild stenosis in the left anterior descending (LAD) artery and a healthy individual were included in this study. Two additional models were developed by removing stenosis from the patient model and adding a corresponding stenosis to the healthy model. Additionally, the inlet flow waveforms for the left and right coronary arteries were swapped in both the patient and healthy models. Results indicated that the AOCA patient without stenosis demonstrated higher wall pressure (LAD: 95.57 +/- 0.73 vs. 93.86 +/- 0.50 mmHg; LCX: 94.97 +/- 0.98 vs. 93.47 +/- 0.56 mmHg; RCA: 96.23 +/- 0.30 vs. 93.86 +/- 0.46 mmHg) and TAWSS (LAD: 24.41 +/- 19.53 vs. 13.82 +/- 9.87 dyne/cm(2), p < 0.0001; LCX: 27.21 +/- 14.51 vs. 19.33 +/- 8.78 dyne/cm(2)) compared to the healthy individual, with similar trends also observed in stenotic conditions. Significant changes in the LCX flow distribution were also noted under varying pulsatile conditions (LCX: 18.28% vs. 9.16%) compared to the healthy individual. The high-pressure, high-shear hemodynamic environment in AOCA patients predisposes them to atherosclerosis, and the unique geometry exacerbates hemodynamic abnormalities when stenosis occurs. Clinicians should closely monitor AOCA patients with stenosis to prevent adverse cardiovascular events.
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页数:14
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  • [1] Angelini P., Coronary artery anomalies—An entity in search of an identity, Circulation, 115, pp. 1296-1305, (2007)
  • [2] Angelini P., Novel Imaging of Coronary Artery Anomalies to Assess Their Prevalence, the Causes of Clinical Symptoms, and the Risk of Sudden Cardiac Death, Circ.-Cardiovasc. Imaging, 7, pp. 747-754, (2014)
  • [3] Zhang L.J., Yang G.F., Huang W., Zhou C.S., Chen P., Lu G.M., Incidence of anomalous origin of coronary artery in 1879 Chinese adults on dual-source CT angiography, Neth. Heart J, 18, pp. 466-470, (2010)
  • [4] Yuan S.M., Anomalous origin of coronary artery: Taxonomy and clinical implication, Rev. Bras. Cir. Cardiovasc, 29, pp. 622-629, (2014)
  • [5] Corrado D., Pennelli T., Piovesana P.G., Thiene G., Anomalous origin of the left circumflex coronary-artery from the right aortic sinus of valsalva and sudden-death, Cardiovasc. Pathol, 3, pp. 269-271, (1994)
  • [6] Basso C., Maron B.J., Corrado D., Thiene G., Clinical profile of congenital coronary artery anomalies with origin from the wrong aortic sinus leading to sudden death in young competitive athletes, J. Am. Coll. Cardiol, 35, pp. 1493-1501, (2000)
  • [7] Harris M.A., Whitehead K.K., Shin D.C., Keller M.S., Weinberg P.M., Fogel M.A., Identifying Abnormal Ostial Morphology in Anomalous Aortic Origin of a Coronary Artery, Ann. Thorac. Surg, 100, pp. 174-180, (2015)
  • [8] Wasilewski J., Czaja-Ziolkowska M.Z., Gasior M., The site-specific distribution of atheromatous plaques in the coronary arteries, Postep. W Kardiol. Interwencyjnej, 19, pp. 195-201, (2023)
  • [9] Ikeda N., Hayashi T., Gen S., Joki N., Aramaki K., Coronary artery lesion distribution in patients with chronic kidney disease undergoing percutaneous coronary intervention, Ren. Fail, 44, pp. 1098-1103, (2022)
  • [10] Bax A.M., Lin F.Y., van Rosendael A.R., Ma X., Lu Y., van den Hoogen I.J., Gianni U., Tantawy S.W., Andreini D., Budoff M.J., Et al., Marked variation in atherosclerotic plaque progression between the major epicardial coronary arteries, Eur. Heart J. Cardiovasc. Imaging, 23, pp. 1482-1491, (2022)