Effect of Left and Right Coronary Flow Waveforms on Aortic Sinus Hemodynamics and Leaflet Shear Stress: Correlation with Calcification Locations

被引：12

作者：

Flemister, Dorma C. ^{[1
]}

Hatoum, Hoda ^{[2
,3
]}

Guhan, Varshini ^{[4
]}

Zebhi, Banafsheh ^{[5
]}

Lincoln, Joy ^{[6
]}

Crestanello, Juan ^{[7
]}

Dasi, Lakshmi P. ^{[2
]}

机构：

[1] Ohio State Univ, Dept Biomed Engn, Columbus, OH 43210 USA

[2] Georgia Inst Technol, Dept Biomed Engn, 387 Technol Circle, Atlanta, GA 30313 USA

[3] Michigan Technol Univ, Dept Biomed Engn, Houghton, MI 49931 USA

[4] Ohio State Univ, Dept Neurosci, Columbus, OH 43210 USA

[5] Colorado State Univ, Dept Mech Engn, Ft Collins, CO 80523 USA

[6] Childrens Hosp Wisconsin, Dept Pediat Cardiol, Milwaukee, WI 53201 USA

[7] Mayo Clin, Div Cardiac Surg, Rochester, MN USA

来源：

ANNALS OF BIOMEDICAL ENGINEERING | 2020年 / 48卷 / 12期

基金：

美国国家卫生研究院;

关键词：

Calcification; CAVD; Sinus flow; Left coronary; Right coronary; Non coronary; IN-VITRO;

D O I：

10.1007/s10439-020-02677-9

中图分类号：

R318 [生物医学工程];

学科分类号：

0831 ;

摘要：

Coronary flow induces hemodynamic alterations in the aortic sinus region. The objectives of this study are to: (1) investigate the differences among sinus hemodynamics and leaflet wall shear stresses engendered by the left versus right versus non-coronary flow and (2) correlate respective wall shear stresses with leaflet calcification in patients. A left heart simulator flow loop with a tunable coronary circuit provided physiological coronary flow waveforms corresponding to the left coronary cusp case (LCC), right coronary cusp case (RCC), and non-coronary cusp case (NCC). High spatio-temporal resolution particle image velocimetry was conducted to quantify leaflet wall shear stress and sinus vorticity fields and to measure aortic leaflet tip kinematics. Thirty-one patients with severe calcific aortic valve disease were segmented from CT data for the calcific volumes in their respective left, right, and non-coronary cusps. Leaflet tip position during systole shows the RCC has a wider leaflet opening compared to LCC and NCC. Velocity and vorticity fields combined with leaflet position data show that sinus vorticity is diminished (peak similar to 43 s(-1)) in the LCC while RCC and NCC maintain high vorticity (similar to 1200 and similar to 950 s(-1) respectively). WSS magnitudes greater than 0.3 Pa show 20 and 81% greater occurrences in the LCC and RCC respectively compared to NCC. Significant differences [X-2 (2, n = 31) = 7.31, p = 0.0258] between the calcification levels in each cusp of the patient population. Coronary flow differences between LCC, RCC, and NCC show significant impact on leaflet kinematics and sinus flow hemodynamics. Clinical data correlations of the coronary flow cases indicate the left coronary cusp has a higher likelihood of calcification compared to the right.

引用

页码：2796 / 2808

页数：13