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Computational fluid dynamic measures of wall shear stress are related to coronary lesion characteristics

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Author(s)
Hyun Jin KimJonghanne ParkJi-Hyun JungMin-Ho LeeHiromasa OtakeJoon-Hyung DohChang-Wook NamEun-Seok ShinBernard De BruyneCharles A TaylorBon-Kwon KooGilwoo ChoiEun Ju ChunJun-Bean Park
Keimyung Author(s)
Nam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
Heart
Issued Date
2016
Volume
102
Issue
20
Abstract
Objective. To assess the distribution of pressure and shear-related forces acting on atherosclerotic plaques and their association with lesion characteristics using coronary CT angiography (cCTA)-based computational fluid dynamics (CFD) model of epicardial coronary arteries.
Methods. Patient-specific models of epicardial coronary arteries were reconstructed from cCTA in 80 patients (12 women, 63.8±9.0 years). The pressure and wall shear stress (WSS) in left anterior descending coronary arteries were assessed using CFD. High-risk plaques were defined as the presence of at least one of the following adverse plaque characteristics: low-density plaque, positive remodelling, napkin-ring sign and spotty calcification.
Results. At resting condition, 39.5% of stenotic segments (% diameter stenosis 52.3±14.4%) were exposed to high WSS (>40 dyne/cm2). When the stenotic lesion was subdivided into three segments, the distribution of WSS was different from that of pressure change and its magnitude was highest at minimal lumen area (p<0.001). High pressure gradient, proximal location, small lumen and short length were independent determinants of WSS (all p<0.05). The plaques exposed to the highest WSS tertile had a significantly greater proportion of high-risk plaques. The addition of WSS to % diameter stenosis significantly improved the measures of discrimination and reclassification of high-risk plaques (area under the curves from 0.540 to 0.718, p=0.031; net reclassification index 0.827, p<0.001).
Conclusions. The cCTA-based CFD method can improve the identification of high-risk plaques and the risk stratification for coronary artery disease patients by providing non-invasive measurements of WSS affecting coronary plaques.
Keimyung Author(s)(Kor)
남창욱
Publisher
School of Medicine
Citation
Hyun Jin Kim et al. (2016). Computational fluid dynamic measures of wall shear stress are related to coronary lesion characteristics. Heart, 102(20), 1655–1661. doi: 10.1136/heartjnl-2016-309299
Type
Article
ISSN
1355-6037
Source
http://heart.bmj.com/content/102/20/1655
DOI
10.1136/heartjnl-2016-309299
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32767
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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