Hemodynamics in Coronary Arterial Tree of Serial Stenoses

PLoS One. 2016 Sep 29;11(9):e0163715. doi: 10.1371/journal.pone.0163715. eCollection 2016.

Abstract

Serial segmental narrowing frequently occurs in humans, which alters coronary hemodynamics and further affects atherosclerotic progression and plaque formation. The objective of this study was to understand the distribution of hemodynamic parameters in the epicardial left main coronary arterial (LMCA) tree with serial stenoses reconstructed from patient computer tomography angiography (CTA) images. A finite volume method was used in conjunction with the inlet pressure wave and outlet flow resistance. The time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI) were determined from the flow field. A stenosis at a mother vessel mainly deteriorated the hemodynamics near the bifurcation while a stenosis at a daughter vessel affected the remote downstream bifurcation. In comparison with a single stenosis, serial stenoses increased the peak pressure gradient along the main trunk of the epicardial left anterior descending arterial tree by > 50%. An increased distance between serial stenoses further increased the peak pressure gradient. These findings have important implications on the diagnosis and treatment of serial coronary stenoses.

Grants and funding

This research is supported in part by the Natural Science Foundation of China Grant 11372010 (YH) and the China MOST Grant 2014DFG32740 (YH) and the Singapore BMRC Grant 1215c013 (LZ) and the Postdoctoral Science Foundation of China 2014M550009 (XC). The California Medical Innovations Institute provided support in the form of salaries for authors (GSK), but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.