Research Papers

Computation of Hemodynamics in Tortuous Left Coronary Artery: A Morphological Parametric Study

[+] Author and Article Information
Xinzhou Xie

Department of Electronic Engineering,
Fudan University,
Shanghai 200433, China
e-mail: 10110720031@fudan.edu.cn

Yuanyuan Wang

Department of Electronic Engineering,
Fudan University,
Shanghai 200433, China
Key Laboratory of Medical
Imaging Computing and Computer
Assisted Intervention of Shanghai,
Shanghai 200433, China
e-mail: yywang@fudan.edu.cn

Hongmin Zhu

Department of Cardiology,
Sixth People's Hospital,
Jiao Tong University,
Shanghai 200233, China
e-mail: zhm0004@163.com

Jingmin Zhou

Department of Cardiology,
Zhongshan Hospital,
Fudan University,
Shanghai 200032, China
e-mail: zhou.jingmin@zs-hospital.sh.cn

1Corresponding author.

Manuscript received March 26, 2014; final manuscript received July 14, 2014; accepted manuscript posted July 22, 2014; published online August 6, 2014. Assoc. Editor: Dalin Tang.

J Biomech Eng 136(10), 101006 (Aug 06, 2014) (8 pages) Paper No: BIO-14-1137; doi: 10.1115/1.4028052 History: Received March 26, 2014; Revised July 14, 2014; Accepted July 22, 2014

Coronary tortuosity (CT) would alter the local wall shear stress (WSS) and may become a risk factor for atherosclerosis. Here we performed a systematic computational study to relate CT morphological parameters to abnormal WSS, which is a predisposing factor to the formation of atherosclerotic lesions. Several idealized left coronary artery (LCA) models were created to conduct a series of morphological parametric studies, in which we concentrate on three specific morphological parameters, the center line radius (CLR), the bend angle (BA), and the length between two adjust bends (LBB). The time averaged WSS (TAWSS), the oscillatory shear index (OSI), and the time averaged WSS gradient (WSSGnd) were explored by using the computational fluid dynamics (CFD) method, in order to determine susceptible sites for the onset of early atherosclerosis. In addition, two realistic LCA models were reconstructed to further validate the finding's credibility. The CLR and LBB had great impact on the distributions of WSS-derived parameters, while the BA had minor impact on the hemodynamic of the tortuous arteries. Abnormal regions with low TAWSS (TAWSS < 0.5 Pa), high OSI (OSI > 0.1) and high WSSGnd (WSSGnd > 8) were observed at the inner wall of bend sections in the models with small CLR or small LBB. These findings were also confirmed in the realistic models. Severe CT with small CLR or LBB would lead to the formation of abnormal WSS regions at the bend sections and providing these regions with favorable conditions for the onset and/or progression of atherosclerosis.

Copyright © 2014 by ASME
Your Session has timed out. Please sign back in to continue.


Lloyd-Jones, D., Adams, R. J., Brown, T. M., Carnethon, M., Dai, S., De Simone, G., Ferguson, T. B., Ford, E., Furie, K., and Gillespie, C., 2010, “Heart Disease and Stroke Statistics—2010 Update: A Report from the American Heart Association,” Circulation, 121(7), pp. e46–e215. [CrossRef]
Zarins, C. K., Giddens, D. P., Bharadvaj, B., Sottiurai, V. S., Mabon, R. F., and Glagov, S., 1983, “Carotid Bifurcation Atherosclerosis. Quantitative Correlation of Plaque Localization With Flow Velocity Profiles and Wall Shear Stress,” Circ. Res., 53(4), pp. 502–514. [CrossRef]
Asakura, T., and Karino, T., 1990, “Flow Patterns and Spatial Distribution of Atherosclerotic Lesions in Human Coronary Arteries,” Circ. Res., 66(4), pp. 1045–1066. [CrossRef]
Zhu, H., Ding, Z., Piana, R. N., Gehrig, T. R., and Friedman, M. H., 2009, “Cataloguing the Geometry of the Human Coronary Arteries: A Potential Tool for Predicting Risk of Coronary Artery Disease,” Int. J. Cardiol., 135(1), pp. 43–52. [CrossRef]
Han, H. C., 2012, “Twisted Blood Vessels: Symptoms, Etiology and Biomechanical Mechanisms,” J. Vasc. Res., 49(3), pp. 185–197. [CrossRef]
Li, Y., Shen, C., Ji, Y., Feng, Y., Ma, G., and Liu, N., 2011, “Clinical Implication of Coronary Tortuosity in Patients With Coronary Artery Disease,” PloS One, 6(8), p. e24232. [CrossRef]
Qiao, A., Guo, X., Wu, S., Zeng, Y., and Xu, X., 2004, “Numerical Study of Nonlinear Pulsatile Flow in S-Shaped Curved Arteries,” Med. Eng. Phys., 26(7), pp. 545–552. [CrossRef]
Liu, Q., Mirc, D., and Fu, B. M., 2008, “Mechanical Mechanisms of Thrombosis in Intact Bent Microvessels of Rat Mesentery,” J. Biomech., 41(12), pp. 2726–2734. [CrossRef]
Grigioni, M., Daniele, C., Morbiducci, U., Del Gaudio, C., D'Avenio, G., Balducci, A., and Barbaro, V., 2005, “A Mathematical Description of Blood Spiral Flow in Vessels: Application to a Numerical Study of Flow in Arterial Bending,” J. Biomech., 38(7), pp. 1375–1386. [CrossRef]
Morbiducci, U., Ponzini, R., Grigioni, M., and Redaelli, A., 2007, “Helical Flow as Fluid Dynamic Signature for Atherogenesis Risk in Aortocoronary Bypass. A Numeric Study,” J. Biomech., 40(3), pp. 519–534. [CrossRef]
Chesnutt, J. K., and Han, H.-C., 2011, “Tortuosity Triggers Platelet Activation and Thrombus Formation in Microvessels,” ASME J. Biomech. Eng., 133(12), p. 121004. [CrossRef]
Xie, X., Wang, Y., and Zhou, H., 2013, “Impact of Coronary Tortuosity on the Coronary Blood Flow: A 3D Computational Study,” J. Biomech., 46(11), pp. 1833–1841. [CrossRef]
Cecchi, E., Giglioli, C., Valente, S., Lazzeri, C., Gensini, G. F., Abbate, R., and Mannini, L., 2011, “Role of Hemodynamic Shear Stress in Cardiovascular Disease,” Atherosclerosis, 214(2), pp. 249–256. [CrossRef]
Archie, J. P., Jr., Hyun, S., Kleinstreuer, C., Longest, P., Truskey, G. A., and Buchanan, J., 2001, “Hemodynamic Parameters and Early Intimal Thickening in Branching Blood Vessels,” Crit. Rev. Biomed. Eng., 29(1), pp. 1–64. [CrossRef]
Rikhtegar, F., Knight, J. A., Olgac, U., Saur, S. C., Poulikakos, D., Marshall Jr, W., Cattin, P. C., Alkadhi, H, and Kurtcuoglu, V., 2012, “Choosing the Optimal Wall Shear Parameter for the Prediction of Plaque Location—A Patient-Specific Computational Study in Human Left Coronary Arteries,” Atherosclerosis, 221(2), pp. 432–437. [CrossRef]
Boutsianis, E., Dave, H., Frauenfelder, T., Poulikakos, D., Wildermuth, S., Turina, M., Ventikos, Y., and Zund, G., 2004, “Computational Simulation of Intracoronary Flow Based on Real Coronary Geometry,” Eur. J. Cardiothorac. Surg., 26(2), pp. 248–256. [CrossRef]
Sakamoto, S., Takahashi, S., Coskun, A. U., Papafaklis, M. I., Takahashi, A., Saito, S., Stone, P. H., and Feldman, C. L., 2013, “Relation of Distribution of Coronary Blood Flow Volume to Coronary Artery Dominance,” Am. J. Cardiol., 111(10), pp. 1420–1424. [CrossRef]
Ku, J. P., Elkins, C. J., and Taylor, C. A., 2005, “Comparison of CFD and MRI Flow and Velocities in an In Vitro Large Artery Bypass Graft Model,” Ann. Biomed. Eng., 33(3), pp. 257–269. [CrossRef]
He, X., and Ku, D. N., 1996, “Pulsatile Flow in the Human Left Coronary Artery Bifurcation: Average Conditions,” ASME J. Biomech. Eng., 118(1), pp. 74–82. [CrossRef]
Lei, M., Kleinstreuer, C., and Truskey, G., 1996, “A Focal Stress Gradient-Dependent Mass Transfer Mechanism for Atherogenesis in Branching Arteries,” Med. Eng. Phys., 18(4), pp. 326–332. [CrossRef]
Caro, C. G., 2009, “Discovery of the Role of Wall Shear in Atherosclerosis,” Arterioscler., Thromb., Vasc. Biol., 29(2), pp. 158–161. [CrossRef]
Cunningham, K. S., and Gotlieb, A. I., 2004, “The Role of Shear Stress in the Pathogenesis of Atherosclerosis,” Lab. Invest., 85(1), pp. 9–23. [CrossRef]
Gimbrone, M. A., and García-Cardena, G., 2013, “Vascular Endothelium, Hemodynamics, and the Pathobiology of Atherosclerosis,” Cardiovasc. Pathol., 22(1), pp. 9–15. [CrossRef]
Chaichana, T., Sun, Z., and Jewkes, J., 2011, “Computation of Hemodynamics in the Left Coronary Artery With Variable Angulations,” J. Biomech., 44(10), pp. 1869–1878. [CrossRef]
Wellnhofer, E., Osman, J., Kertzscher, U., Affeld, K., Fleck, E., and Goubergrits, L., 2010, “Flow Simulation Studies in Coronary Arteries—Impact of Side-Branches,” Atherosclerosis, 213(2), pp. 475–481. [CrossRef]
Torii, R., Wood, N. B., Hadjiloizou, N., Dowsey, A. W., Wright, A. R., Hughes, A. D., Davies, J., Francis, D. P., Mayet, J., and Yang, G. Z., 2009, “Fluid–Structure Interaction Analysis of a Patient-Specific Right Coronary Artery With Physiological Velocity and Pressure Waveforms,” Commun. Numer. Methods Eng., 25(5), pp. 565–580. [CrossRef]
Hasan, M., Rubenstein, D. A., and Yin, W., 2013, “Effects of Cyclic Motion on Coronary Blood Flow,” ASME J. Biomech. Eng., 135(12), p. 121002. [CrossRef]


Grahic Jump Location
Fig. 1

Vascular geometry and boundary conditions. (a) Idealized geometry model and three morphological parameters: the CLR, the BA, and the LBB. (b) Two realistic LCA models. (c) The normalized boundary velocity waveform used at the inlet.

Grahic Jump Location
Fig. 2

Contours of the WSS-derived parameters for different CLRs and BAs. WSS-derived parameters were unwrapped from the artery wall surface and mapped onto a rectangle (the first 2 cm of the inlet extension and the last 2 cm of the outlet extension are cut off). (a) WSS-derived parameters for three different CLRs (BAs and LBBs were kept constant for three models: BA = 90 deg and LBB = 9 mm). (b) Position illustration of line 1 and line 2. (c) WSS-derived parameters for four different BAs (CLRs and LBBs were kept constant for four models: CLR = 4.5 mm and LBB = 9 mm).

Grahic Jump Location
Fig. 3

Contours of the WSS-derived parameters for different LBB and flow rate. WSS-derived parameters were unwrapped from the artery wall surface and mapped onto a rectangle (the first 2 cm of the inlet extension and the last 2 cm of the outlet extension are cut off). (a) WSS-derived parameters for five different LBBs (CLRs and BAs were kept constant for five models: CLR = 4.5 mm and BA = 60 deg). (b) Position illustration of line 1 and line 2. (c) WSS-derived parameters for three different flow rates (CLRs, Bas, and LBBs were kept constant for three models: CLR = 3.0 mm, BA = 60 deg, and LBB = 0 mm).

Grahic Jump Location
Fig. 4

The distribution of WSS-derived parameters for a LAD model. The 3D contours were shown in three different views: left view, front view, and right view.

Grahic Jump Location
Fig. 5

The distribution of WSS-derived parameters for a LCX model. The 3D contours were shown in three different views: left view, front view, and right view.



Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging and repositioning the boxes below.

Related Journal Articles
Related eBook Content
Topic Collections

Sorry! You do not have access to this content. For assistance or to subscribe, please contact us:

  • TELEPHONE: 1-800-843-2763 (Toll-free in the USA)
  • EMAIL: asmedigitalcollection@asme.org
Sign In