Mechanisms of Myocardial Ischemia Inducing Sudden Cardiac Death in Athletes with Anomalous Coronary Origin from the Opposite Sinus: Insights from a computational fluid dynamic study
Autor: | Gianluca Rigatelli, Paola Galasso, Lanza Daniela, Tai T.T.T. Truyen, Thach Nguyen, K. D'Elia, Mauro Carraro, Marco Zuin, Loris Roncon |
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Rok vydání: | 2018 |
Předmět: |
Adult
Male Patient-Specific Modeling medicine.medical_specialty Computed Tomography Angiography Coronary Vessel Anomalies Myocardial Ischemia Hemodynamics 030204 cardiovascular system & hematology Coronary Angiography Sudden death Sudden cardiac death 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine.artery Coronary Circulation medicine Humans 030212 general & internal medicine Circumflex business.industry Coronary Sinus Models Cardiovascular General Medicine Middle Aged medicine.disease Thrombosis Coronary arteries medicine.anatomical_structure Death Sudden Cardiac Athletes Right coronary artery Cardiology Hydrodynamics Female Cardiology and Cardiovascular Medicine business Artery |
Zdroj: | Cardiovascular revascularization medicine : including molecular interventions. 20(12) |
ISSN: | 1878-0938 |
Popis: | AIMS The left coronary anomalous origin from the opposite sinus (L- ACAOS) constitutes the most clinically relevant arterial abnormality among the wide spectrum of coronary artery anomalies. We investigated the physiology of L-ACAOS with and without intramural course (IM) in athletes, using the computational fluid dynamic (CFD) analysis. METHODS AND RESULTS The coronary artery circulation with L-ACAOS with and without IM has been segmented and then reconstructed, after reviewing both the angiographic and computed tomography findings of 13 consecutive athletes (10 males, mean age 45.1 ± 8.2 years) with L-ACAOS collected in our institution between 1st January 2003 and 1st January 2018. Vorticity magnitude, static pressure and wall shear stress (WSS) have been analysed in a model of L-ACAOS with no IM course and in L-ACAOS-IM at rest and during exercise. The mean vorticity magnitude and WSS significantly increased from rest to exercise in both models, in right coronary artery, left anterior descending and left circumflex coronary arteries. The mean static pressure significantly increased with exercise in IM (1.118e + 004 vs 1.164e + 004 Pa, p |
Databáze: | OpenAIRE |
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