Three-Dimensional Fluid Dynamical Features of Coronary Plaque Rupture Provoking Acute Coronary Syndrome
| Autor: | Keisuke Kojima, Takafumi Hiro, Suguru Migita, Takehiro Tamaki, Naotaka Akutsu, Mitsumasa Sudo, Takashi Mineki, Toshihiko Nishida, Daisuke Fukamachi, Tomoyuki Morikawa, Nobuhiro Murata, Yasuo Okumura, Takaaki Kogo, Korehito Iida |
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| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome Diastole Coronary Artery Disease 030204 cardiovascular system & hematology Coronary artery disease 03 medical and health sciences 0302 clinical medicine Internal medicine Coronary plaque Intravascular ultrasound Internal Medicine medicine Humans In patient Acute Coronary Syndrome Ultrasonography Interventional Cardiac cycle medicine.diagnostic_test business.industry Biochemistry (medical) Blood flow medicine.disease Coronary Vessels Plaque Atherosclerotic Cardiology Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Atherosclerosis and Thrombosis. 29:464-473 |
| ISSN: | 1880-3873 1340-3478 |
| DOI: | 10.5551/jat.60509 |
| Popis: | Aim Coronary plaque rupture is the main cause of acute coronary syndrome (ACS), but the role of blood flow features around plaque rupture for ACS is still unknown. The present study aimed to assess the relationship between the geometric configuration of ruptured plaque and ACS occurrence using computational fluid dynamics (CFD) by moving particle method in patients with coronary artery disease. Methods In this study, 45 patients with coronary artery disease who underwent three-dimensional intravascular ultrasound (IVUS) and had a coronary ruptured plaque (24 plaques with provoked ACS, 21 without) were included. To compare the difference in blood flow profile around ruptured plaque between the patients with and without ACS, the IVUS images were analyzed via the novel CFD analysis. Results There were no significant differences in localized flow profile around ruptured plaque between the two groups when the initial particle velocity was 10.0 cm/s corresponded to a higher coronary flow velocity at ventricular diastole. However, when it was 1.0 cm/s corresponded to lower coronary flow velocity at ventricular systole, particles with lower velocity (0 ≤ V ≤ 5 cm/s) were more prevalent around ACS-PR (p=0.035), whereas particles with higher velocity (10 ≤ V ≤ 20 cm/s) were more often detected in silent plaque ruptures (p=0.018). Conclusions Three-dimensional IVUS revealed that coronary plaque rupture was a complex one with a wide variety of its stereoscopic configuration, leading to various patterns of the local coronary flow profile. A novel CFD analysis suggested that the local flow was more stagnant around ACS-provoked ruptures than in silent ones. |
| Databáze: | OpenAIRE |
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