Advances in the Computational Assessment of Disturbed Coronary Flow and Wall Shear Stress: A Contemporary Review

Autor: Avedis Assadour Ekmejian, Harry James Carpenter, Jonathan Laurence Ciofani, Benjamin Howard McIntosh Gray, Usaid Khalil Allahwala, Michael Ward, Javier Escaned, Peter James Psaltis, Ravinay Bhindi
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 13, Iss 19 (2024)
Druh dokumentu: article
ISSN: 2047-9980
DOI: 10.1161/JAHA.124.037129
Popis: Coronary artery blood flow is influenced by various factors including vessel geometry, hemodynamic conditions, timing in the cardiac cycle, and rheological conditions. Multiple patterns of disturbed coronary flow may occur when blood flow separates from the laminar plane, associated with inefficient blood transit, and pathological processes modulated by the vascular endothelium in response to abnormal wall shear stress. Current simulation techniques, including computational fluid dynamics and fluid–structure interaction, can provide substantial detail on disturbed coronary flow and have advanced the contemporary understanding of the natural history of coronary disease. However, the clinical application of these techniques has been limited to hemodynamic assessment of coronary disease severity, with the potential to refine the assessment and management of coronary disease. Improved computational efficiency and large clinical trials are required to provide an incremental clinical benefit of these techniques beyond existing tools. This contemporary review is a clinically relevant overview of the disturbed coronary flow and its associated pathological consequences. The contemporary methods to assess disturbed flow are reviewed, including clinical applications of these techniques. Current limitations and future opportunities in the field are also discussed.
Databáze: Directory of Open Access Journals