Correlations of coronary plaque wall thickness with wall pressure and wall pressure gradient: a representative case study

BioMedical Engineering OnLine

Biyue Liu²  Jie Zheng¹  Richard Bach³  Dalin Tang⁴ 

[1] Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA

[2] Department of Mathematics, Monmouth University, West Long Branch, NJ, 07764, USA

[3] Cardiovascular Division, Washington University School of Medicine, Saint Louis, MO, 63110, USA

[4] Department of Mathematical Sciences, Worcester Polytechnic Institute, Worcester, MA, 01609, USA

关键词: Wall pressure gradient;    Pressure difference;    Pulsatile;    Wall pressure;    Wall thickness;    Stenosis;    Right coronary artery;   

Others  :  798058
DOI  :  10.1186/1475-925X-11-43

 received in 2012-02-09, accepted in 2012-07-13,  发布年份 2012

【 摘 要 】

Background

There are two major hemodynamic stresses imposed at the blood arterial wall interface by flowing blood: the wall shear stress (WSS) acting tangentially to the wall, and the wall pressure (WP) acting normally to the wall. The role of flow wall shear stress in atherosclerosis progression has been under intensive investigation, while the impact of blood pressure on plaque progression has been under-studied.

Method

The correlations of wall thickness (WT) with wall pressure (WP, blood pressure on the lumen wall) and spatial wall pressure gradient (WPG) in a human atherosclerotic right coronary artery were studied. The pulsatile blood flow was simulated using a three dimensional mathematical model. The blood was treated as an incompressible viscous non-Newtonian fluid. The geometry of the artery was re-constructed using an in vivo intravascular ultrasound (IVUS) 44-slice dataset obtained from a patient with consent obtained. The WT, the WP and the WPG were averaged on each slice, respectively, and Pearson correlation analysis was performed on slice averaged base. Each slice was then divided into 8 segments and averaged vessel WT, WP and WPG were collected from all 352 segments for correlation analysis. Each slice was also divided into 2 segments (inner semi-wall of bend and outer semi-wall of bend) and the correlation analysis was performed on the 88 segments.

Results

Under mean pressure, the Pearson coefficient for correlation between WT and WP was r = − 0.52 (p < 0.0001) by 2-segment analysis and r = − 0.81 (p < 0.0001) by slice averaged analysis, respectively. The Pearson coefficient for correlation between WT and WPG was r = 0.30 (p = 0.004) by 2-segment analysis and r = 0.45 (p = 0.002) by slice averaged analysis, respectively. The r-values corresponding to systole and diastole pressure conditions were similar.

Conclusions

Results from this representative case report indicated that plaque wall thickness correlated negatively with wall pressure (r = −0.81 by slice) and positively with wall pressure gradient (r = 0.45). The slice averaged WT has a strong linear relationship with the slice averaged WP. Large-scale patient studies are needed to further confirm our findings.

【 授权许可】

   
2012 Liu et al.; licensee BioMed Central Ltd.

【 图 表 】

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