Computational Fluid Dynamics Simulations of Hemodynamics in Plaque Erosion

• Type of Material: Article
• Authors: Ian C. Campbell, Georgia Institute of Technology; Lucas Timmins, Emory University; Don P Giddens, Emory University; Renu Virmani, CVPath Institute, Inc.; Alessandro Veneziani, Emory University; Syed Rab, Emory University; Habib Samady, Emory University; Michael C McDaniel, Emory University; Aloke Finn, Emory University; William Taylor, Emory University; John Oshinski, Emory University
• Language: English
• Date: 2013-12-01
• Publisher: Springer (part of Springer Nature): Springer Open Choice Hybrid Journals
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013 Biomedical Engineering Society.
• Final Published Version (URL): http://dx.doi.org/10.1007/s13239-013-0165-3
• Title of Journal or Parent Work: Cardiovascular Engineering and Technology
• ISSN: 1869-408X
• Volume: 4
• Issue: 4
• Start Page: 464
• End Page: 473
• Grant/Funding Information: This material is based upon work supported by an American Heart Association Predoctoral Fellowship (11PRE7040000, Campbell); and an American Heart Association Postdoctoral Fellowship (11POST7210012, Timmins); by the National Science Foundation Graduate Research Fellowship under Grant No. DGE-0644493; and by the National Institutes of Health Bioengineering Research Partnership Grant No. R01 HL70531.; The Robert M. Nerem International Travel Award supported training for the execution of this study.
• Keywords: plaque erosion; Computational fluid dynamics; wall shear stress; atherosclerosis; endothelium
• Research Categories: Engineering, Biomedical; Health Sciences, Radiology; Health Sciences, Medicine and Surgery

Abstract

We investigated whether local hemodynamics were associated with sites of plaque erosion and hypothesized that patients with plaque erosion have locally elevated WSS magnitude in regions where erosion has occurred. We generated 3D, patient-specific models of coronary arteries from biplane angiographic images in 3 human patients with plaque erosion diagnosed by optical coherence tomography. Using computational fluid dynamics, we simulated pulsatile blood flow and calculated both wall shear stress (WSS) and oscillatory shear index (OSI). We also investigated anatomic features of plaque erosion sites by examining branching and local curvature in X-ray angiograms of barium-perfused autopsy hearts. Neither high nor low magnitudes of mean WSS were associated with sites of plaque erosion. OSI and local curvature were also not associated with erosion. Anatomically, 8 of 13 hearts had a nearby bifurcation upstream of the site of plaque erosion. This study provides preliminary evidence that neither hemodynamics nor anatomy are predictors of plaque erosion, based upon a very unique dataset. Our sample sizes are small, but this dataset suggests that high magnitudes of WSS, one potential mechanism for inducing plaque erosion, are not necessary for erosion to occur.