Choosing the Optimal Wall Shear Parameter for the Prediction of Plaque Location-A Patient-Specific Computational Study in Human Right Coronary Arteries

OBJECTIVES: Average wall shear-stress (AWSS), average wall shear-stress gradient (AWSSG), oscillatory shear index (OSI) and relative residence time (RRT) are believed to predict areas vulnerable to plaque formation in the coronary arteries. Our aim was to analyze the correlation of these parameters in patients' vessels before the onset of atherosclerosis to the specific plaque sites thereafter, and to compare the parameters' sensitivity and positive predictive value.

METHODS: We obtained 30 patient-specific geometries (mean age 67.1 (+/-9.2) years, all with stable angina) of the right coronary artery (RCA) using dual-source computed tomography (CT) and virtually removed any plaque present. We then performed computational fluid dynamics (CFD) simulations to calculate the wall shear parameters.

PMID:

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One Comment

  1. Although shear stress analysis is currently used for research purposes almost exclusively, it’s important to realize that the progression of coronary atherosclerosis depends on multiple factors, and it is difficult to predict.

    Moreover, the degree of atherosclerosis may not correlate with traditional and novel cardiac risk factors. Coronary shear stress and coronary blood flow dynamics may influence the progression of coronary atherosclerosis. Coronary CT may therefore serve to diagnose the anatomic properties of a coronary vessel and the consequences of coronary shear stress, i.e atherosclerotic plaques (that may later lead to events…). This is an elegant study that used DSCT and contributes to the understanding of the atherosclerotic process.

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