Abstract
Objectives: To examine the putative physiologic role of epicardial fat to buffer the coronary arteries and to review the data on deformation and vibration in coronary arteries. Methods: OvidSP Medline, Embase, and PubMed were systematically searched. Eligible articles on vibration in arteries and deformation of coronary arteries were assessed. Results: Coronary arteries are unique because they undergo substantial deformations with twisting, bending, and stretching that are due to cardiac contraction and the tethering of the large coronary arteries to the epicardial surface of the heart. In addition, phasic coronary artery pressure and blood flow are not synchronous producing a high negative stress phase angle between circumferential strain and wall shear. Fluid flow–induced vibrations, a universal finding in conduits transporting fluid with pulsatile flow, have been documented in arteries. Arterial vibration can damage the structure of arterial wall, especially elastin and endothelial cells, leading to alterations in the arterial function. Support for a beneficial mechanical role for epicardial fat is based on the data that wrapping material to the outside of conduits not only reduces the vibration but also decreases their movement. The overall impact of an external wrap is a reduction in the probability of conduit fatigue and failure. Characteristics of the artery, such as shear modulus, are a function of the properties of each layer of the artery. The application of epicardial fat to the adventitia of arteries alters the biophysical characteristics of the artery which is the sum of each layer including the epicardial fat. Vibration, resonance, and deformation energy are lost when they hit the surface of an absorbing material. Conclusions: The integration of the biophysics of coronary arteries with knowledge of material damping principles supports a physiologic role for epicardial fat to buffer deformation and vibration in coronary arteries.
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