The impact of hemodynamic factors in a coronary main artery to detect the atherosclerotic severity: Single and multiple sequential stenosis cases

Abstract

A conventional invasive catheterization procedure is currently used to detect atherosclerotic severity in coronary arteries. However, it is still challenging to measure multiple consecutive stenoses (MCS) in coronary main arteries, a severe condition, by using the invasive method. In this paper, we report important hemodynamic properties such as wall shear stress (WSS) and velocity magnitude (VM) across different luminal areas of coronary stenosis in patient-based right coronary artery models of MCS using pulsatile heart flow simulations. The hemodynamic factors in coronary blood flow simulations of different degrees of stenosis indicated a relationship between the proximal moderate stenosis and distal severe stenosis models. The results show the physical effects of different hemodynamic factors including VM, mean arterial pressure difference, WSS, and virtual fractional flow reserve (vFFR), which allow for predicting the physiological computation in the MCS artery severity conditions. This study identifies the fundamental physics of coronary plaque with MCS and indicates the impact of these factors on vFFR measurements. These findings provide insights into and improvement of the pathophysiological assessment of MCS. The results reveal hemodynamic properties, which can be used to diagnose coronary irregularities using a visualization method.