Oscillatory Wall Shear Stress Research Articles

Lower extremity amputation increases oscillatory flow in the infrarenal aorta: A new potential risk factor for abdominal aortic aneurysm development

Background Abdominal aortic aneurysms (AAA) are a major cause of morbidity and mortality in the US. The most common location of AAA is the infrarenal abdominal aorta where oscillatory flow is present over the cardiac cycle, figure 1. Oscillatory flow is known to initiate an inflammatory response in endothelial cells. Patients with lower extremity traumatic amputations have a 5-fold increase in AAA occurrence unrelated to co-morbidities. The objective of the study is to determine the amount of infrarenal aortic oscillatory flow changes between baseline and acute occlusion of arterial blood supply to a lower extremity (a condition mimicking a lower extremity amputation). Methods Six healthy volunteers underwent MRI exam which included non-contrast MRA and PCMR measurement in the abdominal aorta. PCMR measurements were done at baseline and during 3-4 minutes of acute arterial occlusion using a blood pressure cuff to mimic a unilateral above knee (AKA) and bilateral above knee (Bi-AKA) amputation. PCMR scans were acquired perpendicular to the aorta at 2 levels: below the renal arteries and immediately above the aortic bifurcation. PCMR was used to create waveforms showing flow versus time over the cardiac cycle, figure 1. In all subjects, we computed the percent of retrograde flow over the cardiac cycle at baseline and during the two acute occlusion conditions. Results The retrograde flow was 17.9%+/-1.6 at baseline. AKA resulted in a significant increase in retrograde flow above the aortic bifurcation, the most common site of AAA formation (26.3%+/-4.2 p<0.05). Bi-AKA further increased retrograde flow to 30.1%+/-3.9 p<0.05. Our results suggest that mimicking a traumatic amputation produces a significant increase in infrarenal retrograde aortic blood flow, leading to an increase in oscillatory wall shear stress, a precursor of endothelial dysfunction. Additionally, the velocity profiles above the aortic bifurcation showed that during unilateral AKA, the diastolic reversal of blood flow was more pronounced on the side of the amputation. These findings agree with

Flow patterns and wall shear stress distribution in human internal carotid arteries: The geometric effect on the risk for stenoses

It has been widely observed that atherosclerotic stenosis occurs at sites with complex hemodynamics, such as arteries with high curvature or bifurcations. These regions usually have very low or highly oscillatory wall shear stress (WSS). In the present study, 3D sinusoidally pulsatile blood flow through the models of internal carotid artery (ICA) with different geometries was investigated with computational simulation. Three preferred sites of stenoses were found along the carotid siphon with low and highly oscillatory WSS. The risk for stenoses at these sites was scaled with the values of time-averaged WSS and oscillating shear index (OSI). The local risk for stenoses at every preferred site of stenoses was found different between 3 types of ICA, indicating that the geometry of the blood vessel plays significant roles in the atherogenesis. Specifically, the large curvature and planarity of the vessel were found to increase the risk for stenoses, because they tend to lower WSS and elevate OSI. Therefore, the geometric study makes it possible to estimate the stenosis location in the ICA siphon as long as the shape of ICA was measured.

Influences of domain extensions to a moderately stenosed patient‐specific carotid bifurcation

PurposeThe purpose of this paper is to numerically study blood flow through a subject‐specific carotid artery with a moderately severe stenosis, also to thoroughly analyse the wall shear stress (WSS), oscillatory shear index (OSI) and WSS angular deviation (WSSAD). One of the important aspects of this study is the investigation on the influence of the extensions attached to the domain outlets.Design/methodology/approachThe segmentation of the carotid artery is carried out using a deformable model based on a level set method. A geometric potential force (GPF) is employed to deform the level set to obtain the carotid artery geometry. The initial surface meshing is generated using an advanced marching cubes (MC) method, before improving the quality of the surface mesh via a number of mesh cosmetic steps. The volume mesh generation has two parts. In the first part, a quasi‐structured, boundary layer mesh is generated in the vicinity of the geometry walls. The second part of the meshing involves unstructured tetrahedral meshing of the inner part of the geometry. After the meshing stage, the flow boundary conditions are generated by numerically solving the Helmholtz equation in both space and time. Finally, the explicit characteristic‐based split (CBS) method is employed in a parallel environment to produce a detailed analysis of wall quantities.FindingsIn general, WSS is very high in the vicinity of the carotid artery apex and in the proximity of the stenosis. From the results obtained, it is clear that the influence of outlet domain extension is marginal. While the peak instantaneous WSS differs by a maximum of 5.7 per cent, the time‐averaged WSS difference due to extended domain is only 1.3 per cent. Two other derived parameters are also examined in the paper, the oscillating shear index and the WSSAD. Both these quantities also display minor or negligible differences due to domain extension.Originality/valueIt has been perceived that domain extension is essential to avoid wrong application of boundary conditions. The results obtained, however, conclusively show that the outlet domain extension has only a moderate influence on WSS. Thus, outlet extension to the domains may not be essential for arterial blood flows. It is also observed that the dramatic values of peak WSS obtained near the stenosis is the result of high resolution mesh along with boundary layers used in this study. Both the outcomes represent the originality of this paper.

Hemodynamics and In-stent Restenosis: Micro-CT Images, Histology, and Computer Simulations

A model that combines the results of in vivo experiment, 3D image data, and computer simulation has been developed. Twelve identical stents were implanted into six healthy pigs and explanted at a range of different post-recovery periods from 6 h to 28 days. The stented vessel segments were embedded in methacrylate resin for the preparation of transverse histological sections and imaged using ultra-high resolution micro-CT. The resulting CT data was used to reconstruct the 3D geometry of the stents and one case was used to inform a 3D computational fluid dynamic model. Derived hemodynamic parameters such as wall shear stress (WSS), axial WSS, and oscillatory shear index were correlated with the distribution of neointimal hyperplasia, assessed from histomorphometric analyses. The direct comparison of hemodynamic parameters and biological response supports the hypothesis that low and oscillatory WSS lead to a greater neointimal response within the stented region. Moreover, the realistic geometry obtained from micro-CT images, characterized by proximal overexpansion and asymmetric deployment of the stent, leads to a markedly non-uniform distribution of WSS values and correlates with asymmetric neo-intimal growth. This correlation cannot be appreciated from studies of idealized geometries.

Computational Fluid Dynamics Simulation of a-v Fistulas: From MRI and Ultrasound Scans to Numeric Evaluation of Hemodynamics

A-v anastomosis entails dramatic changes in hemodynamic conditions, which may lead to major alterations to the vessels involved; primarily dilatations and devastating stenoses. Wall shear stress is thought to play a key role in the remodeling of the vessels exposed to abnormal levels and oscillating wall shear stress. In this study we sought to develop a framework suitable for thorough in vivo analyses of wall shear stress and vessel morphology of a-v fistulas in patients. Using ultrasound and magnetic resonance imaging (MRI) transverse image stacks from six patient a-v fistulas were obtained. From the image stacks three-dimensional geometries of the patient fistulas were created using dedicated segmentation software. Geometries of three a-v fistulas were imported into finite element software in order to perform fluid flow simulations of blood flows and frictional forces on the vessel walls in the a-v fistulas. Boundary conditions for the simulations were obtained using both a MRI phase contrast and an ultrasound Doppler technique. The segmentation of the six fistulas of very different age and morphology (two end-to-side and four side-to-side) showed the ability of the approach to create geometries of various fistula morphologies. Simulations of the three fistulas showed an instant picture of the present status of the exposure to different levels of wall shear stress and the morphological status in the vessel remodeling process. The study demonstrated the capability of the CFD framework to analyze patient a-v fistulas on a regular basis using both MRI and ultrasound-based approaches.

Mechanophysical Stimulations of Mucin Secretion in Cultures of Nasal Epithelial Cells

Nasal epithelial cells secret mucins and are exposed in vivo to airflow-induced mechanophysical stresses, including wall shear stress (WSS), temperature, and humidity. In this work, human nasal epithelial cells cultured under air-liquid interface conditions were subjected to fields of airflow-induced oscillatory WSS at different temperature and humidity conditions. Changes in mucin secretion due to WSS were measured and the role of the cytoskeleton in mucin secretion was explored. Mucin secretion significantly increased in response to WSS in a magnitude-dependent manner with respect to static cultures and independently of the airflow temperature and humidity. In static cultures, mucin secretion decreased at high humidity with or without elevation of the temperature with respect to cultures at a comfortable climate. In cultures exposed to WSS, mucin secretion increased at high temperature with respect to cultures at comfortable climate conditions. The polymerization of actin microfilaments was shown to increase mucin secretion under WSS, whereas the dynamics of microtubule polymerization did not affect secretion. In conclusion, the data in this study show that mucin secretion is sensitive to oscillatory WSS as well as high temperature and humidity conditions.

Redox Signaling in an In Vivo Murine Model of Low Magnitude Oscillatory Wall Shear Stress

Wall Shear Stress (WSS) has been identified as an important factor in the pathogenesis of atherosclerosis. We utilized a novel murine aortic coarctation model to acutely create a region of low magnitude oscillatory WSS in vivo. We employed this model to test the hypothesis that acute changes in WSS in vivo induce upregulation of inflammatory proteins, mediated by reactive oxygen species (ROS). Superoxide generation and VCAM-1 expression both increased in regions of low magnitude oscillatory WSS. WSS-dependent superoxide formation was attenuated by tempol treatment, but was unchanged in p47 phox knockout (ko) mice. However, in both the p47 phox ko mice and the tempol-treated mice, low magnitude oscillatory WSS produced an increase in VCAM-1 expression comparable to control mice. Additionally, this same VCAM-1 expression was observed in ebselen-treated mice and catalase overexpressing mice. These results suggest that although the redox state is important to the overall pathogenesis of atherosclerosis, the initial WSS-dependent inflammatory response leading to lesion localization is not dependent on ROS.

Coronary artery bifurcation biomechanics and implications for interventional strategies

The treatment of atherosclerotic plaques near and involving coronary bifurcations is especially challenging for interventional procedures. Optimization of these treatment strategies should begin with an understanding of how disease came to be localized to these regions, followed by careful design of the interventional tools and implanted devices. This manuscript reviews the basic biomechanics of coronary bifurcations, stented arteries, and the complex biomechanical challenges associated with bifurcation stenting. Flow patterns in bifurcations are inherently complex, including vortex formation and creation of zones of low and oscillating wall shear stress that coincide with early intimal thickening. Bifurcation geometry (in particular, the angle between the side branches), is of paramount importance in creating these proatherogenic conditions. This predilection for disease formation leads to a large number of bifurcation lesions presenting for clinical intervention. Therefore, several strategies have developed for treating these challenging lesions, including both dedicated devices and creative adaptation of single vessel lesion technologies. The biomechanical implications of these strategies are likely important in short and long term clinical outcomes. While the biomechanical environment in a stented coronary bifurcation is extremely challenging to model, computational methods have been deployed recently to better understand these implications. Enhancement of clinical success will be best achieved through the collaborative efforts of clinicians, biomechanicians, and device manufacturers.

Effect of Posture Change on the Geometric Features of the Healthy Carotid Bifurcation

Segmented cross-sectional MRI images were used to construct 3-D virtual models of the carotid bifurcation in ten healthy volunteers. Geometric features, such as bifurcation angle, internal carotid artery (ICA) angle, planarity angle, asymmetry angle, tortuosity, curvature, bifurcation area ratio, ICA/common carotid artery (CCA), external carotid artery (ECA)/CCA, and ECA/ICA diameter ratios, were calculated for both carotids in two head postures: 1) the supine neutral position; and 2) the prone sleeping position with head rotation to the right ( ∼ 80°). The results obtained have shown that head rotation causes 1) significant variations in bifurcation angle [32% mean increase for the right carotid (RC) and 21% mean decrease for the left carotid (LC)] and internal carotid artery angle (97% mean increase for the RC, 43% mean decrease for the LC); 2) a slight increase in planarity and asymmetry angles for both RC and LC; 3) minor and variable curvature changes for the CCA and for the branches; 4) slight tortuosity changes for the braches but not for the CCA; and 5) unsubstantial alterations in area and diameter ratios (percentage changes %). The significant geometric changes observed in most subjects with head posture may also cause significant changes in bifurcation hemodynamics and warrant future investigation of the hemodynamic parameters related to the development of atherosclerotic disease such as low oscillating wall shear stress and particle residence times.

Modelling of pulsatile blood flow in arterial trees of retinal vasculature

The paper presents a numerical investigation of the pulsatile blood flow in the detailed arterial vasculatures of a mouse retina using the mathematical model based on frequency domain incorporating an appropriate outlet boundary impedance at the end of the terminal vessels of the arterial trees. The viscosity in the vessels was evaluated considering the Fahraeus-Lindqvist effect, the plasma skimming effect and in vivo viscosity effect in the microcirculation. Comparative studies of the pulsatile circulation were carried out for cases of rigid vessels, constant viscosity, zero and non-zero outlet boundary impedances. In addition, the dependence of the oscillating input impedance at the inlet of the arterial trees on angular frequencies of the oscillation and vessel elasticises was also studied. The study shows that the pressure wave continues in the pre-capillary vessels throughout the retina. In elastic vessels, the amplitude of oscillatory velocity and wall shear stress in larger vessels and in vessels at the periphery region of the retina is amplified. The pulsatile blood flow is significantly influenced by the outlet boundary (or load) impedance which simulates the effect of the capillary and venous vasculatures. The oscillating input impedance at the inlet of the arterial trees is also found to be dependent on the angular frequency and the Young modulus of the vessel segment. Insights into the potential variations of the dynamic responses of the system under retinal pathological condition of arteriosclerosis may be inferred from the findings of the present study.

관상동맥의 기하학적 형상변화에 따른 동맥경화 위험도

박동유동조건에서 관상동맥 내의 유동특성과 혈류역학적 인자 분포를 선행연구에서 수행하여 혈류역학이 관상동맥 내의 협착현상과 연관관계가 있음을 밝혔다. 동맥경화증의 호발부위인 관상동맥 분지부에서 혈류역학적 변수를 분석하여 동맥경화증의 발생기전을 규명하는 것이 본 연구의 목적이다. 동맥경화증에 의한 협착현상은 혈액과 혈관벽 사이의 생화학 반응뿐 아니라 유동박리나 벽전단응력과 같은 혈류역학적 인자와도 관계 있음을 확인하였다. 관상동맥 분지부의 분지각이 증가할수록 분지부 단면에서의 재순환영역의 크기가 증가하고 교란유동이 발생하게 된다. 이 재순환영역이 관상동맥에서 동맥경화의 시작점으로 의심되는 영역이라 할 수 있다.

An In Vivo Murine Model of Low-Magnitude Oscillatory Wall Shear Stress to Address the Molecular Mechanisms of Mechanotransduction—Brief Report

Current understanding of shear-sensitive signaling pathways has primarily been studied in vitro largely because of a lack of adequate in vivo models. Our objective was to develop a simple and well-characterized murine aortic coarctation model to acutely alter the hemodynamic environment in vivo and test the hypothesis that endothelial inflammatory protein expression is acutely upregulated in vivo by low-magnitude oscillatory wall shear stress (WSS). Our model uses the shape memory response of nitinol clips to reproducibly induce an aortic coarctation and allow subsequent focal control over WSS in the aorta. We modeled the corresponding hemodynamic environment using computational fluid dynamics and showed that the coarctation produces low-magnitude oscillatory WSS distal to the clip. To assess the biological significance of this model, we correlated WSS to inflammatory protein expression and fatty streak formation. Vascular cell adhesion molecule-1 expression and fatty streak formation were both found to increase significantly in regions corresponding to acutely induced low-magnitude oscillatory WSS. We have developed a novel aortic coarctation model that will be a useful tool for analyzing the in vivo molecular mechanisms of mechanotransduction in various murine models.

Impact of competitive flow on wall shear stress in coronary surgery: computational fluid dynamics of a LIMA–LAD model

Competitive flow from native coronary vessels is considered a major factor in the failure of coronary bypass grafts. However, the pathophysiological effects are not fully understood. Low and oscillatory wall shear stress (WSS) is known to induce endothelial dysfunction and vascular disease, like atherosclerosis and intimal hyperplasia. The aim was to investigate the impact of competitive flow on WSS in mammary artery bypass grafts. Using computational fluid dynamics, WSS was calculated in a left internal mammary artery (LIMA) graft to the left anterior descending artery in a three-dimensional in vivo porcine coronary artery bypass graft model. The following conditions were investigated: high competitive flow (non-significant coronary lesion), partial competitive flow (significant coronary lesion), and no competitive flow (totally occluded coronary vessel). Time-averaged WSS of LIMA at high, partial, and no competitive flow were 0.3-0.6, 0.6-3.0, and 0.9-3.0 Pa, respectively. Further, oscillatory WSS quantified as the oscillatory shear index (OSI) ranged from (maximum OSI = 0.5 equals zero net WSS) 0.15 to 0.35, <0.05, and <0.05, respectively. Thus, high competitive flow resulted in substantial oscillatory and low WSS. Moderate competitive flow resulted in WSS and OSI similar to the no competitive flow condition. Graft flow is highly dependent on the degree of competitive flow. High competitive flow was found to produce unfavourable WSS consistent with endothelial dysfunction and subsequent graft narrowing and failure. Partial competitive flow, however, may be better tolerated as it was found to be similar to the ideal condition of no competitive flow.

Shear-induced endothelial cell-cell junction inclination.

Atheroprone regions of the arterial circulation are characterized by time-varying, reversing, and oscillatory wall shear stress. Several in vivo and in vitro studies have demonstrated that flow reversal (retrograde flow) is atherogenic and proinflammatory. The molecular and structural basis for the sensitivity of the endothelium to flow direction, however, has yet to be determined. It has been hypothesized that the ability to sense flow direction is dependent on the direction of inclination of the interendothelial junction. Immunostaining of the mouse aorta revealed an inclination of the cell-cell junction by 13 degrees in direction of flow in the descending aorta where flow is unidirectional. In contrast, polygonal cells of the inner curvature where flow is disturbed did not have any preferential inclination. Using a membrane specific dye, the angle of inclination of the junction was dynamically monitored using live cell confocal microscopy in confluent human endothelial cell monolayers. Upon application of shear the junctions began inclining within minutes to a final angle of 10 degrees in direction of flow. Retrograde flow led to a reversal of junctional inclination. Flow-induced junctional inclination was shown to be independent of the cytoskeleton or glycocalyx. Additionally, within seconds, retrograde flow led to significantly higher intracellular calcium responses than orthograde flow. Together, these results show for the first time that the endothelial intercellular junction inclination is dynamically responsive to flow direction and confers the ability to endothelial cells to rapidly sense and adapt to flow direction.

Can sites prone to flow induced vascular complications in a-v fistulas be assessed using computational fluid dynamics?

Arterio-venous fistulas (shunts between arteries and veins) are the preferred vascular access for hemodialysis. Despite their superior patency, compared with synthetic tubes and grafts, functional problems and inadequate flow rates are the common complications. Local flow conditions, in particular low and oscillating wall shear stresses (WSS), are central to vascular problems and a robust framework for analyzing flow conditions in vascular structures could provide an understanding of the mechanisms leading to vascular complications, such as stenoses, aneurisms, and thromboses. We hypothesize that a validated computational fluid dynamics (CFD) framework can be used to identify critical fistula configurations with elevated risk of complications. Therefore, the aim of the present study was to develop a CFD framework for analyzing fluid flow in complex vascular structures, such as arterio-venous fistulas validated by comparisons of in vitro volume flows with CFD results and flow fields from ultrasound scans with CFD simulations. Volume flows measured in vitro and CFD data differed quantitatively. However, good relative correlations exist between the data using logarithmic scales. Qualitatively, visual comparisons between ultrasound and CFD images showed good agreement between the two methods. In addition, WSS levels and the oscillatory shear index (OSI) were calculated and visualized on the model surface. The method was successfully validated and the method is deemed suitable for more thorough investigations into the field of vascular complications in a-v fistulas.

Three-Dimensional Rotational Angiography in Murine Models: A Technical Note

Atherosclerotic plaques and aneurysms are injuries associated with areas of low and oscillatory wall shear stress at vascular bifurcations1. Experimental animal models have been used extensively in the development of new therapeutic approaches to this pathophysiological process.2 In such models, flow at the artery is complicated by several features1–2; however, these effects are minor compared to anatomical variations of bifurcation.3 Therefore, identifying the geometric features of arterial bifurcation is a priority. Angiography of small animal models has been extensively used as a technique to resolve geometric features of the vascular tree.4 Angiography offers unsurpassed spatial resolution of vasculature, and, furthermore, offers a rapid practical method for the evaluation of large experimental groups.5 Unfortunately, in angiography, the viewing angles are predetermined and limited in number, such that the method has an associated problem of blood vessel superimposition and overlapping; therefore, simple angiography cannot be used to accurately depict the spatial relationship between vessels and between the vasculature and surrounding tissues.6 These limitations have prompted us to consider rotational angiography and rendering reconstruction to evaluate 3D volumes and to resolve the arterial geometry necessary for the generation of a finite elements mesh that is indispensable to computational fluid dynamics studies (CFD).

In vivo assessment of blood flow patterns in abdominal aorta of mice with MRI: implications for AAA localization

Abdominal aortic aneurysms (AAA) localize in the infrarenal aorta in humans, while they are found in the suprarenal aorta in mouse models. It has been shown previously that humans experience a reversal of flow during early diastole in the infrarenal aorta during each cardiac cycle. This flow reversal causes oscillatory wall shear stress (OWSS) to be present in the infrarenal aorta of humans. OWSS has been linked to a variety of proatherogenic and proinflammatory factors. The presence of reverse flow in the mouse aorta is unknown. In this study we investigated blood flow in mice, using phase-contrast magnetic resonance (PCMR) imaging. We measured blood flow in the suprarenal and infrarenal abdominal aorta of 18 wild-type C57BL/6J mice and 15 apolipoprotein E (apoE)-/- mice. Although OWSS was not directly evaluated, results indicate that, unlike humans, there is no reversal of flow in the infrarenal aorta of wild-type or apoE-/- mice. Distensibility of the mouse aortic wall in both the suprarenal and infrarenal segments is higher than reported values for the human aorta. We conclude that normal mice do not experience the reverse flow in the infrarenal aorta that is observed in humans.

Partial carotid ligation is a model of acutely induced disturbed flow, leading to rapid endothelial dysfunction and atherosclerosis

Atherosclerosis is closely associated with disturbed flow characterized by low and oscillatory shear stress, but studies directly linking disturbed flow to atherogenesis is lacking. The major reason for this has been a lack of an animal model in which disturbed flow can be acutely induced and cause atherosclerosis. Here, we characterize partial carotid ligation as a model of disturbed flow with characteristics of low and oscillatory wall shear stress. We also describe a method of isolating intimal RNA in sufficient quantity from mouse carotid arteries. Using this model and method, we found that partial ligation causes upregulation of proatherogenic genes, downregulation of antiatherogenic genes, endothelial dysfunction, and rapid atherosclerosis in 2 wk in a p47(phox)-dependent manner and advanced lesions by 4 wk. We found that partial ligation results in endothelial dysfunction, rapid atherosclerosis, and advanced lesion development in a physiologically relevant model of disturbed flow. It also allows for easy and rapid intimal RNA isolation. This novel model and method could be used for genome-wide studies to determine molecular mechanisms underlying flow-dependent regulation of vascular biology and diseases.

Analysis of flow patterns in a patient-specific thoracic aortic aneurysm model

In this study, a newly developed two-equation transitional model was employed for the prediction of blood flow patterns in a thoracic aortic aneurysm (TAA) where the growth and progression are closely linked to low and oscillating wall shear stresses. Laminar–turbulent transition in the dilated vessel can alter the flow structure, shear stress and pressure distribution within the aneurysm. A patient-specific TAA model was reconstructed from magnetic-resonance (MR) images and measured velocity waveform was used as the inflow condition. Laminar flow and a correlation-based transitional version of Menter’s hybrid k − ϵ/ k − ω Shear Stress Transport (SST Tran) model were implemented in pulsatile simulations from which WSS distribution was obtained throughout a cardiac cycle and velocity profiles were compared with MR measurements. The correlation-based transitional model was found to produce results in closer agreement with the MR data than the laminar flow simulation.

Abstract 2800: Assessment of Computational Fluid Dynamics to Calculate Individual Coronary Wall Shear Stress In-Vivo

Beyond classic risk parameters non physiologic or oscillating wall shear stress (WSS) has been proven to act as a local factor for initiation and progression of atherosclerosis as well as for plaque rupture. Direct measurement of WSS in-vivo is difficult and restricted to animal models. Computational fluid dynamics (CFD) is a validated tool to compute flow parameters and WSS. For this purpose an exact model of the underlying patient specific geometry of the coronary tree is a prerequisite. Using 3D-IVUS or modern multislice computed tomographic coronary angiography (CTA) with submilimeter resolution these data can be provided. The aim of this study was to 1.) demonstrate feasibility of in-vivo CFD calculation of human coronaries based on CTA and 2.) to correlate the findings with radio frequency tissue information derived by intravascular ultrasound. We prospectively included 10 patients with suspected coronary artery disease who received CTA (Dual source 64 slice CT) and invasive conventional coronary angiography. Intravascular ultrasound and ECG-triggered radio frequency analysis (VH) was attempted in all three epicardial vessels. In the CTA-dataset the coronaries were segmented and a mesh model for CFD was generated. CFD calculations were performed using a commercial available software package with laminar flow and blood as a Newtonian fluid as boundary conditions. Coronary models were stationary with rigid vessel walls, while the pulsatile inflow characteristics was derived from invasive Doppler velocity measurement. Flow pattern calculations, vessel wall shear stress and IVUS analysis were successfully performed in 24/30 and 17/30 coronary arteries. The presence of high shear stress and non turbulent flow was inversely correlated with the presence of plaque as determined by intravascular ultrasound. No correlation of any CFD parameter with the radio frequency tissue information could yet be observed. The findings of the present study demonstrate the feasibility of assessing fluid tissue interactions in human coronary arteries using CTA and its correlation to invasive findings. The possible impact of CFD parameters on risk- and treatment stratification has to be determined in a large scale prospective trial.