Abstract 15816: Normal Distribution of Wall Shear Stress in the Coronary Arteries
Introduction: The ability to detect hemodynamically significant coronary artery disease non-invasively has been a goal that has the potential to improve patient care significantly. New non-invasive approaches using coronary CT angiograms (CCTAs) have been proposed and appear to show some promise.
Hypothesis: One such method is the measurement of measuring wall shear stress (WSS), the tangential force of flowing blood against the artery wall, using computational fluid dynamics (CFD). However, in order to deem this technique useful in clinical practice, the normal values must first be defined. These values have been minimally reported and are limited to the left coronary tree.
Methods: We ran a CFD simulation of WSS on 3-D reconstructions of the coronary arteries derived from the CCTAs of 35 patients with either no disease or non-obstructive (< 50%) stenosis from the DeFACTO trial, a multi-center study. The resulting model was segmented according to the Society of Cardiovascular CT guidelines, separating the proximal and distal parts of each artery as well as the major side branches. The segments were composed of WSS values at hundreds of points along the vessel wall. The median value was taken as a representative of each segment.
Results: The average values were calculated and varied significantly from one another, especially the proximal and distal parts of the same artery, as showing in Figure 1.
Conclusions: These results establish the first known WSS distribution within all of the coronary arteries and serve as a foundation for defining a cut-off for abnormal values. Importantly, they also illuminate the variability of WSS that occurs even throughout a single artery and suggests that perhaps multiple abnormal cutoffs need to be established to evaluate WSS based on the location of the stenosis.
Author Disclosures: A. Starikov: None. G. Xiong: None. J.K. Min: Other Research Support; Modest; GE Healthcare. Ownership Interest; Modest; Autoplaq, MDDX. Consultant/Advisory Board; Modest; Abbott Vascular, Arineta, HeartFlow, NeoGraft Technologies, MyoKardia, CardioDx.
- © 2015 by American Heart Association, Inc.