冠状动脉斑块分型及分叉角度对斑块影响的血液动力学模拟
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国家自然科学基金项目(51890891, 51890894)


Effects of Plaque Classification and Bifurcation Angle on Coronary Plaques: A Hemodynamic Simulation
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    摘要:

    目的 分析斑块分布分型和血管分叉角度对冠状动脉分叉血管内血液动力学的影响,进一步探讨对斑块易损性发展的影响规律。方法 基于人体冠状动脉分叉血管的平均几何参数,构建不同斑块分布分型和血管分叉角度情况下的流固耦合模型,研究关键部位处的血流速度、压力以及剪切应力分布。结果 斑块上游的肩部是斑块表面剪切应力最大的部位,容易发生溃疡或破裂并进一步发展;当分叉血管单侧有斑块时,分叉脊处的剪切应力大于双侧有斑块的情况。血管分叉脊处的压力和剪切应力随分叉角度减小而逐渐增大。结论 分叉处单侧有斑块时,斑块溃疡或破裂的概率更大。主支血管内斑块的存在会促进分叉处斑块的形成和发展。血管分叉的角度越小,分叉脊处的血管内壁越易受损。研究结果可为易损斑块治疗方案的设计与优化提供理论参考。

    Abstract:

    Objective To analyze the influence of plaque classification and bifurcation angle on hemodynamics in coronary artery, so as to further discuss the influence on vulnerable atherosclerotic plaques. Methods Based on average geometric parameters of human coronary bifurcation vessels, the model of fluid-solid interaction for coronary bifurcation vessels with different plaque classifications and vessel bifurcation angles was constructed, and the distributions of blood flow velocity, pressure and shear stress at critical positions were investigated. Results The upstream shoulder of the plaque was the site with the highest shear stress on plaque surface, which was prone to ulceration or rupture with further growth. When there were plaques on one side of the bifurcation vessels, the shear stress at the carina of bifurcations was greater than that at the bilateral plaques. The pressure and shear stress at the carina of bifurcations gradually increased as the bifurcation angle decreased. Conclusions When there are plaques on one side of the bifurcation vessels, the probability of ulceration or rupture is greater. The presence of plaque in main vessels can promote formation and growth of the plaque at bifurcations. The inner wall of blood vessels at the carina of bifurcations is more easily damaged in the case of small angle vessels. The results can provide theoretical references for the design and optimization of vulnerable atherosclerotic plaque treatment.

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闫晓彤,乐恺,张燕,张欣欣.冠状动脉斑块分型及分叉角度对斑块影响的血液动力学模拟[J].医用生物力学,2022,37(4):676-683

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  • 收稿日期:2021-09-05
  • 最后修改日期:2021-10-29
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  • 在线发布日期: 2022-08-25
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