Differences in Stress Forces and Geometry between Left and Right Coronary Artery: A Pathophysiological Aspect of Atherosclerosis Heterogeneity

作者：Katranas Sotirios A^*; Kelekis Anastasios L; Antoniadis Antonios P; Ziakas Antonios G; Giannoglou George D

来源：Hellenic Journal of Cardiology, 2015, 56(3): 217-223.

• Coronary computed tomography angiography
• topography of atherosclerosis
• endothelial shear stress
• molecular viscosity
• wall stress
• curvature

Introduction: We sought to assess noninvasively the differences in hemorrheologic and geometric parameters between the left and right coronary artery (RCA). Low endothelial shear stress (ESS), high molecular viscosity (MV), and high wall stress (WS) induce atherosclerosis, while curvature and torsion have lately been implicated in the atherosclerotic process.
Methods: We studied 28 coronary arteries from 22 subjects undergoing coronary computed tomography angiography. We performed 3D reconstruction of the left anterior descending (LAD, n=14), left circumflex (LCx, n=5), and RCA (n=9) arteries. ESS, MV, and WS were calculated for 2-mm segments using computational fluid dynamics. Curvature and torsion were calculated for each segment using morphometric algorithms.
Results: A total length of 187 cm of coronary arteries was studied. ESS was higher in the LAD compared to the LCx and RCA (13.76 Pa vs. 3.49 Pa vs. 3.76 Pa, p<0.001); MV was higher in the LCx compared to the LAD and RCA (0.00542 Pas vs. 0.00173 Pas vs. 0.00240 Pa.s, p<0.001); and WS had higher values in the RCA compared to the LAD and LCx (289.98 mmHg vs. 255.93 mmHg vs. 235.18 mmHg, p<0.001). Curvature was greater in the LCx compared to the LAD and RCA (0.1447 mm(-1) vs. 0.1229 mm(-1) vs. 0.1234 mm(-1), p<0.05), while torsion was found not to differ among the coronary arteries.
Conclusions: Hemorrheologic and geometric parameters differ between the left and right coronary arteries. These factors, either alone or in association with local flow patterns and geometry, may affect the topography of atherosclerosis in the coronary arterial tree.

• 出版日期2015-6