Reduced Shear Stress and Longer Blood Flow Time Occur in Both Severe Focal and Mild Diffuse LAD Lesions: Angiograms Alone Don’t Always Reveal Their True Impact on Blood Flow
<b>Background/Objectives:</b> The similarities and differences from a rheological perspective between significant short focal and mild long coronary lesions warrant investigation to elucidate wall shear stress (WSS) angiographic discrepancies. <b>Methods</b>: Patients who und...
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MDPI AG
2025-06-01
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| author | Gianluca Rigatelli Marco Zuin Niva Mileva Dobrin Vassilev Giuseppe Marchese Ervis Hiso Andrea Bertolini Claudio Bilato |
| author_facet | Gianluca Rigatelli Marco Zuin Niva Mileva Dobrin Vassilev Giuseppe Marchese Ervis Hiso Andrea Bertolini Claudio Bilato |
| author_sort | Gianluca Rigatelli |
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| description | <b>Background/Objectives:</b> The similarities and differences from a rheological perspective between significant short focal and mild long coronary lesions warrant investigation to elucidate wall shear stress (WSS) angiographic discrepancies. <b>Methods</b>: Patients who underwent coronary computed tomography angiography (CCTA) between 1 January 2023 and 1 September 2024 were selected for computational fluid dynamics (CFD) analysis. The selection criteria included either a focal (≤20 mm) hemodynamically significant stenosis, defined as ≥75% lumen narrowing, or a long (30–40 mm) non-hemodynamically significant lesion showing ≤50% stenosis of the left anterior descending (LAD) artery. Patient-specific models were reconstructed from ECG-gated CCTA images. Wall shear stress (WSS, measured in Pascals) and residence time (RT) were evaluated for each patient. <b>Results</b>: The LAD arteries of 30 patients (mean age 54 years, 63.3% men) were evaluated: 16 with focal, hemodynamically significant coronary stenosis, while 14 with diffuse, long, non-hemodynamically significant coronary lesions. Both groups exhibited a lower mean WSS compared to the non-stenosed segment, with no significant difference in mean WSS between the two groups (<i>p</i> = 0.84). Conversely, both groups demonstrated a higher mean residence time (RT) compared to the non-stenosed segments (0.2 ± 0.06 vs. 0.60 ± 0.03, <i>p</i> < 0.001 and 0.2 ± 0.006 vs. 0.59 ± 0.02, <i>p</i> < 0.001, respectively), and no significant difference in mean RT (<i>p</i> = 0.82). <b>Conclusions</b>: Long, angiographically mild coronary stenoses show similar WSS and RT characteristics compared to short hemodynamically significant coronary stenosis. |
| format | Article |
| id | doaj-art-a2e8c2d7dc55446db4bf2fb51419d8c6 |
| institution | Kabale University |
| issn | 1873-149X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
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| series | Pathophysiology |
| spelling | doaj-art-a2e8c2d7dc55446db4bf2fb51419d8c62025-08-20T03:29:35ZengMDPI AGPathophysiology1873-149X2025-06-013222810.3390/pathophysiology32020028Reduced Shear Stress and Longer Blood Flow Time Occur in Both Severe Focal and Mild Diffuse LAD Lesions: Angiograms Alone Don’t Always Reveal Their True Impact on Blood FlowGianluca Rigatelli0Marco Zuin1Niva Mileva2Dobrin Vassilev3Giuseppe Marchese4Ervis Hiso5Andrea Bertolini6Claudio Bilato7Interventional Cardiology Unit, Madre Teresa di Calcutta Hospitals, Padova South Hospitals, 35043 Monselice, ItalyInterventional Cardiology Unit, Madre Teresa di Calcutta Hospitals, Padova South Hospitals, 35043 Monselice, ItalyMedica Cor Hospital, 1713 Ruse, BulgariaMedica Cor Hospital, 1713 Ruse, BulgariaInterventional Cardiology Unit, Madre Teresa di Calcutta Hospitals, Padova South Hospitals, 35043 Monselice, ItalyInterventional Cardiology Unit, Madre Teresa di Calcutta Hospitals, Padova South Hospitals, 35043 Monselice, ItalyInterventional Cardiology Unit, Madre Teresa di Calcutta Hospitals, Padova South Hospitals, 35043 Monselice, ItalyDepartment of Cardiology, West Vicenza Hospitals, 36071 Arzignano, Italy<b>Background/Objectives:</b> The similarities and differences from a rheological perspective between significant short focal and mild long coronary lesions warrant investigation to elucidate wall shear stress (WSS) angiographic discrepancies. <b>Methods</b>: Patients who underwent coronary computed tomography angiography (CCTA) between 1 January 2023 and 1 September 2024 were selected for computational fluid dynamics (CFD) analysis. The selection criteria included either a focal (≤20 mm) hemodynamically significant stenosis, defined as ≥75% lumen narrowing, or a long (30–40 mm) non-hemodynamically significant lesion showing ≤50% stenosis of the left anterior descending (LAD) artery. Patient-specific models were reconstructed from ECG-gated CCTA images. Wall shear stress (WSS, measured in Pascals) and residence time (RT) were evaluated for each patient. <b>Results</b>: The LAD arteries of 30 patients (mean age 54 years, 63.3% men) were evaluated: 16 with focal, hemodynamically significant coronary stenosis, while 14 with diffuse, long, non-hemodynamically significant coronary lesions. Both groups exhibited a lower mean WSS compared to the non-stenosed segment, with no significant difference in mean WSS between the two groups (<i>p</i> = 0.84). Conversely, both groups demonstrated a higher mean residence time (RT) compared to the non-stenosed segments (0.2 ± 0.06 vs. 0.60 ± 0.03, <i>p</i> < 0.001 and 0.2 ± 0.006 vs. 0.59 ± 0.02, <i>p</i> < 0.001, respectively), and no significant difference in mean RT (<i>p</i> = 0.82). <b>Conclusions</b>: Long, angiographically mild coronary stenoses show similar WSS and RT characteristics compared to short hemodynamically significant coronary stenosis.https://www.mdpi.com/1873-149X/32/2/28coronary artery diseasefluid dynamicrheologycomputation fluid dynamic |
| spellingShingle | Gianluca Rigatelli Marco Zuin Niva Mileva Dobrin Vassilev Giuseppe Marchese Ervis Hiso Andrea Bertolini Claudio Bilato Reduced Shear Stress and Longer Blood Flow Time Occur in Both Severe Focal and Mild Diffuse LAD Lesions: Angiograms Alone Don’t Always Reveal Their True Impact on Blood Flow Pathophysiology coronary artery disease fluid dynamic rheology computation fluid dynamic |
| title | Reduced Shear Stress and Longer Blood Flow Time Occur in Both Severe Focal and Mild Diffuse LAD Lesions: Angiograms Alone Don’t Always Reveal Their True Impact on Blood Flow |
| title_full | Reduced Shear Stress and Longer Blood Flow Time Occur in Both Severe Focal and Mild Diffuse LAD Lesions: Angiograms Alone Don’t Always Reveal Their True Impact on Blood Flow |
| title_fullStr | Reduced Shear Stress and Longer Blood Flow Time Occur in Both Severe Focal and Mild Diffuse LAD Lesions: Angiograms Alone Don’t Always Reveal Their True Impact on Blood Flow |
| title_full_unstemmed | Reduced Shear Stress and Longer Blood Flow Time Occur in Both Severe Focal and Mild Diffuse LAD Lesions: Angiograms Alone Don’t Always Reveal Their True Impact on Blood Flow |
| title_short | Reduced Shear Stress and Longer Blood Flow Time Occur in Both Severe Focal and Mild Diffuse LAD Lesions: Angiograms Alone Don’t Always Reveal Their True Impact on Blood Flow |
| title_sort | reduced shear stress and longer blood flow time occur in both severe focal and mild diffuse lad lesions angiograms alone don t always reveal their true impact on blood flow |
| topic | coronary artery disease fluid dynamic rheology computation fluid dynamic |
| url | https://www.mdpi.com/1873-149X/32/2/28 |
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