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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北京科技大学能源与环境工程学院热能工程系

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Hemodynamic simulation of the effects of plaque classification and bifurcation angle on vulnerable atherosclerotic plaques
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    摘要:

    目的 分析斑块分布分型和血管分叉角度两种因素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,研究了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值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。

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    Objective The influence of plaque classification and bifurcation angle on hemodynamics in coronary artery was analyzed, and the effect on vulnerable atherosclerotic plaques was further discussed. Methods Based on the average geometric parameters of human coronary artery bifurcation vessels, a three-dimensional model of fluid-solid interaction for coronary bifurcation vessels with different plaque classifications and vessel bifurcation angles was constructed in this study to investigate the blood flow velocity, pressure and shear stress distribution at the critical areas. Results The upstream shoulder of the plaque is the site with the highest shear stress on the plaque surface, which is prone to ulceration or rupture and further growth. When there are plaques on one side of the bifurcation vessels, the shear stress of the carina of bifurcations is greater than that of the bilateral plaques. The pressure and shear stress at the carina of the bifurcation of vessels gradually increase as the bifurcation angle decreases. Conclusions When there are plaques on one side of the bifurcation vessels, the probability of damage is greater than that of the bilateral plaques. The presence of plaque in main vessels can promote the formation and growth of plaque at the bifurcation plaque. The inner wall of the blood vessels at the carina of the bifurcation is more easily damaged in the case of small angle vessels. The research results can provide theoretical references for the treatment of vulnerable atherosclerotic plaque.

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  • 收稿日期:2021-09-05
  • 最后修改日期:2021-11-24
  • 录用日期:2021-11-26
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