A hemodynamic comparison of myocardial bridging and coronary atherosclerotic stenosis: a computational model with experimental evaluation
M Sharzehee, Y Seddighi… - Journal of …, 2021 - asmedigitalcollection.asme.org
Journal of Biomechanical Engineering, 2021•asmedigitalcollection.asme.org
Myocardial bridging (MB) and coronary atherosclerotic stenosis can impair coronary blood
flow and may cause myocardial ischemia or even heart attack. It remains unclear how MB
and stenosis are similar or different regarding their impacts on coronary hemodynamics. The
purpose of this study was to compare the hemodynamic effects of coronary stenosis and MB
using experimental and computational fluid dynamics (CFD) approaches. For CFD
modeling, three MB patients with different levels of lumen obstruction, mild, moderate, and …
flow and may cause myocardial ischemia or even heart attack. It remains unclear how MB
and stenosis are similar or different regarding their impacts on coronary hemodynamics. The
purpose of this study was to compare the hemodynamic effects of coronary stenosis and MB
using experimental and computational fluid dynamics (CFD) approaches. For CFD
modeling, three MB patients with different levels of lumen obstruction, mild, moderate, and …
Abstract
Myocardial bridging (MB) and coronary atherosclerotic stenosis can impair coronary blood flow and may cause myocardial ischemia or even heart attack. It remains unclear how MB and stenosis are similar or different regarding their impacts on coronary hemodynamics. The purpose of this study was to compare the hemodynamic effects of coronary stenosis and MB using experimental and computational fluid dynamics (CFD) approaches. For CFD modeling, three MB patients with different levels of lumen obstruction, mild, moderate, and severe were selected. Patient-specific left anterior descending (LAD) coronary artery models were reconstructed from biplane angiograms. For each MB patient, the virtually healthy and stenotic models were also simulated for comparison. In addition, an in vitro flow-loop was developed, and the pressure drop was measured for comparison. The CFD simulations results demonstrated that the difference between MB and stenosis increased with increasing MB/stenosis severity and flowrate. Experimental results showed that increasing the MB length (by 140%) only had significant impact on the pressure drop in the severe MB (39% increase at the exercise), but increasing the stenosis length dramatically increased the pressure drop in both moderate and severe stenoses at all flow rates (31% and 93% increase at the exercise, respectively). Both CFD and experimental results confirmed that the MB had a higher maximum and a lower mean pressure drop in comparison with the stenosis, regardless of the degree of lumen obstruction. A better understanding of MB and atherosclerotic stenosis may improve the therapeutic strategies in coronary disease patients and prevent acute coronary syndromes.
The American Society of Mechanical Engineers
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