تأثیر تنش برشی دیواره و شاخص برش نوسانی بر احتمال تشکیل پلاک‌های آترواسکلروز در درخت طبیعی عروق کرونر چپ

نوع مقاله: مقاله کامل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد مکانیک، گروه مکانیک، دانشکدهمهندسی مکانیک، دانشگاه صنعتی شاهرود

2 استادیار گروه بیومکانیک، دانشکده مهندسی، دانشگاه آزاد اسلامی واحد مشهد

10.22041/ijbme.2016.22693

چکیده

تنش برشی دیواره(WSS)  و شاخص برش نوسانی(OSI)  از عوامل همودینامیکی هستند که ارتباطی قوی با توسعة پلاک­های آترواسکلروتیک (AS) دارند. WSS در برخی زمان­ها قادر به بیان گرفتگی عروق نیست؛ در حالی­که OSI تنش برشی را بدون در­نظر­گرفتن میانگین زمانی بردار تنش برشی بیان می­کند. بیشتر شبیه­سازی­های دینامیک سیالات محاسباتی (CFD) برای هندسة دوشاخه شدن کرونر چپ اصلی انجام­شده­ است و تاکنون به بررسی کل درخت کرونر چپ پرداخته نشده است. در این مطالعه، یک مدل سه­بعدی کامل از درخت کرونر چپ شامل کرونر چپ اصلی، کرونر نزولی قدامی چپ و انشعابات آن، سیرکمفلکس چپ و انشعابات آن ایجاد شد. اثرات حرکت قلب بر دیوارة عروق کرونر چپ اعمال شد. تجزیه و تحلیل المان محدود از معادلات جریان ناویر استوکس برای جریان ضربانی و رفتار غیرنیوتنی از خون صورت گرفت. توزیع تنش­های برشی  و توزیع OSI روی دیوارة عروق، نتایج به­دست­آمده از این تحقیق هستند. مقایسة این نتایج با اطلاعات بالینی نشان داد که مناطق با تنش برشی متوسط 1.50 [Pa] و کمتر از آن در حضور OSI بیشتر از 0.3، می‌تواند مناطق پر خطر در تشکیل پلاک­های AS محسوب شود. بنابراین می‌توان پیش­بینی کرد که علاوه بر ناحیة انشعاب LCxA-LMCA (که در بسیاری از تحقیقات اعلام شده­اند)، نواحی دیگری در درخت شریانی کرونر چپ ازجمله ناحیة LAD بعد از انشعاب سوم و ناحیة انشعاب LCxA-OM، نواحی با خطر بالا خواهند بود.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

The effect of wall shear stress and oscillatory shear index on probability of atherosclerosis plaque formation in normal left coronary artery tree

نویسندگان [English]

  • Saeed Bahrami 1
  • Faramarz Firouzi 2
1 M.Sc Student, Mechanical EngineeringDepartment, Shahrood University of Technology, Shahrood, Iran
2 Assistant Professor, Biomechanic Department, Biomedical Engineering Faculty, Islamic Azad University of Mashhad, Iran
چکیده [English]

It is accepted that wall shear stress (WSS) and Oscillatory Shear index (OSI) are strong hemodynamic factors to development of atherosclerotic (AS) plaque. Sometimes, OSI has an important effect on AS plaque formation, because WSSdoesn't make it happenalone. Most computational fluid dynamic (CFD) simulations were performed on left main coronary bifurcation geometry, and whole left coronary artery tree has not been investigated by now. In this paper, a thorough three-dimensional model of left coronary artery tree was considered, including left main coronary, left anterior descending and its branches, left circumflex artery and its branches. Effects of cardiac motions on vessel wall of left coronary were considered. The governingNavier–Stokes equations for pulsatile flow and incompressible non-Newtonian blood was analyzed with finite element method. The study concentrates on shear stress distribution and OSI distribution on the vessel wall. Comparing the results of this study with previous clinical investigations shows that the regions with low wall shear stress (equal to and less than 1.5[Pa]) along with high OSI value (equal to and more than 0.3) have potential to development of AS plaque.So it can be predicted that the LAD region after D3 and the bifurcation of LCxA-OM have high potential to development of AS, in addition to the bifurcation of LCxA-LMCA which had been specified before.

کلیدواژه‌ها [English]

  • Computational fluid dynamic
  • Artery stenosis
  • Shear stressoscillatory
  • Left coronary tree

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