Document Type : Full Research Paper


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



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.


Main Subjects

  1. [1]   J. Bukala, et al., “Numerical analysis of stent expansion process in coronary artery stenosis with the use of non-compliant balloon,”Biocybernetics and Biomedical Engineering, 2016, Vol. 36, No. 1, pp. 145–156.

    [2]   Donald Lloyd-Jones,, et al., “Executive summary: Heart disease and stroke statistics-2010 update: A report from the american heart association,” Circulation.,2010, 121:948-954.

    1. S. Go, D. Mozaffarian, V. L. Roger, E. J. Benjamin, et al., Heart disease and stroke statistics-2013 update: a report from the american heart association, Circulation, 2012, Vol. 127, No.1, pp. 6-24.

    [3]     M. Malve , et al., “Tortuosity of Coronary Bifurcation as a Potential Local Risk Factor for Atherosclerosis: CFD Steady State Study Based on In Vivo Dynamic CT Measurements,” Ann Biomed Eng, 2015, Vol. 43, No. 1, pp. 82–93.

    [4]     Malek AM, et al., “hemodynamic shear stress and its role in atherosclerosis,” JAMA, 1999, 1;282(21):2035-42.

    [5]     Heather A. Himburg, et al., “Spatial comparison between wall shear stress measures and porcine arterial endothelial permeability,” Am J Physiol Heart CircPhysiol, 2004, 286: H1916–H1922.

    [6]     Wei Yin, et al., “The effect of physiologically relevant dynamic shear stress on platelet and endothelial cell activation” Thrombosis Research, 2011, 127;235–241.

    [7]     Christopher K. Zarins, et al., “Carotid bifurcation atherosclerosis. Quantitative correlation of plaque localization with flow velocity profiles and wall shear stress,” Circ Res., 1983,53(4):502-14.

    [8]     Thomas M. Farmakis, et al., “Wall shear stress gradient topography in the normal left coronary arterial tree: possible implications for atherogenesis,” Curr Med Res Opin., 2004, 20(5):587-96.

    [9]     Chatzizisis YS, et al., “Prediction of the localization of high-risk coronary atherosclerotic plaques on the basis of low endothelial shear stress,” Circulation, 2008, 26;117(8):993-1002.

    [10] Santamarina A, et al., “Computational analysis of flow in a curved tube model of the coronary arteries,” Ann Biomed Eng.,1998,26(6):944-54.

    [11] J. Theodore Dodge Jr.,et al,. “Intrathoracic Spatial Location of Specified Coronary Segments on the Normal Human Heart,” Circulation, 1988, Vol 78, No 5.

    [12]                       J. Theodore Dodge Jr.,et al,. “Influence of Age, Sex, Anatomic Variation, and Left Ventricular Hypertrophy or Dilation,” Circulation, 1992, 86:232-246.

    [13]                       Murray, C.D., “The physiological principle of minimum work. I.The vascular system and the cost of blood volume,” Proceedings of National Academy Science, 1926, 12, 207–14.

    [14]                       YoshinobuMurasato, et al,. “Recent Perspective on Coronary Bifurcation Intervention: Statement of theBifurcation Club in KOKURA,” Journal of Interventional Cardiology, 2010, Vol. 23, No. 4.

    [15]                       Wiwatanapataphee B, et al., “Effect of branchings on blood flow in the system of human coronary arteries,” Math Biosci Eng., 2012, 1;9(1):199-214.

    [16]                       Chaichana TSun ZJewkes J. “Computation of hemodynamics in the left coronary artery with variable angulations,” J Biomech., 2011,7;44(10):1869-78.

    [17]                       Johnston BMJohnston PRCorney SKilpatrick D. “Non-Newtonian blood flow in human right coronary arteries: steady state simulations,” J Biomech.,2004,  37(5):709-20.

    [18]                       M Xavier, et al,. “An Adapted Optical Flow Algorithm for RobustQuantification of Cardiac Wall Motion FromStandard Cine-MR Examinations,” IEEE Trans InfTechnol Biomed., 2012, 16(5):859-68.

    [19]                       Chiastra CMorlacchi S, at al., “Computational fluid dynamic simulations of image-based stented coronary bifurcation models” J R Soc Interface., 2013, 15;10(84).

    [20] Ku, D.N., Giddens, D.P., Zarins, C.K., Glagov, S., “Pulsatile flow and athero- sclerosis in the human carotid bifurcation,Positive correlation between plaque location and low oscillating shear stress” Arteriosclerosis,1985, 85 (5), 293–302.

    [21] Xiaoyi He, David N. Ku, “Pulsatile Flow in the Human Left Coronary Artery Bifurcation: Average Conditions1”, J Biomech Eng.,1996,74, Vol. 118.

    [22] Kabinejadian FChua LP, at al., “A Novel Coronary Artery Bypass Graft Design of Sequential Anastomoses,” Ann Biomed Eng., 2010, 38(10):3135-50.

    [23] Soulis JV, Farmakis TM, Giannoglou GD, Louridas GE. “Wall shear stress in normal left coronary artery tree,” J Biomech.,2006, 39(4):742-9.

    [24] Parham Eshtehardi, at al., “Association of Coronary Wall Shear Stress With Atherosclerotic Plaque Burden, Composition, and Distribution in Patients With Coronary Artery Disease,” J Am Heart Assoc. 2012;1:e002543.

    [25]                       HavardNordgaard, et al., “Impact of competitive flow on wall shear stress in coronary surgery: computational fluiddynamics of a LIMA–LAD model,” Cardiovascular Research,2010, pp. 512-519.

    [26]                       Papafaklis MI, Koskinas KC, Chatzizisis YS, Stone PH, Feldman CL. “In-vivo assessment of the natural history of coronary atherosclerosis: vascular remodeling and endothelial shear stress determine the complexity of atherosclerotic disease progression.”CurrOpinCardiol, 2010;25:627–638.

    [27]                       LaDisa JF Jr, at al., “Alterations in regional vascular geometry produced by theoretical stent implantation influence distributions of wall shear stress: analysis of a curved coronary artery using 3D computational fluid dynamics modeling, “Biomed Eng Online., 2006, 16;5:40.

    [28]                       Zeng D, Ding Z, Friedman MH, Ethier CR. “Effects of Cardiac Motion on Right Coronary Artery Hemodynamics,” Ann Biomed Eng. , 2003, 31(4):420-9.

    [29]                       Sadeghi MR, at al., “The effects of stenosis severity on the hemodynamic parameters-assessment of the correlation between stress phase angle and wall shear stress,” J Biomech., Oct 2011, 13;44(15):2614-26.