Left main coronary artery morphological phenotypes and its hemodynamic properties
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Published:2024-01-22
Issue:1
Volume:23
Page:
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ISSN:1475-925X
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Container-title:BioMedical Engineering OnLine
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language:en
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Short-container-title:BioMed Eng OnLine
Author:
Wang Qi,Ouyang Hua,Lv Lei,Gui Long,Yang Songran,Hua Ping
Abstract
Abstract
Background
Atherosclerosis may be linked to morphological defects that lead to variances in coronary artery hemodynamics. Few objective strategies exit at present for generalizing morphological phenotypes of coronary arteries in terms of hemodynamics. We used unsupervised clustering (UC) to classify the morphology of the left main coronary artery (LM) and looked at how hemodynamic distribution differed between phenotypes.
Methods
In this study, 76 LMs were obtained from 76 patients. After LMs were reconstructed with coronary computed tomography angiography, centerlines were used to extract the geometric characteristics. Unsupervised clustering was carried out using these characteristics to identify distinct morphological phenotypes of LMs. The time-averaged wall shear stress (TAWSS) for each phenotype was investigated by means of computational fluid dynamics (CFD) analysis of the left coronary artery.
Results
We identified four clusters (i.e., four phenotypes): Cluster 1 had a shorter stem and thinner branches (n = 26); Cluster 2 had a larger bifurcation angle (n = 10); Cluster 3 had an ostium at an angulation to the coronary sinus and a more curved stem, and thick branches (n = 10); and Cluster 4 had an ostium at an angulation to the coronary sinus and a flatter stem (n = 14). TAWSS features varied widely across phenotypes. Nodes with low TAWSS (L-TAWSS) were typically found around the branching points of the left anterior descending artery (LAD), particularly in Cluster 2.
Conclusion
Our findings demonstrated that UC is a powerful technique for morphologically classifying LMs. Different LM phenotypes exhibited distinct hemodynamic characteristics in certain regions. This morphological clustering method could aid in identifying people at high risk for developing coronary atherosclerosis, hence facilitating early intervention.
Funder
Natural Science Foundation Project in Guangdong province
Guangzhou Science and Technology project of Major Special Research Topics on International Collaborative Innovation
National Natural Science Foundation of China
Publisher
Springer Science and Business Media LLC
Subject
Radiology, Nuclear Medicine and imaging,Biomedical Engineering,General Medicine,Biomaterials,Radiological and Ultrasound Technology