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. 2012;7(8):e42558.
doi: 10.1371/journal.pone.0042558. Epub 2012 Aug 14.

Impact of coronary tortuosity on coronary pressure: numerical simulation study

Yang Li  1 , Zhengtao Shi, Yan Cai, Yi Feng, Genshan Ma, Chengxing Shen, Zhiyong Li, Naifeng Liu
Affiliations

Impact of coronary tortuosity on coronary pressure: numerical simulation study

Yang Li et al. PLoS One. 2012.

Abstract

Background: Coronary tortuosity (CT) is a common coronary angiographic finding. Whether CT leads to an apparent reduction in coronary pressure distal to the tortuous segment of the coronary artery is still unknown. The purpose of this study is to determine the impact of CT on coronary pressure distribution by numerical simulation.

Methods: 21 idealized models were created to investigate the influence of coronary tortuosity angle (CTA) and coronary tortuosity number (CTN) on coronary pressure distribution. A 2D incompressible Newtonian flow was assumed and the computational simulation was performed using finite volume method. CTA of 30°, 60°, 90°, 120° and CTN of 0, 1, 2, 3, 4, 5 were discussed under both steady and pulsatile conditions, and the changes of outlet pressure and inlet velocity during the cardiac cycle were considered.

Results: Coronary pressure distribution was affected both by CTA and CTN. We found that the pressure drop between the start and the end of the CT segment decreased with CTA, and the length of the CT segment also declined with CTA. An increase in CTN resulted in an increase in the pressure drop.

Conclusions: Compared to no-CT, CT can results in more decrease of coronary blood pressure in dependence on the severity of tortuosity and severe CT may cause myocardial ischemia.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Angiography of LAD tortuosity.
Figure 2
Figure 2. Geometrical parameters of model (CTA = 30°, CTN = 1).
Figure 3
Figure 3. The distribution of velocity with different CTN (CTA = 30°).
Figure 4
Figure 4. Pressure drop at different CTN and CTA.
Figure 5
Figure 5. Pressure drop at different length of coronary artery.
Figure 6
Figure 6. Boundary conditions under pulsatile state.
(A) Inlet velocity curve in one cardiac cycle, (B) Outlet pressure curve in one cardiac cycle.
Figure 7
Figure 7. Pressure distribution at three time points in one cardiac cycle (CTA = 30o and CTN = 2).
(A) Blood pressure variation at t1, (B) Blood pressure variation at t2, (C) Blood pressure variation at t3.
See this image and copyright information in PMC

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