Arteriosclerosis, Vol 5, 293-302, Copyright © 1985 by American Heart Association

ARTICLES

Pulsatile flow and atherosclerosis in the human carotid bifurcation. Positive correlation between plaque location and low oscillating shear stress

DN Ku, DP Giddens, CK Zarins and S Glagov

Fluid velocities were measured by laser Doppler velocimetry under conditions of pulsatile flow in a scale model of the human carotid bifurcation. Flow velocity and wall shear stress at five axial and four circumferential positions were compared with intimal plaque thickness at corresponding locations in carotid bifurcations obtained from cadavers. Velocities and wall shear stresses during diastole were similar to those found previously under steady flow conditions, but these quantities oscillated in both magnitude and direction during the systolic phase. At the inner wall of the internal carotid sinus, in the region of the flow divider, wall shear stress was highest (systole = 41 dynes/cm2, diastole = 10 dynes/cm2, mean = 17 dynes/cm2) and remained unidirectional during systole. Intimal thickening in this location was minimal. At the outer wall of the carotid sinus where intimal plaques were thickest, mean shear stress was low (-0.5 dynes/cm2) but the instantaneous shear stress oscillated between -7 and +4 dynes/cm2. Along the side walls of the sinus, intimal plaque thickness was greater than in the region of the flow divider and circumferential oscillations of shear stress were prominent. With all 20 axial and circumferential measurement locations considered, strong correlations were found between intimal thickness and the reciprocal of maximum shear stress (r = 0.90, p less than 0.0005) or the reciprocal of mean shear stress (r = 0.82, p less than 0.001). An index which takes into account oscillations of wall shear also correlated strongly with intimal thickness (r = 0.82, p less than 0.001). When only the inner wall and outer wall positions were taken into account, correlations of lesion thickness with the inverse of maximum wall shear and mean wall shear were 0.94 (p less than 0.001) and 0.95 (p less than 0.001), respectively, and with the oscillatory shear index, 0.93 (p less than 0.001). These studies confirm earlier findings under steady flow conditions that plaques tend to form in areas of low, rather than high, shear stress, but indicate in addition that marked oscillations in the direction of wall shear may enhance atherogenesis.

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				S. A. R. Hernandez, A. A. Kroon, M. P.J. van Boxtel, W. H. Mess, J. Lodder, J. Jolles, and P. W. de Leeuw Is There a Side Predilection for Cerebrovascular Disease? Hypertension, July 1, 2003; 42(1): 56 - 60. [Abstract] [Full Text] [PDF]

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				U. U. Ernemann, E. Gronewaller, F. B. Duffner, O. Guervit, J. Claassen, and M. D. Skalej Influence of Geometric and Hemodynamic Parameters on Aneurysm Visualization during Three-Dimensional Rotational Angiography: An in Vitro Study AJNR Am. J. Neuroradiol., April 1, 2003; 24(4): 597 - 603. [Abstract] [Full Text] [PDF]

				S. Mohan, M. Hamuro, G. P. Sorescu, K. Koyoma, E. A. Sprague, H. Jo, A. J. Valente, T. J. Prihoda, and M. Natarajan Ikappa Balpha -dependent regulation of low-shear flow-induced NF-kappa B activity: role of nitric oxide Am J Physiol Cell Physiol, April 1, 2003; 284(4): C1039 - C1047. [Abstract] [Full Text] [PDF]

				H. Kirii, T. Niwa, Y. Yamada, H. Wada, K. Saito, Y. Iwakura, M. Asano, H. Moriwaki, and M. Seishima Lack of Interleukin-1{beta} Decreases the Severity of Atherosclerosis in ApoE-Deficient Mice Arterioscler Thromb Vasc Biol, April 1, 2003; 23(4): 656 - 660. [Abstract] [Full Text] [PDF]

				M. Sitzer, D. Puac, A. Buehler, D. A. Steckel, S. von Kegler, H. S. Markus, and H. Steinmetz Internal Carotid Artery Angle of Origin: A Novel Risk Factor for Early Carotid Atherosclerosis Stroke, April 1, 2003; 34(4): 950 - 955. [Abstract] [Full Text] [PDF]

				C. P. Cheng, R. J. Herfkens, and C. A. Taylor Inferior vena caval hemodynamics quantified in vivo at rest and during cycling exercise using magnetic resonance imaging Am J Physiol Heart Circ Physiol, April 1, 2003; 284(4): H1161 - H1167. [Abstract] [Full Text] [PDF]

				J. F. LaDisa Jr., D. A. Hettrick, L. E. Olson, I. Guler, E. R. Gross, T. T. Kress, J. R. Kersten, D. C. Warltier, and P. S. Pagel Stent implantation alters coronary artery hemodynamics and wall shear stress during maximal vasodilation J Appl Physiol, December 1, 2002; 93(6): 1939 - 1946. [Abstract] [Full Text] [PDF]

				F. J. Miller Jr. Aortic Aneurysms: It's All About the Stress Arterioscler Thromb Vasc Biol, December 1, 2002; 22(12): 1948 - 1949. [Full Text] [PDF]

				Y. Wang, H. Miao, S. Li, K.-D. Chen, Y.-S. Li, S. Yuan, J. Y.-J. Shyy, and S. Chien Interplay between integrins and FLK-1 in shear stress-induced signaling Am J Physiol Cell Physiol, November 1, 2002; 283(5): C1540 - C1547. [Abstract] [Full Text] [PDF]

				Y. Hojo, Y. Saito, T. Tanimoto, R. J. Hoefen, C. P. Baines, K. Yamamoto, J. Haendeler, R. Asmis, and B. C. Berk Fluid Shear Stress Attenuates Hydrogen Peroxide-Induced c-Jun NH2-Terminal Kinase Activation via a Glutathione Reductase-Mediated Mechanism Circ. Res., October 18, 2002; 91(8): 712 - 718. [Abstract] [Full Text] [PDF]

				G. M. London, S. J. Marchais, A. P. Guerin, F. Metivier, and H. Adda Arterial structure and function in end-stage renal disease Nephrol. Dial. Transplant., October 1, 2002; 17(10): 1713 - 1724. [Full Text] [PDF]

				S. Kinlay, J. Grewal, D. Manuelin, J. C. Fang, A. P. Selwyn, J. A. Bittl, and P. Ganz Coronary Flow Velocity and Disturbed Flow Predict Adverse Clinical Outcome After Coronary Angioplasty Arterioscler Thromb Vasc Biol, August 1, 2002; 22(8): 1334 - 1340. [Abstract] [Full Text] [PDF]

				B. Ariff, A. Stanton, D. Barratt, A. Augst, F. Glor, N. Poulter, P. Sever, Yun Xu, A. Hughes, and S. A. Thom Comparison of the effects of antihypertensive treatment with angiotensin II blockade and beta-blockade on carotid wall structure and haemodynamics: protocol and baseline demographics Journal of Renin-Angiotensin-Aldosterone System, June 1, 2002; 3(2): 116 - 122. [Abstract] [PDF]

				A. R. Brooks, P. I. Lelkes, and G. M. Rubanyi Gene expression profiling of human aortic endothelial cells exposed to disturbed flow and steady laminar flow Physiol Genomics, April 10, 2002; 9(1): 27 - 41. [Abstract] [Full Text] [PDF]

				H. B. Barner Remodeling of arterial conduits in coronary grafting Ann. Thorac. Surg., April 1, 2002; 73(4): 1341 - 1345. [Abstract] [Full Text] [PDF]

				M. J. Starmans-Kool, A. V. Stanton, S. Zhao, X. Y. Xu, S. A. M. Thom, and A. D. Hughes Measurement of hemodynamics in human carotid artery using ultrasound and computational fluid dynamics J Appl Physiol, March 1, 2002; 92(3): 957 - 961. [Abstract] [Full Text] [PDF]

				R. Palumbo, C. Gaetano, A. Antonini, G. Pompilio, E. Bracco, L. Ronnstrand, C.-H. Heldin, and M. C. Capogrossi Different Effects of High and Low Shear Stress on Platelet-Derived Growth Factor Isoform Release by Endothelial Cells: Consequences for Smooth Muscle Cell Migration Arterioscler Thromb Vasc Biol, March 1, 2002; 22(3): 405 - 411. [Abstract] [Full Text] [PDF]