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Atherosclerosis and Lipoproteins |
From the Department of Biomedical Engineering, Duke University, Durham, NC.
Correspondence to Morton H. Friedman, Box 90281, Campus, Duke University, Durham NC 27708-0281. E-mail mhfriedm{at}duke.edu
Objective It is widely recognized that hemodynamic and wall mechanical forces are involved in the initiation and development of atherosclerosis. In the coronary vasculature, these forces are likely mediated by arterial dynamics and geometry. This research examines the hypothesis that coronary artery motion and geometry affect the local predisposition to disease, presumably through their influence on the stresses at and in the artery wall.
Methods and Results The dynamics of a human right coronary artery and the variation of wall thickness along its length were characterized from biplane cineangiograms and intravascular ultrasound records, respectively. The dynamic geometry parameters were distance along the vessel, cyclic displacement, axial strain, curvature, and torsion. Multiple regression analyses using principal components show that (1) no single dynamic geometry parameter has a dominant influence on wall thickness, (2) linear combinations of such parameters predict wall thickness measures with high confidence (P<0.001; R2 between 0.17 and 0.44), and (3) both the time-average values of curvature and torsion and their excursion during the cardiac cycle are positively correlated with maximum wall thickness and cross-sectional asymmetry.
Conclusions The relationships seen here support the hypothesis that dynamic geometry plays a role in the localization of early coronary artery thickening.
Key Words: coronary arteries dynamic geometry wall thickness biplane angiography intravascular ultrasound
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