Impact of coronary bifurcation morphology on wave propagation

Rivolo, Simone; Hadjilucas, Lucas; Sinclair, Matthew; Horssen, Pepijn van; Wijngaard, Jeroen P. van den; Wesolowski, Roman; Chiribiri, Amedeo; Siebes, Maria; Smith, Nicolas P.; Lee, Jack

doi:10.1152/ajpheart.00130.2016

Cited by 6 publications

(11 citation statements)

References 78 publications

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“…Yet, branching was more symmetric and very asymmetric nodes occurred far less in the current human heart as compared to porcine hearts. For example, for large mother diameters (>500 µm) the median observed symmetry ratio was 0.59, in contrast to values below 0.40 for porcine data (VanBavel and Spaan, 1992;Kalsho and Kassab, 2004;Rivolo et al, 2016). Despite the same trend of increasing symmetry with decreasing diameter, this difference was found for all diameter classes, and at least for the larger diameter classes this cannot be attributed to the 30 µm resolution in the current study.…”

Section: Topologycontrasting

confidence: 81%

“…Available anatomical studies address specific research questions and provide only limited data that do not allow a translation toward global coronary hemodynamics. This includes the vascularization of the anterior papillary muscle, perfused by the LCA versus RCA (Zajaczkowski et al, 2018), the impact of branching on wave propagation (Rivolo et al, 2016), the effect of side branches on coronary flow (Wiwatanapataphee et al, 2012), and branching patterns of only the large coronary arteries (Hutchins et al, 1976;Seiler et al, 1992;van der Waal et al, 2009;Schoenenberger et al, 2012;Cardenes et al, 2013;Gupta et al, 2013;Medrano-Gracia et al, 2017;Ormiston et al, 2018). In an initial study, we analyzed the presence of collateral connections within and between the perfusion territories in the human heart .…”

Section: Previous Datamentioning

confidence: 99%

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Topologic and Hemodynamic Characteristics of the Human Coronary Arterial Circulation

et al. 2020

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Background: Many processes contributing to the functional and structural regulation of the coronary circulation have been identified. A proper understanding of the complex interplay of these processes requires a quantitative systems approach that includes the complexity of the coronary network. The purpose of this study was to provide a detailed quantification of the branching characteristics and local hemodynamics of the human coronary circulation. Methods: The coronary arteries of a human heart were filled post-mortem with fluorescent replica material. The frozen heart was alternately cut and block-face imaged using a high-resolution imaging cryomicrotome. From the resulting 3D reconstruction of the left coronary circulation, topological (node and loop characteristics), topographic (diameters and length of segments), and geometric (position) properties were analyzed, along with predictions of local hemodynamics (pressure and flow). Results: The reconstructed left coronary tree consisted of 202,184 segments with diameters ranging from 30 µm to 4 mm. Most segments were between 100 µm and 1 mm long. The median segment length was similar for diameters ranging between 75 and 200 µm. 91% of the nodes were bifurcations. These bifurcations were more symmetric and less variable in smaller vessels. Most of the pressure drop occurred in vessels between 200 µm and 1 mm in diameter. Downstream conductance variability affected neither local pressure nor median local flow and added limited extra variation of local flow. The left coronary circulation perfused 358 cm 3 of myocardium. Median perfused volume at a truncation level of 100 to 200 µm was 20 mm 3 with a median perfusion of 5.6 ml/min/g and a high local heterogeneity. Conclusion: This study provides the branching characteristics and hemodynamic analysis of the left coronary arterial circulation of a human heart. The resulting model can be deployed for further hemodynamic studies at the whole organ and local level.

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Section: Topologycontrasting

confidence: 81%

Section: Previous Datamentioning

confidence: 99%

Topologic and Hemodynamic Characteristics of the Human Coronary Arterial Circulation

et al. 2020

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“…Rumberger et al (1979) posited wave reflection as an explanation for prominent pressure and velocity oscillations observed in distal coronary arteries of the horse, while Arts et al (1979) concluded that, in dogs, frequencies below 7 Hz are reflected at the coronary peripheral resistance, whereas higher frequencies undergo minimal reflection. The study by Arts et al (1979), and in particular a recent detailed morphometric and theoretical study by Rivolo et al (2016), suggested that the major conduit coronary arteries are relatively well matched in the forward direction, as was assumed in the design of our 1D model. This implies that wave reflection occurs mainly in the small resistance arteries.…”

Section: Wave Reflection In Coronary Arteriesmentioning

confidence: 84%

“…(), and in particular a recent detailed morphometric and theoretical study by Rivolo et al . (), suggested that the major conduit coronary arteries are relatively well matched in the forward direction, as was assumed in the design of our 1D model. This implies that wave reflection occurs mainly in the small resistance arteries.…”

Section: Discussionmentioning

confidence: 99%

Major influence of a ‘smoke and mirrors’ effect caused by wave reflection on early diastolic coronary arterial wave intensity

Mynard

Penny

Smolich

2018

The Journal of Physiology

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Coronary arterial wave intensity analysis (WIA) is thought to provide clear insight into upstream and downstream forces on coronary flow, with a large early-diastolic surge in coronary flow accompanied by a prominent backward decompression wave (BDW ), as well as a forward decompression wave (FDW ) and forward compression wave (FCW ). The BDW is believed to arise from distal suction due to release of extravascular compression by relaxing myocardium, while FDW and FCW are thought to be transmitted from the aorta into the coronary arteries. Based on an established multi-scale computational model and high-fidelity measurements from the proximal circumflex artery (Cx) of 18 anaesthetized sheep, we present evidence that wave reflection has a major impact on each of these three waves, with a non-linear addition/subtraction of reflected waves obscuring the true influence of upstream and downstream forces through concealment and exaggeration, i.e. a 'smoke and mirrors' effect. We also describe methods, requiring additional measurement of aortic WIA, for unravelling the separate influences of wave reflection versus active upstream/downstream forces on coronary waves. Distal wave reflection accounted for ∼70% of the BDW in sheep, but had a lesser influence (∼25%) in the computer model representing a hypertensive human. Negative reflection of the BDW at the coronary-aortic junction attenuated the Cx FDW (by ∼40% in sheep) and augmented Cx FCW (∼5-fold), relative to the corresponding aortic waves. We conclude that wave reflection has a major influence on early-diastolic WIA, and thus needs to be considered when interpreting coronary WIA profiles.

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“…Moreover, a recent study (15) of the coronary vasculature showed that 1D models attain similar haemodynamic predictions as 3D when using appropriate boundary conditions. Recent studies have analysed 1D systemic arterial models (10,16) to understand how uncertainty in network structure impacts haemodynamics. Fossan et.…”

mentioning

confidence: 99%

Influence of image segmentation on one-dimensional fluid dynamics predictions in the mouse pulmonary arteries

Colebank

Păun

Qureshi

et al. 2019

J. R. Soc. Interface.

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Computational fluid dynamics (CFD) models are emerging tools for assisting in diagnostic assessment of cardiovascular disease. Recent advances in image segmentation have made subject-specific modelling of the cardiovascular system a feasible task, which is particularly important in the case of pulmonary hypertension, requiring a combination of invasive and non-invasive procedures for diagnosis. Uncertainty in image segmentation propagates to CFD model predictions, making the quantification of segmentation-induced uncertainty crucial for subject-specific models. This study quantifies the variability of one-dimensional CFD predictions by propagating the uncertainty of network geometry and connectivity to blood pressure and flow predictions. We analyse multiple segmentations of a single, excised mouse lung using different pre-segmentation parameters. A custom algorithm extracts vessel length, vessel radii and network connectivity for each segmented pulmonary network. Probability density functions are computed for vessel radius and length and then sampled to propagate uncertainties to haemodynamic predictions in a fixed network. In addition, we compute the uncertainty of model predictions to changes in network size and connectivity. Results show that variation in network connectivity is a larger contributor to haemodynamic uncertainty than vessel radius and length.

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Impact of coronary bifurcation morphology on wave propagation

Cited by 6 publications

References 78 publications

Topologic and Hemodynamic Characteristics of the Human Coronary Arterial Circulation

Topologic and Hemodynamic Characteristics of the Human Coronary Arterial Circulation

Major influence of a ‘smoke and mirrors’ effect caused by wave reflection on early diastolic coronary arterial wave intensity

Influence of image segmentation on one-dimensional fluid dynamics predictions in the mouse pulmonary arteries

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