Hemodynamic and histomorphometric measurements in the human right coronary artery

摘要

Hemodynamic factors such as wall shear stress have been implicated in the localization and genesis of atherosclerosis, a disease process whose clinical significance is greatest within the coronary circulation.Previous flow studies of the human coronary circulation have not conclusively demonstrated the precise near-wall flow features that may be causative in atherogenesis. Our incomplete understanding of this important area in cardiovascular pathology hasresulted primarily from three inadequacies: the incompatibility of established flow measurement techniques with the complex geometries found in the human vasculature; limitations in the fabrication of realistic coronary arterial casts; and the lack of aquantitative study combining detailed morphometric measurements with coronary flow studies.This study addresses these restrictions by investigating the relationship between blood flow and atherosclerotic intimal thickening in the human right coronary artery (RCA). First, a high fidelity physical flow model was constructed and utilized in alaser photochromic flow analysis to characterize the velocity field in the RCA. Second, histologic and morphometric analyses were performed on RCA specimens to examine the distribution of atherosclerotic lesions.