Haemodynamic analysis of the effect of different types of plaques in the left coronary artery

Purpose: Coronary plaque has been shown to directly affect the blood parameters, however, haemodynamic variations based on the plaque configuration has not been studied. In this study we investigate the haemodynamic effects of various types of plaques in the left coronary bifurcation. 

Methods: Eight types of plaque configurations were simulated and located in various positions in the left main stem, the left anterior descending and left circumflex to produce a >50% narrowing of the coronary lumen. We analyse and characterise haemodynamic effects caused by each type of plaque. Computational fluid dynamics was performed to simulate realistic physiological conditions that reveal the in vivo cardiac haemodynamics. Velocity, wall shear stress (WSS) and pressure gradient (PSG) in the left coronary artery were calculated and compared in all plaque configurations during cardiac cycles. 

Results: Our results showed that the highest velocity and PSG were found in the type of plaque configuration which involved all of the three left coronary branches. Plaques located in the left circumflex branch resulted in highly significant changes of the velocity, WSS and PSG (. p<. 0.001) when compared to the other types of plaque configurations. 

Conclusion: Our analysis provides an insight into the distribution of plaque at the left bifurcation, and corresponding haemodynamic effects, thus, improving our understanding of atherosclerosis.