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The Atheroprotective Nature of Helical Flow in Coronary Arteries

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Abstract

Arterial hemodynamics is markedly characterized by the presence of helical flow patterns. Previous observations suggest that arterial helical blood flow is of physiological significance, and that its quantitative analysis holds promise for clinical applications. In particular, it has been reported that distinguishable helical flow patterns are potentially atheroprotective in the carotid bifurcation as they suppress flow disturbances. In this context, there is a knowledge gap about the physiological significance of helical flow in coronary arteries, a prominent site of atherosclerotic plaque formation. This study aimed at the quantitative assessment of helical blood flow in coronary arteries, and to investigate its possible associations with vascular geometry and with atherogenic wall shear stress (WSS) phenotypes in a representative sample of 30 swine coronary arteries. This study demonstrates that in coronary arteries: (1) the hemodynamics is characterized by counter-rotating bi-helical flow structures; (2) unfavorable conditions of WSS are strongly and inversely associated with helicity intensity (r = − 0.91; p < 0.001), suggesting an atheroprotective role for helical flow in the coronary tree; (3) vascular torsion dictates helical flow features (r = 0.64; p < 0.001). The findings of this work support future studies on the role of helical flow in atherogenesis in coronary arteries.

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All authors declare that they have no financial and personal relationships with other people or organizations that could have inappropriately influenced the submitted work.

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  1. PolitoBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Corso Duca degli Abruzzi, 24, 10129, Turin, Italy

    Giuseppe De Nisco, Diego Gallo & Umberto Morbiducci

  2. Department of Cardiology, Biomedical Engineering, Erasmus MC, Rotterdam, The Netherlands

    Annette M. Kok, Ayla Hoogendoorn & Jolanda J. Wentzel

  3. Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering ‘‘Giulio Natta”, Politecnico di Milano, Milan, Italy

    Claudio Chiastra & Francesco Migliavacca

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  1. Giuseppe De Nisco
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De Nisco, G., Kok, A.M., Chiastra, C. et al. The Atheroprotective Nature of Helical Flow in Coronary Arteries. Ann Biomed Eng 47, 425–438 (2019). https://doi.org/10.1007/s10439-018-02169-x

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