Sharif Digital Repository

Heart attack is one of the most common causes of death in the world. Coronary artery disease is the most recognized cause of heart attack whose onset and progression have been attributed to low-density lipoprotein (LDL) passing through the wall of the artery. In this paper, hemodynamic variables as well as the concentration of LDL through the coronary porous artery at the Left Anterior Descending coronary artery (LAD), and its first diagonal branch (D1) under the heart motion investigated using computational simulation. The geometry that has been studied in this paper is the first bifurcation of Left Anterior Descending (LAD) that has been placed on a perimeter of hypothetical sphere... 

This study investigated the effects of different patterns of coronary artery tortuosity (CAT) on the stress concentration of the plaques and the blood flow pattern inside an atherosclerotic artery to predict the risk of plaque rupture and progression. Four different loadings of the coronary artery, including pulsatile blood pressure as well as one-end twist around the artery axis at blood pressures of 74, 100, and 120 mmHg were considered. No study has addressed bent and twist buckling of an atherosclerotic artery considering pulsatile flow (for bent buckling), fluid-solid interaction, and different geometrical parameters of the plaque. The results showed that C-shape tortuosity under... 

Fractional flow reserve (FFR)-based decision improves the outcomes of percutaneous coronary intervention (PCI) for some patients, while its effectiveness in improving the results of coronary artery bypass graft (CABG) is unclear, in particular for moderate stenosis. It may be due to the fact that FFR cannot take into account the impacts of competitive flow (CF), intimal hyperplasia (IH), as well as compliance mismatch (CMM). As a result, two questions arise 1) whether FFR is a sufficient factor to decide to perform the CABG for patients with moderate to severe stenosis or not and 2) whether post-operative FFR shows the effectiveness of a graft. To shed light on this matter, two... 

Atherosclerosis as a common cardiovascular disease is a result of both adverse hemodynamics conditions and monocyte deposition within coronary arteries. It is known that the adhesion of monocytes on the arterial wall and their interaction with the vascular surface are one of the main parameters in the initiation and progression of atherosclerosis. In this work, hemodynamic parameters and monocyte deposition have been investigated in a 3D computational model of the Left Anterior Descending coronary artery (LAD) and its first diagonal branch (D1) under the heart motion. A one-way Lagrangian approach is performed to trace the monocyte particles under different blood flow regimes and heart motion... 

Purpose: Cardiac multimodal image fusion can offer an image with various types of information in a single image. Many coronary stenosis, which are anatomically clear, are not functionally significant. The treatment of such kind of stenosis can cause irreversible effects on the patient. Thus, choosing the best treatment planning depend on anatomical and functional information is very beneficial. Methods: An algorithm for the fusion of coronary computed tomography angiography (CCTA) as an anatomical and transthoracic echocardiography (TTE) as a functional modality is presented. CCTA and TTE are temporally registered using manifold learning. A pattern search optimization algorithm, using... 

Nitric Oxide (NO) provides myocardial oxygen demands of the heart during exercise and cardiac pacing and also prevents cardiovascular diseases such as atherosclerosis and platelet adhesion and aggregation. However, the direct in vivo measurement of NO in coronary arteries is still challenging. To address this matter, a mathematical model of dynamic changes of calcium and NO concentration in the coronary artery was developed for the first time. The model is able to simulate the effect of NO release in coronary arteries and its impact on the hemodynamics of the coronary arterial tree and also to investigate the vasodilation effects of arteries during cardiac pacing. For these purposes, flow... 

Coronary artery disease (CAD) is the prevalent reason of mortality all around the world. Targeting CAD, specifically atherosclerosis, with controlled delivery of micro and nanoparticles, as drug carriers, is a very proficient approach. In this work, a patient-specific and realistic model of an atherosclerotic plaque in the left anterior descending (LAD) artery was created by image-processing of CT-scan images and implementing a finite-element mesh. Next, a fluid-solid interaction simulation considering the physiological boundary conditions was conducted. By considering the simulated force fields and particle-particle interactions, the correlation between injected particles at each cardiac... 

Background and Objective: Blood flow variation during cardiac cycle is the main mechanism of atherosclerotic development which is dependent on. Methods: The present work mainly tends to investigate stenosis effect in dynamic curvature of coronary artery. This paper presents numerical investigations on wall shear stress profiles in three-dimensional pulsatile flow through curved stenotic coronary arteries for both static and dynamic model. In order to do so, three-dimensional models related to the curved arteries with two degrees of stenosis (30% and 50%). Results: Lower amount of wall shear stress is found near the inner wall of artery distal to the plaque region (stenosis) and in both... 

The objective of this paper is to apply computational fluid dynamic (CFD) as a complementary tool for clinical tests to not only predict the present and future status of left coronary artery stenosis but also to evaluate some clinical hypotheses. In order to assess the present status of the coronary artery stenosis severity, and thereby selecting the most appropriate type of treatment for each patient, fractional flow reserve (FFR), instantaneous wave free-ratio (iFR), and coronary flow reserve (CFR) are calculated. To examine FFR, iFR, and CFR results, the effect of geometric features of stenoses, including diameter reduction (%), lesion length (LL), and minimum lumen diameter (MLD), is... 

Coronary artery disease is the first cause of death across the world. Targeted delivery of therapeutics through controlled release of micro- and nano-particles remains a very capable approach to develop new strategies in treating restenosis and atherosclerotic plaques. In this research, to produce the arterial geometry, an image-processing was done using CT-scan images of a LAD coronary artery. After implementing the finite element mesh, the Fluid-Structure Interaction (FSI) simulation based on physiological boundary conditions was performed. Next, a Lagrangian description of particles dynamics in a non-Newtonian blood flow considering momentum equation of motion for each particle and the... 

The currently available robotic systems rely on rigid heart stabilizers to perform totally endoscopic coronary artery bypass (TECAB) surgery on beating hearts. Although such stabilizers facilitate the anastomosis procedure by immobilizing the heart and holding the surgery site steady, they can cause damage to the heart tissue and rupture of the capillary vessels, due to applying relatively large pressures on the epicardium. In this paper, we propose an advanced robotic approach to perform TECAB on a beating heart with minimal invasiveness. The idea comes from the fact that the main pulsations of the heart occur as excursions in normal direction, i.e., perpendicular to the heart surface. We... 

Biomechanical forces and hemodynamic factors influence the blood flow and the endothelial cells (ECs) morphology. These factors behave differently beyond the coronary artery stenosis. In the present study, unsteady blood flow in the left coronary artery (LCA) and its atherosclerotic bifurcating vessels, left anterior descending (LAD) and left circumflex (LCX) arteries, were numerically simulated to investigate the risk of plaque length development and secondary plaque formation in the post-stenotic areas. Using fluid–structure interaction (FSI) model, compliance of arterial wall and vessel curvature variations due to cardiac motion were considered. The arteries included plaques at the... 

Biomechanical forces and hemodynamic factors influence the blood flow and the endothelial cells (ECs) morphology. These factors behave differently beyond the coronary artery stenosis. In the present study, unsteady blood flow in the left coronary artery (LCA) and its atherosclerotic bifurcating vessels, left anterior descending (LAD) and left circumflex (LCX) arteries, were numerically simulated to investigate the risk of plaque length development and secondary plaque formation in the post-stenotic areas. Using fluid–structure interaction (FSI) model, compliance of arterial wall and vessel curvature variations due to cardiac motion were considered. The arteries included plaques at the... 

Obstruction of left anterior descending artery (LAD) due to the thrombosis or atherosclerotic plaques is the leading cause of death worldwide. Targeted delivery of drugs through micro- and nanoparticles is a very promising approach for developing new strategies in clot-busting or treating restenosis. In this work, we modelled the blood flow characteristics in a patient-specific reconstructed LAD artery by the fluid–solid interaction method and based on physiological boundary conditions. Next, we provided a Lagrangian description of micro- and nanoparticles dynamics in the blood flow considering their Brownian motion and the particle–particle interactions. Our results state that the number of... 

Due to increased atherosclerosis-caused mortality, identification of its genesis and development is of great importance. Although, key factors of the origin of the disease is still unknown, it is widely believed that cholesterol particle penetration and accumulation in arterial wall is mainly responsible for further wall thickening and decreased rate of blood flow during a gradual progression. To date, various effective components are recognized whose simultaneous consideration would lead to a more accurate approximation of Low Density Lipoprotein (LDL) distribution within the wall. In this research, a multilayer Fluid-Structure Interaction (FSI) model is studied to simulate the penetration... 

Cardiovascular disease is one of the most rampant causes of death around the world and was deemed as a major illness in Middle and Old ages. Coronary artery disease, in particular, is a widespread cardiovascular malady entailing high mortality rates. Angiography is, more often than not, regarded as the best method for the diagnosis of coronary artery disease; on the other hand, it is associated with high costs and major side effects. Much research has, therefore, been conducted using machine learning and data mining so as to seek alternative modalities. Accordingly, we herein propose a highly accurate hybrid method for the diagnosis of coronary artery disease. As a matter of fact, the... 

The function and morphology of Endothelial Cells (ECs) play a key role in atherosclerosis. The mechanical stimuli of ECs, such as Wall Shear Stress (WSS) and arterial wall strain, greatly inuence the function and morphology of these cells. The present article deals with computations of these stimuli for a 3D model of a healthy coronary artery bifurcation. The focus of the study is to propose an accurate method for computations of WSS and strains. Two approaches are considered: Coupled simultaneous simulation of arterial wall and blood flow, called fluid-Structure Interaction (FSI) simulation, and decoupled, which simulates each domain (fluid and solid domain) separately. The study... 

Atherosclerosis is a world-spread and well-known disease. This disease strongly relates to the endothelial cells (ECs) function. Normally, the endothelial cells align in the flow direction in the atheroprotected sites; however, in the case of atheroprone sites these cells orient randomly. The mechanical stimuli such as wall shear stress and strains could determine the morphology and function of the endothelial cells. In the present study, we numerically simulated the left main coronary artery (LCA) and its branches to left anterior descending (LAD) and left circumflex coronary (LCX) artery using fluid-structure interaction (FSI) modeling. The results were presented as longitudinal and... 

Atherosclerosis is a major cause of coronary artery disease leading to morbidity and mortality worldwide. Currently, coronary angiography is considered to be the most accurate technique to diagnose coronary artery disease (CAD). However, this technique is an invasive and expensive procedure with risks of serious complications. Since the symptoms of CAD are not noticed until advanced stages of the disease, early and effective diagnosis of CAD is considered a pertinent measure. In this paper, a non-invasive optical signal, the finger photoplethysmogram (PPG) obtained before and after reactive hyperemia is investigated to discriminate between subjects with different CAD conditions. To this end,... 

One of the main causes of death the world over are cardiovascular diseases, of which coronary artery disease (CAD) is a major type. This disease occurs when the diameter narrowing of one of the left anterior descending, left circumflex, or right coronary arteries is equal to or greater than 50 percent. Angiography is the principal diagnostic modality for the stenosis of heart vessels; however, because of its complications and costs, researchers are looking for alternative methods such as data mining. This study conducts data mining algorithms on the Z-Alizadeh Sani dataset which has been collected from 303 random visitors to Tehran's Shaheed Rajaei Cardiovascular, Medical and Research...