Experimental and computational flow evaluation of coronary stents

Local flow alterations created by a metallic stent in a simulated coronary artery were studied to compare the hemodynamic effects of two different stent geometries. Dye injection flow visualization and computational fluid dynamics were used. Resting and exercise conditions were studied. Flow visualization using the dye injection method provided a qualitative picture of stent hemodynamics while the computational approach provided detailed quantitative information on the flow next to the vessel wall near the intersections of stent wires. Dye injection visualization revealed that more dye became entrapped between the wires where the wire spacing was smallest. The dye washout times were shorter under exercise conditions for both wire spacings tested. The computational results showed that stagnation zones were continuous from one wire to the next when the wire spacing was small. Results from greater wire spacing (more than six wire diameters) showed that the stagnation zones were separate for at least part of the cardiac cycle. The sizes of the stagnation zones were larger under exercise conditions, and the largest stagnation zones were observed distal to the stent. These studies demonstrate that stent geometry has a significant effect on local hemodynamics. The observation that fluid stagnation is continuous in stents with wire spacings of less than six wire diameters may provide a criterion for future stent design.

Computational analysis of flow in a curved tube model of the coronary arteries: effects of time-varying curvature

The flow through a curved tube whose radius of curvature varies with time was studied in order to better understand flow patterns in coronary arteries. A computational flow model was constructed using commercially available software. The artery model featured a uniform circular cross section, and the curvature was assumed to be constant along the tube, and in one plane. The computational model was verified with the use of a dynamically similar in vitro apparatus. A steady uniform velocity was prescribed at the entrance at a Reynolds number of 300. Two sets of results were obtained: one in which the curvature was held constant at the mean, maximum and minimum radii of curvature (quasistatic), and another in which the curvature was varied sinusoidally in time at a frequency of I Hz (dynamic). The results of the dynamic analysis showed that the wall shear rates varied as much as 52% of the static mean wall shear rate within a region of 10 tube diameters from the inlet. The results of the dynamic analysis were within 6% of the quasistatic predictions. Realistic modeling of the deforming geometry is important in determining which locations in the coronary arteries are subjected to low and oscillating wall shear stresses, flow patterns that have been associated with atherogenesis.

Frequency dependence of dynamic curvature effects on flow through coronary arteries

The flow through a curved tube model of a coronary artery was investigated computationally to determine the importance of time-varying curvature on flow patterns that have been associated with the development of atherosclerosis. The entry to the tube was fixed while the radius of curvature varied sinusoidally in time at a frequency of 1 or 5 Hz. Angiographic data from other studies suggest that the radius of curvature waveform contains significant spectral content up to 6 Hz. The overall flow patterns were similar to those observed in stationary curved tubes; velocity profile skewed toward the outer wall, secondary flow patterns, etc. The effects of time-varying curvature on the changes in wall shear rate were expressed by normalizing the wall shear rate amplitude with the shear rate calculated at the static mean radius of curvature. It was found that the wall shear rate varied as much as 94 percent of the mean wall shear rate at the mid wall of curvature for a mean curvature ratio of 0.08 and a 50 percent change in radius of curvature. The effects of 5 Hz deformation were not well predicted by a quasi-static approach. The maximum values of the normalized inner wall shear rate amplitude were found to scale well with a dimensionless parameter equivalent to the product of the mean curvature ratio (delta), normalized change in radius of curvature (epsilon), and a Womersley parameter (alpha). This parameter was less successful at predicting the amplitudes elsewhere in the tube, thus additional studies are necessary. The mean wall shear rate was well predicted with a static geometry. These results indicate that dynamic curvature plays an important role in determining the inner wall shear rates in coronary arteries that are subjected to deformation levels of epsilon delta alpha > 0.05. The effects were not always predictable with a quasi-static approach. These results provide guidelines for constructing more realistic models of coronary artery flow for atherogenesis research.

The genetics of exceptional longevity: Insights from centenarians

As the world population ages, so the prevalence increases of individuals aged 100 years or more, known as centenarians. Reaching this age has been described as exceptional longevity (EL) and is attributed to both genetic and environmental factors. Many genetic variations known to affect life expectancy exist in centenarians. This review of studies conducted on centenarians and supercentenarians (older than 110 years) updates knowledge of the impacts on longevity of the twenty most widely investigated single nucleotide polymorphisms (SNPs).