Significance of Hemodynamic Effects on the Generation of Atherosclerosis

  • Suh Sang-Ho (Department of Mechanical Engineering, Soongsil University) ;
  • Roh Hyung-Woon (Department of Mechanical Engineering, Soongsil University) ;
  • Kim Dong-Joo (Department of Mechanical Engineering, Soongsil University) ;
  • Kwon Hyuck-Moon (Department of Internal Medicine, College of Medicine, Yonsei University) ;
  • Lee Byoung-Kwon (Department of Internal Medicine, College of Medicine, Inje University)
  • Published : 2005.03.01

Abstract

Atherosclerosis, which is a degenerative vascular disease, is believed to occur in the blood vessels due to deposition of cholesterol or low density lipoprotein (LDL). Atherosclerotic lumen narrowing causes reduction of blood flow due to hemodynamic features. Several hypothetical theories related to the hemodynamic effects have been reported : high shear stress theory, low shear stress theory, high shear stress gradient theory, flow separation and turbulence theory, and high pressure theory. However, no one theory clearly explains, the causes of atherosclerosis. The objective of the present study was to investigate the mechanism of the generation of atherosclerosis. In the study, the database of Korean carotid and coronary arteries for geometrical and hemodynamic clinical data was established. The atherosclerotic sites were predicted by the computer simulations. The results of the computer simulation were compared with the in vivo experimental results, and then the pathogenesis of atherosclerosis by using the clinical data and several hypothetical theories were investigated. From the investigation, it was concluded carefully that the mechanism of the generation of atherosclerosis was related to the hemodynamic effects such as flow separation and oscillatory wall shear stress on the vessel walls.

Keywords

References

  1. Caro, C. G., Fitz-Gerald, J. M. and Schroter, R. C., 1971, 'Atheroma and Arterial Wall Shear : Observation, Correlation and Proposal of a Shear Dependent Mass Transfer Mechanism for Atherogenesis,' Proc. R. Soc. B., vol. 177, pp. 109-159 https://doi.org/10.1098/rspb.1971.0019
  2. Cho, M. T., Roh, H. W., Suh, S. H. and Kim, J. S., 2002, 'Pulsatile Flow Analysis of Newtonian Fluid in Circlular Tube,' KSME (B), Vol. 26, No. 1 , pp. 1585-1596 https://doi.org/10.3795/KSME-B.2002.26.11.1585
  3. Fox, J. A. and Hugh, A. E., 1966, 'Localization of Atheroma : a Theory Based on Boundary Layer Separation,' Br Heart J., Vol. 28, No. 3, pp. 388~399 https://doi.org/10.1136/hrt.28.3.388
  4. Fry, D. L., 1972, 'Response of the Arterial Wall to Certain Physical Factors. Atherogenesis: Initiating Factors.,' A Ciba Foundation Symp., ASP, Amsterdam, The Neterlands., pp. 40-83
  5. Lee, B. K., Kwon, H. M., Hong, B. K., Park, B. E., Suh, S. H., Cho, M. T., Lee, C. S., Kim, M. C., Kim, C. J., Yoo, S. S. and Kim, H. S., 2001, 'Hemodynamic Effects on Atherosclerosis-Prone Coronary Artery : wall Shear Stress/Rate Distribution and Impedance Phase Angle in Coronary and Aortic Circulation,' Yonsei Med J., Vol. 42, No. 4, pp. 375-383 https://doi.org/10.3349/ymj.2001.42.4.375
  6. Suh, S. H., Roh, H. W. and Kim, J. S., 2003, 'Effect of the Velocity Waveform of the Physisologycal Flow on Hemodynamies in the Bufurcated Tube,' KSME International Journal, Vol. 17, No. 2, pp. 296-309
  7. Suh, S. H. , Roh, H. W. , Yoo, S. S. and Kwon, H. M., 1996, 'Numerical Simulatton of Blood Flow in the Human Left Coronary Artery,' The 9th Int. Symp. on Trans. Phenonzena in the Thermal-Fluids Eng., pp. 91-96
  8. Texon, M., Imparato, A. M. and Helpern, M., 1965, 'Role of Vascular Dynamies in the Development of Atherosclerosis,' JAMA, Vol. 194, pp. 168~172 https://doi.org/10.1001/jama.1965.03090260078039
  9. Tucker, C. and Myron, I. C., 2001, 'NF-${\kappa}$B: Pivotal Mediator or Innocent Bystander in Atherogenesis?' J Clin Invest., Vol. 107, No. 3, pp. 255~264 https://doi.org/10.1172/JCI10373