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The nonuniform distribution of atherosclerosis in the human vasculature suggests that local fluid dynamics or wall mechanics may be involved in atherogenesis. Thus certain aspects of vascular geometry, which mediates both fluid dynamics and wall mechanics, might be risk factors for coronary atherosclerosis. Cataloguing the geometry of normal human coronary arteries and its variability is a first step toward identifying specific geometric features that increase vascular susceptibility to the disease.
In this project, images of angiographically normal coronary arteries, including 32 left anterior descending (LAD) and 35 right coronary arteries (RCA), were acquired by clinical biplane cineangiography from 52 patients. The vessel axes in end diastole were reconstructed and geometric parameters that included measures of curvature, torsion and tortuosity were quantified for the proximal, middle and distal segments of the arteries. The three arterial segments we used are commonly referred to at clinic and are defined by the American Heart Association.
Statistical analysis shows that: (1) in the LAD, curvature, torsion and tortuosity are generally highest in the distal portion; (2) in the RCA, these parameters are smallest in the middle segment; (3) the LAD exhibits significantly higher torsion than the RCA (P<0.005), and (4) more than 80% of the variability of coronary arterial geometry can be expressed in terms of two factors, one dominated by the curvature measures and tortuosity, and the other emphasizing the torsion parameters.
The catalogue may be used to identify individuals whose coronary artery geometry is abnormal and guide the identification of geometric features that might be atherogenic risk factors.
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