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Số người truy cập: 74,131,847

 Intracoronary cavitation as a causeof plaque rupture and thrombosispropagation in patients with acutemyocardial infarction: A computationalstudy
Tác giả hoặc Nhóm tác giả: Gianluca Rigatelli1, Marco Zuin2, Tra T. Ngo3, Hung T. Nguyen4,Aravinda Nanjundappa5, Ernest Talarico6, Le Cao Phuong Duy7, Thach Nguyen3,81Section of Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy;2Section of Internal and Cardiopulmonary Medicine, University of Ferrara, Ferrara, Italy;3Cardiovascular Research, Methodist Hospital, Merrillville, IN 46410, USA;4Danang University, Danang, Vietnam;5Department of Cardiology, Charleston Area Medical Center, Charleston, WV, USA;6Anatomy Department, Indiana University NW, Gary IN USA;7Cardiology Department, Nguyen Tri Phuong Hospital, Ho Chi Minh city, Vietnam;8Tan Tao University, School of Medicine, Long An, Vietnam
Nơi đăng: JOURNAL OF TRANSLATIONAL INTERNAL MEDICINE / APR-JUN 2019 / VOL 7 |ISSUE 2; Số: / APR-JUN 2019 / VOL 7 |ISSUE 2;Từ->đến trang: 69-75;Năm: 2019
Lĩnh vực: Y - Dược; Loại: Bài báo khoa học; Thể loại: Quốc tế
TÓM TẮT
Background and Objectives: Significant rather than moderate coronary artery stenosis hasbeen postulated to be the main substrate of plaque rupture in acute myocardial infarction (AMI).We evaluate if cavitation could influence the coronary artery plaque rupture contributing to theprogression of thrombotic process. Methods: We reconstructed a 3D model of the left anteriordescending coronary artery (LAD) after reviewing the intravascular ultrasound (IVUS) data of30 consecutive patients with mild to severe coronary artery disease. Results: Turbulent flow orcavitation occurs in both concentric and eccentric coronary artery stenosis (≥ 75% for the formerand ≥ 50% for the latter). The analysis of vapor phase demonstrated that cavitation propagateddownstream, creating microbubbles, which exploded when the fluid pressure was lower thanthe vapor pressure at a local thermodynamic state. The relative higher vorticity magnitude(as turbulent flow in vivo angiogram) observed on the distal cap of the atherosclerotic plaquecreated a higher turbulence, probably able to destabilize the plaque through a micro-erosionprocess. Conclusions: Cavitation seems to be able to promote the thrombotic occlusion withinthe coronary vessels due the ‘constant injuries’ created by the micro-explosion of bubbles.
ABSTRACT
Background and Objectives: Significant rather than moderate coronary artery stenosis hasbeen postulated to be the main substrate of plaque rupture in acute myocardial infarction (AMI).We evaluate if cavitation could influence the coronary artery plaque rupture contributing to theprogression of thrombotic process. Methods: We reconstructed a 3D model of the left anteriordescending coronary artery (LAD) after reviewing the intravascular ultrasound (IVUS) data of30 consecutive patients with mild to severe coronary artery disease. Results: Turbulent flow orcavitation occurs in both concentric and eccentric coronary artery stenosis (≥ 75% for the formerand ≥ 50% for the latter). The analysis of vapor phase demonstrated that cavitation propagateddownstream, creating microbubbles, which exploded when the fluid pressure was lower thanthe vapor pressure at a local thermodynamic state. The relative higher vorticity magnitude(as turbulent flow in vivo angiogram) observed on the distal cap of the atherosclerotic plaquecreated a higher turbulence, probably able to destabilize the plaque through a micro-erosionprocess. Conclusions: Cavitation seems to be able to promote the thrombotic occlusion withinthe coronary vessels due the ‘constant injuries’ created by the micro-explosion of bubbles.
[ 2019\2019m010d031_10_6_44[Journal_of_Translational__Internal_Medicine]_Intracoronary_cavitation_as_a_cause_of_plaque_rupture__and_thrombosis_propagation_in_patients_with_acute_myocardial_infarction_A__computational_study.pdf ]
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