Morphometric Studies of Human Coronary Artery Trees in Healthy and Disease
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摘要
Objective According to the report from American Heart Association(AHA),cardiovascular diseases(CVDs)are the leading causes of death globally,and coronary artery disease(CAD),known as coronary atherosclerotic plaques,accounts for over 30%of cardiovascular diseases.Therefore,it is of great clinical significance to study the relationship between coronary bifurcations morphometrical feature change and coronary artery disease.Although coronary atherosclerosis has been extensively investigated,there is a lack of in-deep study on the differences in morphometric features between optimal and realistic geometry of coronary arterial trees.The purpose of the present paper is to determine the morphological changes in patients with CAD lesion compared with non-coronary artery disease(non-CAD)subjects.Methods Due to the difficulty of studying the coronary bifurcations in vivo,image-based in vitro anatomical 3D models have been widely used as a noninvasive method for morphometric measurement and clinical diagnosis of the coronary bifurcations.With the development of coronary computed tomography angiography(CTA)hardware and software technologies,the CTA imaging technique has been shown a promising application in the characterization,visualization,and identification of coronary artery disease in recent decades.The CTA images used to reconstruct three-dimensional(3D)coronary arterial trees are from Asia populations(Southern Chinese populations),including five cadavers without CAD lesion and 102 patients with CAD lesion.The best fit artery diameter was calculated as twice the average radius between the points in the centerlines and the points on the coronary arterial inner wall.The bifurcation angles between larger daughter artery and smaller daughter artery were determined by the intersection angle of their centerlines.Murray's law was introduced to assess the deviation of the realistic vascular networks from its optimal state.Results Based on the morphometric analysis of coronary artery bifurcations in non-CAD subjects and patients with CAD lesion subjects,the most important finding is that morphological feature parameters of non-CAD subjects are closer to the optimal values than those of patients with CAD lesion.Moreover,by comparing the morphometric data between the left and right coronary arteries,the right coronary artery exhibits a structure closer to the optimal one in morphological feature than the left coronary artery.In addition,coronary arterial trees with CAD lesion have higher asymmetry and larger area expansion ratio(AER)than those of the coronary arterial trees without CAD lesion.Conclusions We morphologically found that the coronary arterial trees with CAD lesion and left are more likely to deviate from the optimal structure predicted by Murray's law than those without CAD lesion and right.The degree to which coronary arterial system deviating from their optimal state may directly affect the incidence of coronary artery disease.This computer morpho-logical analysis strategy is illustrated to be effective in the distinguishing of the geometric differences between the healthy and diseased coronary arteries,and the analysis method may have a large potential in cardiovascular disease earlier diagnosis.
Objective According to the report from American Heart Association(AHA),cardiovascular diseases(CVDs)are the leading causes of death globally,and coronary artery disease(CAD),known as coronary atherosclerotic plaques,accounts for over 30%of cardiovascular diseases.Therefore,it is of great clinical significance to study the relationship between coronary bifurcations morphometrical feature change and coronary artery disease.Although coronary atherosclerosis has been extensively investigated,there is a lack of in-deep study on the differences in morphometric features between optimal and realistic geometry of coronary arterial trees.The purpose of the present paper is to determine the morphological changes in patients with CAD lesion compared with non-coronary artery disease(non-CAD)subjects.Methods Due to the difficulty of studying the coronary bifurcations in vivo,image-based in vitro anatomical 3D models have been widely used as a noninvasive method for morphometric measurement and clinical diagnosis of the coronary bifurcations.With the development of coronary computed tomography angiography(CTA)hardware and software technologies,the CTA imaging technique has been shown a promising application in the characterization,visualization,and identification of coronary artery disease in recent decades.The CTA images used to reconstruct three-dimensional(3D)coronary arterial trees are from Asia populations(Southern Chinese populations),including five cadavers without CAD lesion and 102 patients with CAD lesion.The best fit artery diameter was calculated as twice the average radius between the points in the centerlines and the points on the coronary arterial inner wall.The bifurcation angles between larger daughter artery and smaller daughter artery were determined by the intersection angle of their centerlines.Murray's law was introduced to assess the deviation of the realistic vascular networks from its optimal state.Results Based on the morphometric analysis of coronary artery bifurcations in non-CAD subjects and patients with CAD lesion subjects,the most important finding is that morphological feature parameters of non-CAD subjects are closer to the optimal values than those of patients with CAD lesion.Moreover,by comparing the morphometric data between the left and right coronary arteries,the right coronary artery exhibits a structure closer to the optimal one in morphological feature than the left coronary artery.In addition,coronary arterial trees with CAD lesion have higher asymmetry and larger area expansion ratio(AER)than those of the coronary arterial trees without CAD lesion.Conclusions We morphologically found that the coronary arterial trees with CAD lesion and left are more likely to deviate from the optimal structure predicted by Murray's law than those without CAD lesion and right.The degree to which coronary arterial system deviating from their optimal state may directly affect the incidence of coronary artery disease.This computer morpho-logical analysis strategy is illustrated to be effective in the distinguishing of the geometric differences between the healthy and diseased coronary arteries,and the analysis method may have a large potential in cardiovascular disease earlier diagnosis.
Objective According to the report from American Heart Association(AHA),cardiovascular diseases(CVDs)are the leading causes of death globally,and coronary artery disease(CAD),known as coronary atherosclerotic plaques,accounts for over 30%of cardiovascular diseases.Therefore,it is of great clinical significance to study the relationship between coronary bifurcations morphometrical feature change and coronary artery disease.Although coronary atherosclerosis has been extensively investigated,there is a lack of in-deep study on the differences in morphometric features between optimal and realistic geometry of coronary arterial trees.The purpose of the present paper is to determine the morphological changes in patients with CAD lesion compared with non-coronary artery disease(non-CAD)subjects.Methods Due to the difficulty of studying the coronary bifurcations in vivo,image-based in vitro anatomical 3D models have been widely used as a noninvasive method for morphometric measurement and clinical diagnosis of the coronary bifurcations.With the development of coronary computed tomography angiography(CTA)hardware and software technologies,the CTA imaging technique has been shown a promising application in the characterization,visualization,and identification of coronary artery disease in recent decades.The CTA images used to reconstruct three-dimensional(3D)coronary arterial trees are from Asia populations(Southern Chinese populations),including five cadavers without CAD lesion and 102 patients with CAD lesion.The best fit artery diameter was calculated as twice the average radius between the points in the centerlines and the points on the coronary arterial inner wall.The bifurcation angles between larger daughter artery and smaller daughter artery were determined by the intersection angle of their centerlines.Murray's law was introduced to assess the deviation of the realistic vascular networks from its optimal state.Results Based on the morphometric analysis of coronary artery bifurcations in non-CAD subjects and patients with CAD lesion subjects,the most important finding is that morphological feature parameters of non-CAD subjects are closer to the optimal values than those of patients with CAD lesion.Moreover,by comparing the morphometric data between the left and right coronary arteries,the right coronary artery exhibits a structure closer to the optimal one in morphological feature than the left coronary artery.In addition,coronary arterial trees with CAD lesion have higher asymmetry and larger area expansion ratio(AER)than those of the coronary arterial trees without CAD lesion.Conclusions We morphologically found that the coronary arterial trees with CAD lesion and left are more likely to deviate from the optimal structure predicted by Murray's law than those without CAD lesion and right.The degree to which coronary arterial system deviating from their optimal state may directly affect the incidence of coronary artery disease.This computer morpho-logical analysis strategy is illustrated to be effective in the distinguishing of the geometric differences between the healthy and diseased coronary arteries,and the analysis method may have a large potential in cardiovascular disease earlier diagnosis.
引文