On the association between helical flow and plaque progression in coronary arteries

Arterial hemodynamics is markedly characterized by the presence of helical flow (HF) patterns, whose physiological significance has been investigated in recent years, in particular with respect to the atheroprotective role played by specific HF structures. However, a gap in knowledge still exist on the significance of HF in coronary arteries, a prominent site of atherosclerotic plaque formation. The aim of this study is to carry out, in a representative sample of 15 swine coronary arteries, a systematic analysis of HF and wall thickness using computational fluid dynamics and intravascular ultrasound imaging. In detail, here we investigate possible associations of HF with (1) atherogenic wall shear stress (WSS) phenotypes, and (2) atherosclerotic plaque progression (in a follow up study). Our findings demonstrate for the first time that: (1) HF naturally characterizes coronary hemodynamics; (2) unfavourable conditions of WSS are strongly inversely associated with helicity intensity; (3) HF intensity protects against atherosclerotic plaque growth.