血流动力学对斑块性质的影响

1、血流动力学对斑块性质的影响北京天坛医院北京天坛医院 秦海强秦海强临床决策临床决策管腔狭窄血流斑块性质2022-6-233FAME5200920122014FAME:血管狭窄FFRTonino PA, Fearon WF, De Bruyne B, et al. Angiographic versus functional severity of coronary artery stenoses in the FAME Study: Fractional flow reserve versus angiography in multivessel evaluation. J Am Coll Ca

2、rdiol. 2010;55;25:2816. 6美国FDA批准临床使用CFD分析软件测量FFR（2014年11月）临床决策管腔狭窄血流斑块性质2022-6-238动脉粥样硬化的分类Modified by V Fuster et al. NEJM 1992;326:242区分脑梗死的病因 低剪切力区10 dyne/cm2高剪切力区25dyne/cm2剪切力振荡600dyne/cm2Cheng C, et al. Circulation, 2006,113:2744-53. n低剪切力在动脉粥样硬化斑块的形成中起关键作用病理分析病理分析Caroline Cheng et al. Circulat

3、ion. 2006;113:2744-2753Caroline Cheng et al. Circulation. 2006;113:2744-2753病理分析病理分析Caroline Cheng et al. Circulation. 2006;113:2744-2753Copyright American Heart Association, Inc. All rights reserved.基因学分析基因学分析Caroline Cheng et al. Circulation. 2006;113:2744-2753低剪切力区10 dyne/cm2高剪切力区25dyne/cm2剪切力振荡6

4、00dyne/cm2Cheng C, et al. Circulation, 2006,113:2744-53. n低剪切力在动脉粥样硬化斑块的形成中起关键作用Occurrence of plaque complications in relation to the flow direction. Iwona Cicha et al. Stroke. 2011;42:3502-3510Computational fluid dynamics (CFD) analysis. Iwona Cicha et al. Stroke. 2011;42:3502-3510Dalin Tang, Biomed Eng Online. 2009; 8: 15.Dalin Tang, Biomed Eng Online. 2009; 8: 15.Dalin Tang, Biomed Eng Online. 2009; 8: 15.临床决策管腔狭窄血流斑块性质2022-6-2330储备能力影像发现血流动力学总结 计算流体力学不仅影响斑块的形成，而且影响斑块发展过程/性质； 在体血流动力学