Authors:

Jacob Christophe Sues

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Purpose: Investigators have long been puzzled by the mystery of what initiates plaque formation and then the development of coronary artery disease (CAD), a disease in which there is a narrowing or blockage of the coronary arteries. Coronary arteries have turns and ostia where plaques seem to form, yet peripheral vessels only develop plaques near ostia. In the heating and air conditioning industry (HVAC), similar damage to the inner coating of pipes is observed near bends and pumps. This is termed Cavitation Phenomenon. This investigation applied the principles of fluid dynamics from the HVAC industry to the blood flow in coronary arteries to explore the origin of CAD. Methods: Approval was obtained from the hospital Internal Review Board. Patient consent was obtained. Coronary angiograms (CAGs) of 200 patients with stable CAD were selected and de-identified. CAGs were analyzed using the novel technique of dynamic coronary angiography and observing the flow of contrast media against background blood flow. Results: Laminar flow was characterized by organized fluid layers with steady velocity and minimal/absent boundary layers in areas lacking plaque development. Lesions were seen in areas of turbulent flow (near ostia); helical flow (at curves) and collision lines (areas of water hammer shock). In patients with anatomy restoration, CAD failed to worsen. Conclusion: The results suggest that damage to the intima occurs from separation flow that becomes turbulent leading to Cavitation Phenomenon. This approach allows for mechanistic explanation of lesion formation and growth. These data bring a provocative new approach not only to the identification and prediction of lesion formation, but also to possible restorative interventions that might prevent or minimize lesion formation in what could be revolutionary in interventional cardiology. † Presenting Undergrad Author; ‡ Contributing Undergrad Author; * Undergrad Acknowledgment Keywords: Cavitation; Coronary Arteries; Fluid Dynamics; Water Hammer Shock; Coronary Angiography

Source:

Purdue University / 2025

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Co-authors:

Jacob Christophe Sues