Authors:

Bao Lam Phan

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About Paper:

Background: Uncontrolled hypertension (HTN) is a major modifiable risk factor for coronary artery disease (CAD). Prior research demonstrated that laminar flow protects the endothelium, whereas turbulent flow-particularly from retrograde-antegrade collision-can injure the intima and trigger atherosclerosis. This study aimed to determine the systolic and diastolic BP thresholds that avoid reversed flow and turbulence in the coronary and iliac arteries. Methods: Fifty patients underwent dynamic coronary and iliac angiography. Following contrast opacification, blood inflow (white over black contrast) was recorded at 15 frames/second to assess flow direction (antegrade vs. retrograde) and type (laminar vs. turbulent). A machine learning (ML) model was developed in Python. Model 1, based on U-net and DenseNet-121, performed vessel segmentation. Model 2, a convolutional neural network, classified flow patterns. Results: Group A (n = 30) with uncontrolled systolic BP >160 mmHg and diastolic BP >110 mmHg exhibited retrograde flow and turbulence in both coronary and iliac arteries. In contrast, Group B (n = 20) with diastolic BP <75 mmHg showed no retrograde flow in the iliac arteries. Moreover, when systolic BP was maintained below 110 mmHg, no retrograde flow occurred in the coronary arteries. Conclusion: † Presenting Undergrad Author; ‡ Contributing Undergrad Author; * Undergrad Acknowledgment The absence of retrograde flow and turbulence was observed with systolic BP <110 mmHg and diastolic BP <75 mmHg, suggesting these thresholds may represent optimal hemodynamic conditions for vascular protection. These findings provide physiological insights for BP targets in CAD management. Keywords: Hypertension; Laminar Flow; Turbulent Flow; Retrograde-Antegrade Collision; Coronary Artery Disease

Source:

Purdue University / 2025

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Co-authors:

Bao Lam Phan