Title: High-Intensity Helical Flow: A Double-Edged Sword in Coronary Artery Haemodynamics Show Chinese title

Title: 高强度螺旋流：冠状动脉血流动力学中的双刃剑

Abstract: The role of Helical Flow (HF) in human coronary arteries remains uncertain, yet its understanding promises unprecedented insights into atherosclerotic processes. In this study, we investigated the effects of HF and key haemodynamic descriptors in 39 patient-specific left coronary artery trees from the ASOCA dataset, including 20 non-stenosed and 19 stenosed cases. Absolute HF intensity $h_2$ correlated with higher Time-Averaged Endothelial Shear Stress (TAESS) in all vessel segments regardless of stenosis (p < 0.05). In stenosed cases, this correlation was so prominent that the vessel area exposed to adversely low TAESS was reduced (< 0.5 Pa, p = 0.0001), while areas of adversely high TAESS increased (> 4.71 Pa, p < 0.05), coinciding with high $h_2$ regions. This suggests that HF in coronary arteries is not always protective as previously thought. It not only mitigates low TAESS, which is associated with long-term plaque development and restenosis, but also exacerbates adversely high TAESS, which is linked to increased plaque vulnerability and acute events. Our findings redefine the current understanding of helical blood flow's role in cardiovascular atherosclerotic disease processes. Show Chinese abstract

Abstract: 螺旋流（HF）在人体冠状动脉中的作用仍然不确定，但其理解有望为动脉粥样硬化过程提供前所未有的见解。 在本研究中，我们调查了39个来自ASOCA数据集的患者特异性左冠状动脉树中HF和关键血流动力学描述符的影响，包括20个非狭窄和19个狭窄病例。 绝对HF强度$h_2$与所有血管段的平均时间内皮剪切应力（TAESS）相关，无论是否存在狭窄（p < 0.05）。 在狭窄病例中，这种相关性非常显著，导致暴露于不利低TAESS的血管区域减少（< 0.5 Pa，p = 0.0001），而暴露于不利高TAESS的区域增加（> 4.71 Pa，p < 0.05），这与高$h_2$区域一致。 这表明，冠状动脉中的HF并不总是如以前认为的那样具有保护作用。 它不仅减轻与长期斑块形成和再狭窄相关的低TAESS，还加剧与斑块易损性和急性事件相关的不利高TAESS。 我们的发现重新定义了当前对螺旋血流在心血管动脉粥样硬化疾病过程中的作用的理解。