https://doi.org/10.1140/epjs/s11734-025-01883-7
Regular Article
Effects of increased heart rates on the hemodynamic features and arterial stress in a realistic left anterior descending coronary artery model of a young human with different degrees of stenosis
1
Advanced Technology Development Centre, IIT Kharagpur, 721302, Kharagpur, India
2
Department of Mechanical Engineering, UPES (University of Petroleum and Energy Studies), 248007, Dehradun, India
3
Centre for Computational and Data Sciences, IIT Kharagpur, 721302, Kharagpur, India
4
Department of Mechanical Engineering, IIT Kharagpur, 721302, Kharagpur, India
a
somnath.roy@mech.iitkgp.ac.in
Received:
16
June
2025
Accepted:
23
August
2025
Published online:
6
September
2025
This computational study presents a detailed hemodynamic evaluation of anatomically defined stenoses in a young subject-specific left anterior descending (LAD) coronary artery model under varying heart rates (HRs) of 60, 120, 140, and 160 bpm, simulating rest to strenuous exercise. At rest, severe stenosis (70% diameter, 91% area reduction) induces a significant time-averaged pressure drop (> 18 mmHg), intense vortex formation, and elevated time-averaged wall shear stress (TAWSS) reaching 55 Pa at the stenosis throat. Moderate stenoses (50–60% diameter reduction) show lower pressure drops (2.5–5.4 mmHg) at rest but exhibit a 4-to-6-fold increase under elevated HRs (≥ 120 bpm), along with disturbed flow and abnormal shear profiles comparable to those observed in severe stenosis at rest. These hemodynamic changes significantly impair distal coronary perfusion pressure (CPP) and reduce the Endocardial Viability Ratio (EVR), an indicator of myocardial oxygen balance, by approximately 25% in severe stenosis at rest and around 35% in moderate stenosis at high HRs, relative to the healthy case. In contrast, mild stenosis maintains stable coronary flow and myocardial perfusion across all HRs, indicating limited physiological impact. The study utilizes a multi-parametric CFD framework, incorporating velocity decomposition, TAWSS, oscillatory shear index (OSI), relative residence time (RRT), and pressure gradients to link flow disturbances to clinical ischemic risk. Results highlight that elevated HRs exacerbate vortical activity and oscillatory shear, promoting atherogenesis and plaque instability. This underscores the importance of physiological context in stenosis evaluation and provides quantitative tools for personalized risk assessment in young patients.
Supplementary Information The online version contains supplementary material available at https://doi.org/10.1140/epjs/s11734-025-01883-7.
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Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
