Abstract 4113951: Calcification Alters Luminal Surface Complexity in Cadaveric Left Anterior Descending Arteries

Background: Understanding the intricacies of luminal surface topographic changes in pathologic coronary arteries may yield insight not only on the efficacy of existing clinical interventions (e.g. impact of surface changes on stent anchoring), but also on the subsequent hemodynamic changes and pathophysiology of thrombus formation. In this study, we aim to detect and quantify luminal surface alterations induced by the presence of calcification in cadaveric left anterior descending arteries (LADs) using a novel approach–surface metrology. Methods: LADs (n=10) were harvested from cadaveric hearts using a systematic dissection approach, scanned using the Bruker Skyscan 1173 microCT scanner, and then underwent threshold-based image segmentation on Dragonfly by Object Research Systems to quantify the total calcium volume present throughout the vessel. Each specimen was then splayed open and up to 15 scans were performed at 20X magnification using the Sensofar S Neox optical profiler. Each scan subsequently underwent surface metrologic scale-sensitive fractal analyses in SensoMap 10. Results: Extent of calcification was standardized and expressed using the following ratio: total calcium volume by total vessel length (TC/VL). We considered a TC/VL ratio of 0-0.25 as low calcification and 0.26-0.5 as high calcification. Interestingly, our findings demonstrated statistically significant increases in smooth-rough crossover (SRC) and scale of maximum complexity (Smfc) with positive correlation, but reductions in fractal complexity (Lsfc) and fractal dimension (Dls) with negative correlation, in highly calcified compared to lowly calcified LADs. Conclusions: Our data suggests that the presence of calcium in the walls of LADs may translate to increased roughness in luminal surfaces generally, but smoothness over calcified plaques, locally. Our proposed mechanism is increased endothelial tension directly over areas of calcification, thus reducing surface complexity. Future studies will involve modeling blood flow using smooth particle hemodynamics (SPH) based on complete luminal and surface topographical geometries to evaluate the impact of these surface changes on hemodynamics.