Computational Analysis of Non-Obstructive Coronary Lesions in Myocardial Infarction Patients Using Lattice Boltzmann Method: High-Risk Plaque or Not?

Despite effective treatment, many myocardial infarction patients develop additional nonculprit lesions, raising the risk of major adverse cardiovascular events. This substudy of the PECTUS-obs study investigates the role of physiological and wall shear stress (WSS)-based variables in identifying optical coherence tomography-defined high-risk nonculprit lesions in myocardial infarction patients using computational fluid dynamics (CFD) simulations. We used prototype software based on the finite volume method and a novel CFD analysis pipeline employing the Lattice Boltzmann Method solver to analyze WSS-based and hemodynamic variables in ten patients. Findings show that high-risk plaques have distinct hemodynamic profiles, including unique shear stress distribution and microvascular resistance, suggesting their potential to identify vulnerable plaques. Significant correlations were found between key hemodynamic variables, linking central flow dynamics, vessel resistance, and shear forces. However, the study faced limitations in flow rate realism due to boundary condition constraints. In conclusion, WSS-based and hemodynamic parameters show promise in identifying vulnerable plaques in myocardial infarction patients. However, further research is recommended to refine techniques and validate findings in larger cohorts.