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Am J Physiol Heart Circ Physiol 287: H1670-H1681, 2004; doi:10.1152/ajpheart.01186.2003
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Influence of head position on carotid hemodynamics in young adults

F. P. Glor,1,2 B. Ariff,3 A. D. Hughes,3 P. R. Verdonck,1 D. C. Barratt,3,4 A. D. Augst,2 S. A. M. Thom,3 and X. Yun Xu2

1Cardiovascular Mechanics and Biofluid Dynamics Unit, Ghent University, 9000 Gent, Belgium; 2Department of Chemical Engineering and Chemical Technology, Imperial College London, London SW7 2AZ; 3Clinical Pharmacology and Therapeutics, St. Mary’s Hospital, Imperial College London, London W2 1NY; 4Computational Imaging Sciences Group, Imaging Sciences, Guy’s Hospital, King’s College London, London SE1 9RT, United Kingdom

Submitted 23 December 2003 ; accepted in final form 2 June 2004

Studies in adults have shown marked changes in geometry and relative positions of the carotid arteries when rotating the head. The aim of this study was to quantify the change in geometry and analyze its effect on carotid hemodynamics as a result of head rotation. The right carotid arteries of nine young adult subjects were investigated in supine position with straight and left turned head positions, respectively. The three-dimensional (3D) carotid geometry was reconstructed by using 3D ultrasound (3D US), and the carotid hemodynamics were calculated by combining 3D US with computational fluid dynamics. It was observed that cross-sectional areas and shapes did not change markedly with head rotation, but carotid vessel center lines altered with planarification of the common carotid artery as a main feature (P < 0.05). Measured common carotid flow rates changed significantly at the individual level when the head was turned, but on the average, the change in mean common carotid flow rate was relatively small (0.37 ± 1.11 ml/s). The effect of the altered center lines and flow rates on the atherogenic nature of the carotid bifurcation was evaluated by using calculated hemodynamic wall parameters, such as wall shear stress (WSS) and oscillatory shear index (OSI). It was found that WSS and OSI patterns changed significantly with head rotation, but the variations were very subject dependent and could not have been predicted without assessing the altered geometry and flow of the carotid bifurcation for individual cases. This study suggests that there is a need for standardization of the choice of head position in the 3D US scan protocol, and that carotid stents and emboli diverters should be studied in different head positions.

three-dimensional ultrasound; atherosclerosis; wall shear stress; computational fluid dynamics



Address for reprint requests and other correspondence: F. P. Glor, Laboratorium voor Hydraulica, Sint-Pietersnieuwstraat 41, 9000 Gent, Belgium (E-mail: fadi{at}navier.UGent.be)







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