Numerical Simulation of Sinusoidal Fluctuated Pulsatile Laminar Flow Through Stenotic Artery

A numerical investigation is carried out for laminar sinusoidal pulsating flow through a modeled arterial stenosis with a trapezoidal profile up to peak Reynolds number of 1000. Finite element based numerical technique is used to solve the fluid flow governing equations where the fluid is assumed to be viscous, incompressible and Newtonian. The effects of pulsation, stenosis severity, Reynolds number and Womersley number on the flow behavior are studied. The dynamic nature of pulsating flow disturbs the radial velocity distribution and thus generates recirculation zone in the poststenotic region. The peak wall shear stress develops for 65% stenosis (by area) is 3, 2.2, and 1.3 times higher than that for 30%, 45%, and 55% stenosis, respectively. Peak wall shear stress and wall vorticity appear to intense at the throat of the stenosis. It is also observed that the peak wall vorticity seems to increase with the increase of stenosis size and Reynolds number. However, the peak values of instantaneous wall vorticity are not greatly affected by the variation of Womersley number

Data file of the study.

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Characteristics of the participants (n = 2077).

Characteristics of the participants (n = 2077).</p

Factors associated with osteoarthritis prevalence in the pooled data (n = 2077).

Factors associated with osteoarthritis prevalence in the pooled data (n = 2077).</p

Changes in prevalence of osteoarthritis after adjusting for potential covariates (n = 2077).

Changes in prevalence of osteoarthritis after adjusting for potential covariates (n = 2077).</p

Changes in prevalence of osteoarthritis over time (n = 2077).

Changes in prevalence of osteoarthritis over time (n = 2077).</p

COVID-19 infected ST-Elevation myocardial infarction in India (COSTA INDIA)

Objective: To find out differences in the presentation, management and outcomes of COVID-19 infected STEMI patients compared to age and sex-matched non-infected STEMI patients treated during the same period. Methods: This was a retrospective multicentre observational registry in which we collected data of COVID-19 positive STEMI patients from selected tertiary care hospitals across India. For every COVID-19 positive STEMI patient, two age and sex-matched COVID-19 negative STEMI patients were enrolled as control. The primary endpoint was a composite of in-hospital mortality, re-infarction, heart failure, and stroke. Results: 410 COVID-19 positive STEMI cases were compared with 799 COVID-19 negative STEMI cases. The composite of death/reinfarction/stroke/heart failure was significantly higher among the COVID-19 positive STEMI patients compared with COVID-19 negative STEMI cases (27.1% vs 20.7% p value = 0.01); though mortality rate did not differ significantly (8.0% vs 5.8% p value = 0.13). Significantly lower proportion of COVID-19 positive STEMI patients received reperfusion treatment and primary PCI (60.7% vs 71.1% p value=< 0.001 and 15.4% vs 23.4% p value = 0.001 respectively). Rate of systematic early PCI (pharmaco-invasive treatment) was significantly lower in the COVID-19 positive group compared with COVID-19 negative group. There was no difference in the prevalence of high thrombus burden (14.5% and 12.0% p value = 0.55 among COVID-19 positive and negative patients respectively) Conclusions: In this large registry of STEMI patients, we did not find significant excess in in-hospital mortality among COVID-19 co-infected patients compared with non-infected patients despite lower rate of primary PCI and reperfusion treatment, though composite of in-hospital mortality, re-infarction, stroke and heart failure was higher