Over the last decade, several in vivo and computational investigations have significantly advanced our understanding of the pathophysiology of coronary bifurcations, contributing to the enhancement of their percutaneous revascularization. The carina of the coronary bifurcations plays a substantial role in generating their main hemodynamic features, including distinctive flow patterns with secondary flows and specific shear stress patterns. These factors play a pivotal role in determining the susceptibility, development, and progression of atherosclerosis. The underlying pathophysiological mechanisms of atherosclerosis in coronary bifurcations are complex and multifactorial. Understanding these mechanisms is fundamental to comprehending lesions at the bifurcation level and informing future treatment strategies. This review aims to present the currently available data regarding the pathophysiological and prognostic role of the carina in coronary bifurcations, offering an interpretation of these findings from the perspective of interventional cardiologists, providing valuable insights for their clinical practice.

中文翻译：

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隆突：冠状动脉分叉病变病理生理学和治疗的主要决定因素


在过去的十年中，一些体内和计​​算研究极大地增进了我们对冠状动脉分叉病理生理学的理解，有助于增强其经皮血运重建。冠状动脉分叉处的隆凸在产生其主要血流动力学特征方面发挥着重要作用，包括具有二次流动的独特流动模式和特定的剪切应力模式。这些因素在决定动脉粥样硬化的易感性、发生和进展方面发挥着关键作用。冠状动脉分叉处动脉粥样硬化的潜在病理生理机制是复杂且多因素的。了解这些机制对于理解分叉水平的病变并为未来的治疗策略提供信息至关重要。本综述旨在介绍目前有关冠状动脉分叉中的病理生理学和预后作用的现有数据，从介入心脏病学家的角度对这些发现进行解释，为其临床实践提供有价值的见解。