Numerical Simulation and Clinical Implications of Stenosis in Coronary Blood Flow

Fractional flow reserve (FFR) is the gold standard to guide coronary interventions. However it can only be obtained via invasive angiography. The objective of this study is to propose a noninvasive method to determine FFRCT by combining computed tomography angiographic (CTA) images and computational...

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Bibliographic Details
Published in:BioMed research international 2014-01, Vol.2014 (2014), p.1-10
Main Authors: Luo, Tong, Zhong, Liang, Zhang, Jun-Mei, Huo, Yunlong, Tan, Swee Yaw, Wong, Aaron Sung Lung, Su, Boyang, Wan, Min, Zhao, Xiaodan, Kassab, Ghassan S., Lee, Heow Pueh, Khoo, Boo Cheong, Kang, Chang-Wei, Ba, Te, Tan, Ru San
Format: Article
Language:English
Subjects:
Anatomy & physiology
Angiography
Animals
Biomedical research
Blood
Blood Flow Velocity
Boundary conditions
Cardiovascular disease
Care and treatment
Compliance
Coronary Circulation
Coronary heart disease
Coronary Stenosis - pathology
Coronary Stenosis - physiopathology
Coronary vessels
Coronary Vessels - pathology
Coronary Vessels - physiopathology
Fluid dynamics
Heart
Heart attacks
Humans
Medical research
Medicine, Experimental
Models, Cardiovascular
Myocardium
NMR
Nuclear magnetic resonance
Reynolds number
Simulation
Stenosis
Studies
Swine
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Summary:Fractional flow reserve (FFR) is the gold standard to guide coronary interventions. However it can only be obtained via invasive angiography. The objective of this study is to propose a noninvasive method to determine FFRCT by combining computed tomography angiographic (CTA) images and computational fluid dynamics (CFD) technique. Utilizing the method, this study explored the effects of diameter stenosis (DS), stenosis length, and location on FFRCT. The baseline left anterior descending (LAD) model was reconstructed from CTA of a healthy porcine heart. A series of models were created by adding an idealized stenosis (with DS from 45% to 75%, stenosis length from 4 mm to 16 mm, and at 4 locations separately). Through numerical simulations, it was found that FFRCT decreased (from 0.89 to 0.74), when DS increased (from 45% to 75%). Similarly, FFRCT decreased with the increase of stenosis length and the stenosis located at proximal position had lower FFRCT than that at distal position. These findings are consistent with clinical observations. Applying the same method on two patients’ CTA images yielded FFRCT close to the FFR values obtained via invasive angiography. The proposed noninvasive computation of FFRCT is promising for clinical diagnosis of CAD.
ISSN:2314-6133
2314-6141
DOI:10.1155/2014/514729