Physiologically personalized coronary blood flow model to improve the estimation of noninvasive fractional flow reserve

2021 ◽  
Author(s):  
Xiujian Liu ◽  
Chuangye Xu ◽  
Simin Rao ◽  
Ye Zhang ◽  
Dhanjoo Ghista ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Blood Flow ◽  
Fractional Flow Reserve ◽  
Flow Model ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Blood Flow Model

scholarly journals Impact of Elective Percutaneous Coronary Intervention on Global Absolute Coronary Flow and Flow Reserve Evaluated by Phase-Contrast Cine-Magnetic Resonance Imaging in Relation to Regional Invasive Physiological Indices

2018 ◽  
Vol 11 (7) ◽  
Author(s):  
Yoshihisa Kanaji ◽  
Taishi Yonetsu ◽  
Rikuta Hamaya ◽  
Tadashi Murai ◽  
Eisuke Usui ◽  
...  
Keyword(s):  
Blood Flow ◽  
Magnetic Resonance ◽  
Coronary Blood Flow ◽  
Fractional Flow Reserve ◽  
Coronary Flow ◽  
Phase Contrast ◽  
Coronary Intervention ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Physiological Indices

Background: Few studies have documented changes in global absolute coronary blood flow and global coronary flow reserve after percutaneous coronary intervention (PCI) in relation to regional physiological measures. Phase-contrast cine-magnetic resonance of the coronary sinus is a promising approach to quantify global absolute coronary blood flow. We aimed to assess the impact of elective PCI on global absolute coronary blood flow and global coronary flow reserve by quantifying coronary sinus flow (CSF) using phase-contrast cine-magnetic resonance in relation to regional physiological indices. Methods and Results: We prospectively studied 54 patients with stable angina undergoing elective PCI for a single proximal lesion. Phase-contrast cine-magnetic resonance was used to assess CSF and CSF reserve at rest and during maximum hyperemia, before and after PCI. Regional physiological indices were obtained during PCI. A complete data set was obtained in 50 patients. Hyperemic CSF increased significantly after PCI (pre-PCI, 230.2 [167.4–282.8] mL/min; post-PCI, 267.4 [224.1–346.2] mL/min; P <0.01), although 12 patients (24.0%) showed a decrease, despite successful PCI and improved fractional flow reserve. CSF reserve numerically, albeit not statistically significant ( P =0.19), increased from 2.65 (1.95–3.96) to 2.98 (2.13–4.32). Patients with decreased CSF after PCI were associated with significantly greater pre-PCI hyperemic CSF, lower global coronary vascular resistance, lower regional microcirculatory resistance, and higher fractional flow reserve (all P <0.01). Conclusions: Fractional flow reserve–guided PCI in patients with single de novo lesions was associated with increased absolute hyperemic CSF, although 24% of patients showed decreased hyperemic CSF, despite successful and uncomplicated PCI. The present approach combining regional and global physiological assessments may provide a novel insight into the dynamic behavior of the coronary hemodynamics and microvascular function after PCI.

scholarly journals Improvement of Fractional Flow Reserve after Percutaneous Coronary Intervention Does Not Necessarily Indicate Increased Coronary Flow

2019 ◽  
Vol 14 (1) ◽  
pp. 10-12 ◽  
Author(s):  
Rikuta Hamaya ◽  
Yoshihisa Kanaji ◽  
Eisuke Usui ◽  
Masahiro Hoshino ◽  
Tadashi Murai ◽  
...  
Keyword(s):  
Blood Flow ◽  
Percutaneous Coronary Intervention ◽  
Coronary Blood Flow ◽  
Fractional Flow Reserve ◽  
Coronary Flow ◽  
Coronary Intervention ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Percutaneous Coronary ◽  
Microvascular Resistance

Coronary flow is expected to increase by epicardial lesion modification after successful percutaneous coronary intervention (PCI) in stable angina. According to the concept of fractional flow reserve (FFR), the improvement in FFR after PCI reflects the extent of coronary flow increase. However, this theory assumes that hyperaemic microvascular resistance does not change after PCI, which is being refuted in recent studies. The authors quantitated regional absolute coronary blood flow (ABF) before and after PCI using a thermodilution method and compared it with FFR in 28 patients with stable coronary artery disease who had undergone successful PCI. Although FFR indicated changes in ABF, with a mean difference of −5.5 ml/min, there was no significant relationship between individual changes in FFR and in ABF (R=0.27, p=0.16). The discrepancy was partly explained by changes in microvascular resistance following PCI. These results suggest that changes in FFR do not necessarily indicate an increase in absolute coronary blood flow following PCI in individual patients, although they could be correlated in a cohort level.

scholarly journals TCT-453 Quantification of Disturbed Coronary Blood Flow: Disturbed Vorticity Index and its Relation With Fractional Flow Reserve

2017 ◽  
Vol 70 (18) ◽  
pp. B187
Author(s):  
Miao Chu ◽  
Clemens von Birgelen ◽  
Yingguang Li ◽  
Jelmer Westra ◽  
Junqing Yang ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Blood Flow ◽  
Fractional Flow Reserve ◽  
Fractional Flow ◽  
Flow Reserve

scholarly journals Effect of Plaque Burden and Morphology on Myocardial Blood Flow and Fractional Flow Reserve

2018 ◽  
Vol 71 (5) ◽  
pp. 499-509 ◽  
Author(s):  
Roel S. Driessen ◽  
Wijnand J. Stuijfzand ◽  
Pieter G. Raijmakers ◽  
Ibrahim Danad ◽  
James K. Min ◽  
...  
Keyword(s):  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Fractional Flow Reserve ◽  
Plaque Burden ◽  
Fractional Flow ◽  
Flow Reserve

Fractional flow reserve

2021 ◽  
pp. 63-67
Author(s):  
Giovanni Ciccarelli ◽  
Emanuele Barbato ◽  
Bernard De Bruyne
Keyword(s):  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Coronary Intervention ◽  
Aortic Pressure ◽  
Fractional Flow ◽  
Coronary Pressure ◽  
Flow Reserve ◽  
Percutaneous Coronary

Fractional flow reserve is an index of the physiological significance of a coronary stenosis, defined as the ratio of maximal myocardial blood flow in the presence of the stenosis to the theoretically normal maximal myocardial blood flow (i.e. in the absence of the stenosis). This flow ratio can be calculated from the ratio of distal coronary pressure to central aortic pressure during maximal hyperaemia. More practically, fractional flow reserve indicates to what extent the epicardial segment can be responsible for myocardial ischaemia and, accordingly, fractional flow reserve quantifies the expected perfusion benefit from revascularization by percutaneous coronary intervention. Very limited evidence exists on the role on fractional flow reserve for bypass grafts.

scholarly journals Numerical simulation of the fractional flow reserve (FFR)

2018 ◽  
Vol 13 (6) ◽  
pp. 57 ◽  
Author(s):  
Keltoum Chahour ◽  
Rajae Aboulaich ◽  
Abderrahmane Habbal ◽  
Cherif Abdelkhirane ◽  
Nejib Zemzemi
Keyword(s):  
Fractional Flow Reserve ◽  
Flow Model ◽  
Rigid Wall ◽  
Fractional Flow ◽  
Wall Model ◽  
Factors Affecting ◽  
Non Invasive ◽  
Flow Reserve ◽  
Weakly Coupled ◽  
Preliminary Study

The fractional flow reserve (FFR) provides an efficient quantitative assessment of the severity of a coronary lesion. Our aim is to address the problem of computing non-invasive virtual fractional flow reserve (VFFR). In this paper, we present a preliminary study of the main features of flow over a stenosed coronary arterial portion, in order to enumerate the different factors affecting the VFFR. We adopt a non-Newtonian flow model and we assume that the two-dimensional (2D) domain is rigid in a first place. In a second place, we consider a simplified weakly coupled FSI model in order to take into account the infinitesimal displacements of the upper wall. A 2D finite element solver was implemented using Freefem++. We computed the VFFR profiles with respect to different lesion parameters and compared the results given by the rigid wall model to those obtained for the elastic wall one.

13N-ammonia PET/CT stress myocardial blood flow compared to fractional flow reserve in coronary artery disease

2020 ◽  
Vol 41 (2) ◽  
pp. 133-138 ◽  
Author(s):  
Jouke J. Boer ◽  
Johan J.J.S. Kappelhof ◽  
Friso M. van der Zant ◽  
Maurits Wondergem ◽  
Hans(J) B.R.M. de Swart ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Blood Flow ◽  
Coronary Artery ◽  
Myocardial Blood Flow ◽  
Fractional Flow Reserve ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Stress Myocardial Blood Flow ◽  
Pet Ct ◽  
Artery Disease

scholarly journals Coronary Tortuosity Overestimate The FFR Measurement In Stenotic Coronary Artery Model

2021 ◽  
Author(s):  
Jiatong Liu ◽  
Libo Zhang ◽  
Hongzeng Xu
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Fractional Flow Reserve ◽  
Three Dimensional ◽  
Pressure Profile ◽  
Measurement Procedure ◽  
Fractional Flow ◽  
Load Effect ◽  
Flow Reserve ◽  
Coronary Tortuosity

Abstract Background: The object of the study is to investigate the effect of coronary tortuosity (CT) on fractional flow reserve (FFR) in stenotic coronary artery.Methods: A three dimensional computational model of simulation of blood flow in stenotic coronary artery with multi-bend CT was constructed with Fluent 16.0 software. Blood was simulated as non-Newtonian fluid with the Carreau model. The simulation of blood flow in coronary artery stenotic model was used by the finite element methods with the condition of CT and no coronary tortuosity (NCT). Coronary artery hemodynamic parameters such as pressure, velocity and physiological diagnostic parameter fractional flow reserve (FFR) were studied in the model with the coronary tortuosity condition.Results: The results showed that the downstream CT impedance condition has significant impacts on numerical simulation. The pressure profile of pre-stenotic is almost identical in the two models. However the pressure in the pre-stenotic and post-stenotic artery domain is much higher in the CT model. The pressure fluctuation range in CT model was much higher than that in the NCT model. In the coronary artey model with 75% stenosis for the CT condition, the FFR was 0.823 while the FFR was 0.767 in the same model with NCT condition.Conclusions: This study provides evidence that FFR value was increased in coronary stenotic artery with the presence of CT. Therefore, it should be taking into account the influence of CT load effect in FFR measurement procedure, otherwise the CAD risk will be underestimated.

Sign in / Sign up

Export Citation Format

Share Document