Influence of Multi Stenosis on Hemodynamic Parameters in an Idealized Coronary Artery Model

BACKGROUND: The blood flow in the human artery has been a subject of sincere interest due to its prime importance linked with human health. The hemodynamic study has revealed an essential aspect of blood flow that eventually proved to be paramount to make a correct decision to treat patients suffering from cardiac disease. OBJECTIVE: The current study aims to elucidate the two-way fluid-structure interaction (FSI) analysis of the blood flow and the effect of stenosis on hemodynamic parameters. METHODS: A patient-specific 3D model of the left coronary artery was constructed based on computed tomography (CT) images. The blood is assumed to be incompressible, homogenous, and behaves as Non-Newtonian, while the artery is considered as a nonlinear elastic, anisotropic, and incompressible material. Pulsatile flow conditions were applied at the boundary. Two-way coupled FSI modeling approach was used between fluid and solid domain. The hemodynamic parameters such as the pressure, velocity streamline, and wall shear stress were analyzed in the fluid domain and the solid domain deformation. RESULTS: The simulated results reveal that pressure drop exists in the vicinity of stenosis and a recirculation region after the stenosis. It was noted that stenosis leads to high wall stress. The results also demonstrate an overestimation of wall shear stress and velocity in the rigid wall CFD model compared to the FSI model.

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Evaluation of Left Ventricular Diastolic Dysfunction in Patients with Coronary Artery Disease: Correlation between Echocardiographic and Hemodynamic Parameters

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v5i11.57 ◽

2017 ◽

Vol 5 (11) ◽

Author(s):

Kushaal Vikram ◽

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Diastolic Dysfunction ◽

Left Ventricular Diastolic Dysfunction ◽

Left Ventricular ◽

Hemodynamic Parameters ◽

Ventricular Diastolic Dysfunction ◽

Artery Disease

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Clonidine improves perioperative myocardial ischemia, reduces anesthetic requirement, and alters hemodynamic parameters in patients undergoing coronary artery bypass surgery

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1016/1053-0770(93)90157-g ◽

1993 ◽

Vol 7 (4) ◽

pp. 386-395 ◽

Cited By ~ 68

Author(s):

B. Hugh Dorman ◽

Jonathan R. Zucker ◽

Edward D. Verher ◽

David M. Gartman ◽

Frank N. Slachman

Keyword(s):

Coronary Artery ◽

Myocardial Ischemia ◽

Coronary Artery Bypass ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Artery Bypass ◽

Hemodynamic Parameters ◽

Anesthetic Requirement

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P5620Clinical and hemodynamic determinants of coronary flow reserve in non-obstructed coronary arteries - A patient level pooled analysis of the DEBATE and ILIAS studies

European Heart Journal ◽

10.1093/eurheartj/ehz746.0564 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

V E Stegehuis ◽

G W M Wijntjens ◽

M Bax ◽

M Meuwissen ◽

S A J Chamuleau ◽

...

Keyword(s):

Regression Analysis ◽

Coronary Artery ◽

Coronary Flow Reserve ◽

Coronary Arteries ◽

Coronary Flow ◽

Female Gender ◽

Hemodynamic Parameters ◽

Flow Measurements ◽

Flow Reserve ◽

Dutch Health

Abstract Aim Coronary Flow Reserve (CFR) is a valuable physiological index for the assessment of myocardial flow impairment due to focal or microcirculatory coronary artery disease (CAD). Coronary flow capacity (CFC) is another flow-based concept in diagnosing ischemic heart disease (IHD), based on hyperemic average peak velocity (hAPV) and CFR. We evaluated clinical and hemodynamic factors which potentially influence CFR and CFC in non-obstructed coronary arteries. Methods We analysed CFR and CFC of 396 non-obstructed vessels of patients from two large multi-center trials (DEBATE and ILIAS) with stable CAD who were scheduled for percutaneous coronary intervention (PCI). Doppler flow measurements were performed after inducing hyperemia with either intracoronary or intravenous infusion of adenosine. Results Akaike's Information Criterion (AIC) revealed the parameters age, female gender, a history of myocardial infarction, hypercholesterolemia, current or previous smoking and rate pressure product (RPP) as independent predictors in the best model of fit for CFR in an angiographically non-obstructed vessel. After multivariate regression analysis age, female gender and RPP remained as determinants of CFR in angiographically non-obstructed vessels. Subsequently, ordered logistic regression analysis revealed that age is associated with a worse CFC. Conclusion Clinical and hemodynamic parameters are associated with CFR and to a lesser extent CFC in an angiographically non-obstructed coronary artery. CFC is less sensitive to variations in clinical and hemodynamic parameters than CFR and therefore a promising tool in contemporary clinical decision making in the cardiac catheterization laboratory. Acknowledgement/Funding DEBATE: Cardiometrics INC. ILIAS: Dutch Health Insurance Board; RADI Medical Systems, Uppsala, Sweden; and Endosonics, Rancho Cordova, CA.

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