Effect of side branch flow upon physiological indices in coronary artery disease. (16th April 2020)

• Record Type: Journal Article
• Authors: Gosling, Rebecca C.; Sturdy, Jacob; Morris, Paul D.; Fossan, Fredrik Eikeland; Hellevik, Leif Rune; Lawford, Patricia; Hose, D. Rodney; Gunn, Julian
• Is Part Of: Journal of biomechanics. Volume 103(2020)
• Publication Date: 2020-04-16
• Subjects: 1D One dimensional -- 1Dleaky One dimensional with leakage term -- 3D Three dimensional -- CFD Computational fluid dynamics -- CFR Coronary Flow Reserve -- CMVR Coronary Microvascular Resistance -- FFR Fractional flow reserve -- LCX Left circumflex artery -- LAD Left anterior descending artery -- RCA Right coronary artery -- IM Intermediate artery -- SR Stenotic segment Resistance -- vFFR virtual fractional flow reserve -- vCFR virtual coronary flow reserve; Hemodynamics -- Computational fluid dynamics -- Translational modeling -- Coronary artery disease -- Stenosis -- Cardiovascular physiology -- Mathematical modeling; Animal mechanics -- Periodicals; Biomechanics -- Periodicals; Biomechanics -- Periodicals; Mécanique animale -- Périodiques; Biomécanique -- Périodiques; Electronic journals; 571.4305
• DOI: 10.1016/j.jbiomech.2020.109698
• Languages: English
• ISSNs: 0021-9290

Abstract

Abstract: Recent efforts have demonstrated the ability of computational models to predict fractional flow reserve from coronary artery imaging without the need for invasive instrumentation. However, these models include only larger coronary arteries as smaller side branches cannot be resolved and are therefore neglected. The goal of this study was to evaluate the impact of neglecting the flow to these side branches when computing angiography-derived fractional flow reserve (vFFR) and indices of volumetric coronary artery blood flow. To compensate for the flow to side branches, a leakage function based upon vessel taper (Murray's Law) was added to a previously developed computational model of coronary blood flow. The augmented model with a leakage function (1Dleaky ) and the original model (1D) were then applied to predict FFR as well as inlet and outlet flow in 146 arteries from 80 patients who underwent invasive coronary angiography and FFR measurement. The results show that the leakage function did not significantly change the vFFR but did significantly impact the estimated volumetric flow rate and predicted coronary flow reserve. As both procedures achieved similar predictive accuracy of vFFR despite large differences in coronary blood flow, these results suggest careful consideration of the application of this index for quantitatively assessing flow.