Effect of side branch flow upon physiological indices in coronary artery disease
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 therefor...
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| Veröffentlicht in: | Journal of biomechanics 2020-04, Vol.103, p.109698-109698, Article 109698 |
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| creator | Gosling, Rebecca C. Sturdy, Jacob Morris, Paul D. Fossan, Fredrik Eikeland Hellevik, Leif Rune Lawford, Patricia Hose, D. Rodney Gunn, Julian |
| description | 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. |
| doi_str_mv | 10.1016/j.jbiomech.2020.109698 |
| format | Article |
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Rodney ; Gunn, Julian</creator><creatorcontrib>Gosling, Rebecca C. ; Sturdy, Jacob ; Morris, Paul D. ; Fossan, Fredrik Eikeland ; Hellevik, Leif Rune ; Lawford, Patricia ; Hose, D. Rodney ; Gunn, Julian</creatorcontrib><description>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.</description><identifier>ISSN: 0021-9290</identifier><identifier>EISSN: 1873-2380</identifier><identifier>DOI: 10.1016/j.jbiomech.2020.109698</identifier><identifier>PMID: 32151377</identifier><language>eng</language><publisher>United States: Elsevier Ltd</publisher><subject>Accuracy ; Aged ; Angiography ; Arteries ; Blood flow ; Blood vessels ; Cardiovascular disease ; Cardiovascular physiology ; Computational fluid dynamics ; Computer applications ; Computer Simulation ; Coronary Angiography ; Coronary artery ; Coronary artery disease ; Coronary Artery Disease - physiopathology ; Coronary vessels ; Coronary Vessels - diagnostic imaging ; Coronary Vessels - physiopathology ; Female ; Flow velocity ; Fractional Flow Reserve, Myocardial ; Heart diseases ; Hemodynamics ; Humans ; Leakage ; Male ; Mathematical modeling ; Mathematical models ; Medical imaging ; Middle Aged ; Models, Cardiovascular ; Outlet flow ; Physiological effects ; Physiology ; Predictive Value of Tests ; Stenosis ; Translational modeling</subject><ispartof>Journal of biomechanics, 2020-04, Vol.103, p.109698-109698, Article 109698</ispartof><rights>2020 The Authors</rights><rights>Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><rights>2020. The Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c444t-6d14a0364ab2ef9ad6c0a30ca093f9f618868160e7cf08984abd4a0dc1e7c40a3</citedby><cites>FETCH-LOGICAL-c444t-6d14a0364ab2ef9ad6c0a30ca093f9f618868160e7cf08984abd4a0dc1e7c40a3</cites><orcidid>0000-0003-0028-3226 ; 0000-0001-9302-7541</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2417015941?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976,64364,64366,64368,72218</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32151377$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gosling, Rebecca C.</creatorcontrib><creatorcontrib>Sturdy, Jacob</creatorcontrib><creatorcontrib>Morris, Paul D.</creatorcontrib><creatorcontrib>Fossan, Fredrik Eikeland</creatorcontrib><creatorcontrib>Hellevik, Leif Rune</creatorcontrib><creatorcontrib>Lawford, Patricia</creatorcontrib><creatorcontrib>Hose, D. Rodney</creatorcontrib><creatorcontrib>Gunn, Julian</creatorcontrib><title>Effect of side branch flow upon physiological indices in coronary artery disease</title><title>Journal of biomechanics</title><addtitle>J Biomech</addtitle><description>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.</description><subject>Accuracy</subject><subject>Aged</subject><subject>Angiography</subject><subject>Arteries</subject><subject>Blood flow</subject><subject>Blood vessels</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular physiology</subject><subject>Computational fluid dynamics</subject><subject>Computer applications</subject><subject>Computer Simulation</subject><subject>Coronary Angiography</subject><subject>Coronary artery</subject><subject>Coronary artery disease</subject><subject>Coronary Artery Disease - physiopathology</subject><subject>Coronary vessels</subject><subject>Coronary Vessels - diagnostic imaging</subject><subject>Coronary Vessels - physiopathology</subject><subject>Female</subject><subject>Flow velocity</subject><subject>Fractional Flow Reserve, Myocardial</subject><subject>Heart diseases</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Leakage</subject><subject>Male</subject><subject>Mathematical modeling</subject><subject>Mathematical models</subject><subject>Medical imaging</subject><subject>Middle Aged</subject><subject>Models, Cardiovascular</subject><subject>Outlet flow</subject><subject>Physiological effects</subject><subject>Physiology</subject><subject>Predictive Value of Tests</subject><subject>Stenosis</subject><subject>Translational modeling</subject><issn>0021-9290</issn><issn>1873-2380</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkMFuGyEQhlGVqHbdvkKE1Esu6wwshuXWykrSSpGSQ3JGGIaa1XpxwZsqb18sJz3k0tMvjb5_YD5CLhgsGTB51S_7TUw7dNslB34caqm7D2TOOtU2vO3gjMwBOGs01zAjn0rpAUAJpT-SWcvZirVKzcnDdQjoDjQFWqJHusl2dFsahvSHTvs00v32pcQ0pF_R2YHG0UeHpSZ1KafR5hdq8wFr-FjQFvxMzoMdCn55zQV5url-XP9o7u5vf66_3zVOCHFopGfCQiuF3XAM2nrpwLbgLOg26CBZ18mOSUDlAnS6q5yvBe9YnYiKLsjlae8-p98TloPZxeJwGOyIaSqGt2qlQcl654J8fYf2acpj_Z3hgilgKy2OlDxRLqdSMgazz3FXDzQMzNG56c2bc3N0bk7Oa_Hidf202aH_V3uTXIFvJwCrj-eI2RQXcXToY67ujU_xf2_8BWHalWs</recordid><startdate>20200416</startdate><enddate>20200416</enddate><creator>Gosling, Rebecca C.</creator><creator>Sturdy, Jacob</creator><creator>Morris, Paul D.</creator><creator>Fossan, Fredrik Eikeland</creator><creator>Hellevik, Leif Rune</creator><creator>Lawford, Patricia</creator><creator>Hose, D. 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Rodney</au><au>Gunn, Julian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of side branch flow upon physiological indices in coronary artery disease</atitle><jtitle>Journal of biomechanics</jtitle><addtitle>J Biomech</addtitle><date>2020-04-16</date><risdate>2020</risdate><volume>103</volume><spage>109698</spage><epage>109698</epage><pages>109698-109698</pages><artnum>109698</artnum><issn>0021-9290</issn><eissn>1873-2380</eissn><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.</abstract><cop>United States</cop><pub>Elsevier Ltd</pub><pmid>32151377</pmid><doi>10.1016/j.jbiomech.2020.109698</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-0028-3226</orcidid><orcidid>https://orcid.org/0000-0001-9302-7541</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of biomechanics, 2020-04, Vol.103, p.109698-109698, Article 109698 |
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| subjects | Accuracy Aged Angiography Arteries Blood flow Blood vessels Cardiovascular disease Cardiovascular physiology Computational fluid dynamics Computer applications Computer Simulation Coronary Angiography Coronary artery Coronary artery disease Coronary Artery Disease - physiopathology Coronary vessels Coronary Vessels - diagnostic imaging Coronary Vessels - physiopathology Female Flow velocity Fractional Flow Reserve, Myocardial Heart diseases Hemodynamics Humans Leakage Male Mathematical modeling Mathematical models Medical imaging Middle Aged Models, Cardiovascular Outlet flow Physiological effects Physiology Predictive Value of Tests Stenosis Translational modeling |
| title | Effect of side branch flow upon physiological indices in coronary artery disease |
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