The Comparative Method Based on Coronary Computed Tomography Angiography for Assessing the Hemodynamic Significance of Coronary Artery Stenosis.

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Engineering and Technology Pub Date : 2023-06-01 DOI:10.1007/s13239-023-00658-2

Zbigniew Małota, Wojciech Sadowski, Konrad Pieszko, Rafał Zimoląg, Filip Czekała, Renata Malinowska, Jarosław Hiczkiewicz

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引用次数: 1

Abstract

Purpose: An important aspect in the prevention and treatment of coronary artery disease is the functional evaluation of narrowed blood vessels. Medical image-based Computational Fluid Dynamic methods are currently increasingly being used in the clinical setting for flow studies of cardio vascular system. The aim of our study was to confirm the feasibility and functionality of a non-invasive computational method providing information about hemodynamic significance of coronary stenosis.

Methods: A comparative method was used to simulate the flow energy losses in real (stenotic) and reconstructed models without (reference) stenosis of the coronary arteries under stress test conditions, i.e. for maximum blood flow and minimal, constant vascular resistance. In addition to the absolute pressure drop in the stenotic arteries (FFR_sten) and in the reconstructed arteries (FFR_rec), a new energy flow reference index (EFR) was also defined, which expresses the total pressure changes caused by stenosis in relation to the pressure changes in normal coronary arteries, which also allows a separate assessment of the haemodynamic significance of the atherosclerotic lesion itself. The article presents the results obtained from flow simulations in coronary arteries, reconstructed on the basis of 3D segmentation of cardiac CT images of 25 patients from retrospective data collection, with different degrees of stenoses and different areas of their occurrence.

Results: The greater the degree of narrowing of the vessel, the greater drop of flow energy. Each parameter introduces an additional diagnostic value. In contrast to FFR_sten, the EFR indices that are calculated on the basis of a comparison of stenosed and reconstructed models, are associated directly with localization, shape and geometry of stenosis only. Both FFR_sten and EFR showed very significant positive correlation (P < 0.0001) with coronary CT angiography-derived FFR, with a correlation coefficient of 0.8805 and 0.9011 respectively.

Conclusion: The study presented promising results of non-invasive, comparative test to support of prevention of coronary disease and functional evaluation of stenosed vessels.

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基于冠状动脉ct血管造影的血流动力学评价方法。

目的:血管狭窄的功能评价是冠状动脉疾病防治的一个重要方面。基于医学图像的计算流体动力学方法目前越来越多地应用于临床环境中，用于心血管系统的血流研究。我们研究的目的是确认一种非侵入性计算方法的可行性和功能，该方法可以提供有关冠状动脉狭窄血流动力学意义的信息。方法:采用对比的方法模拟在压力测试条件下真实(狭窄)和重构(参考)冠状动脉狭窄模型的血流能量损失，即最大血流量和最小恒定血管阻力。除了狭窄动脉(FFRsten)和重建动脉(FFRrec)的绝对压降外，还定义了一个新的能量流参考指数(EFR)，它表示狭窄引起的总压变化相对于正常冠状动脉的压力变化，这也可以单独评估动脉粥样硬化病变本身的血流动力学意义。本文介绍了冠状动脉血流模拟的结果，该结果是在回顾性收集的25例患者的心脏CT图像的三维分割的基础上重建的，这些患者有不同程度的狭窄和不同的发生区域。结果:血管狭窄程度越大，血流能下降越大。每个参数都会引入一个附加的诊断值。与FFRsten相比，基于狭窄和重建模型的比较计算的EFR指数仅与狭窄的定位、形状和几何形状直接相关。结论:无创、比比性试验对冠心病的预防和血管狭窄的功能评价提供了有希望的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Engineering and Technology Engineering-Biomedical Engineering

CiteScore

4.00

自引率

0.00%

发文量

期刊介绍： Cardiovascular Engineering and Technology is a journal publishing the spectrum of basic to translational research in all aspects of cardiovascular physiology and medical treatment. It is the forum for academic and industrial investigators to disseminate research that utilizes engineering principles and methods to advance fundamental knowledge and technological solutions related to the cardiovascular system. Manuscripts spanning from subcellular to systems level topics are invited, including but not limited to implantable medical devices, hemodynamics and tissue biomechanics, functional imaging, surgical devices, electrophysiology, tissue engineering and regenerative medicine, diagnostic instruments, transport and delivery of biologics, and sensors. In addition to manuscripts describing the original publication of research, manuscripts reviewing developments in these topics or their state-of-art are also invited.