Patient-specific modelling of coronary hemodynamics: state of the art

Abstract

Coronary arteries serve a crucial purpose in the circulatory system as they supply blood to the human heart, a highly oxidative organ. As the blood flows through these arteries, the constituents of blood such as proteins and fatty acid molecules may start depositing on the arterial lining. These depositions narrow down the arteries and obstruct the blood flow to the heart. This phenomenon is termed as atherosclerosis, responsible for coronary artery disease, a leading cause of death globally. The progression of disease is affected by coronary hemodynamics which strongly depends on the geometrical complexities such as branching and tapering, and the associated parameters such as curvature and tortuosity. These geometrical parameters vary across the population and are affected by factors such as dietary habits, gender, lifestyle and genetics. Technological advancements in the past few decades have resulted in emergence of patient-specific computational fluid dynamics (CFD) modelling as an important tool in cardiovascular engineering and technology. Patient-specific CFD modelling utilises the clinically obtained patient-specific geometrical and boundary condition data to model the flow and gain an insight in the detailed hemodynamic behaviour, calculate different parameters which can be used as biomarkers and assess different treatment options. In this article, we provide a brief overview of the human coronary circulation and typical steps involved in patient-specific modelling. Further, the studies on patient-specific coronary hemodynamics are extensively reviewed and a perspective on future trends is provided. We believe that the article will serve as a beginner’s guide for the researchers working in this emerging area.

Graphical abstract