title: Myocardial perfusion distribution and coronary arterial pressure and flow signals: clinical relevance in relation to multiscale modeling, a review.
abstract: Coronary artery disease, CAD, is associated with both narrowing of the epicardial coronary arteries and microvascular disease, thereby limiting coronary flow and myocardial perfusion. CAD accounts for almost 2 million deaths within the European Union on an annual basis. In this paper, we review the physiological and pathophysiological processes underlying clinical decision making in coronary disease as well as the models for interpretation of the underlying physiological mechanisms. Presently, clinical decision making is based on non-invasive magnetic resonance imaging, MRI, of myocardial perfusion and invasive coronary hemodynamic measurements of coronary pressure and Doppler flow velocity signals obtained during catheterization. Within the euHeart project, several innovations have been developed and applied to improve diagnosis-based understanding of the underlying biophysical processes. Specifically, MRI perfusion data interpretation has been advanced by the gradientogram, a novel graphical representation of the spatiotemporal myocardial perfusion gradient. For hemodynamic data, functional indices of coronary stenosis severity that do not depend on maximal vasodilation are proposed and the Valsalva maneuver for indicating the extravascular resistance component of the coronary circulation has been introduced. Complementary to these advances, model innovation has been directed to the porous elastic model coupled to a one-dimensional model of the epicardial arteries. The importance of model development is related to the integration of information from different modalities, which in isolation often result in conflicting treatment recommendations.
authors.affiliation: Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Froukje
authors.initials: F
authors.lastname: Nolte
authors.forename: Eoin R
authors.initials: ER
authors.lastname: Hyde
authors.forename: Cristina
authors.initials: C
authors.lastname: Rolandi
authors.forename: Jack
authors.initials: J
authors.lastname: Lee
authors.forename: Pepijn
authors.initials: P
authors.lastname: van Horssen
authors.forename: Kal
authors.initials: K
authors.lastname: Asrress
authors.forename: Jeroen P H M
authors.initials: JP
authors.lastname: van den Wijngaard
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Cookson
authors.forename: Tim
authors.initials: T
authors.lastname: van de Hoef
authors.forename: Radomir
authors.initials: R
authors.lastname: Chabiniok
authors.forename: Reza
authors.initials: R
authors.lastname: Razavi
authors.forename: Christian
authors.initials: C
authors.lastname: Michler
authors.forename: Gilion L T F
authors.initials: GL
authors.lastname: Hautvast
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Piek
authors.forename: Marcel
authors.initials: M
authors.lastname: Breeuwer
authors.forename: Maria
authors.initials: M
authors.lastname: Siebes
authors.forename: Eike
authors.initials: E
authors.lastname: Nagel
authors.forename: Nic P
authors.initials: NP
authors.lastname: Smith
authors.forename: Jos A E
authors.initials: JA
authors.lastname: Spaan
mesh_terms: D062186:Arterial Pressure; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D016208:Databases, Factual; D003935:Diagnostic Techniques, Cardiovascular; D015150:Echocardiography, Doppler; D006801:Humans; D008279:Magnetic Resonance Imaging; D008955:Models, Cardiovascular; D055414:Myocardial Perfusion Imaging; D062645:Percutaneous Coronary Intervention
references.citation: Am J Physiol Heart Circ Physiol. 2012 Aug 15;303(4):H422-8
references.pmid: 22730389
references.citation: Ann Biomed Eng. 2012 Nov;40(11):2399-413
references.pmid: 22565815
references.citation: Circ Res. 1991 Sep;69(3):561-70
references.pmid: 1873859
references.citation: Prog Biophys Mol Biol. 2011 Jan;104(1-3):49-76
references.pmid: 21040741
references.citation: Circ Res. 1992 Nov;71(5):1200-12
references.pmid: 1394880
references.citation: J Am Coll Cardiol. 2010 Aug 10;56(7):561-9
references.pmid: 20688211
references.citation: Am J Physiol Heart Circ Physiol. 2001 Apr;280(4):H1674-82
references.pmid: 11247779
references.citation: Magn Reson Med. 2012 Dec;68(6):1994-2004
references.pmid: 22354744
references.citation: J Magn Reson Imaging. 2008 Jun;27(6):1271-7
references.pmid: 18421683
references.citation: Circulation. 2004 Feb 17;109(6):756-62
references.pmid: 14970112
references.citation: J Physiol. 2012 Sep 15;590(18):4623-35
references.pmid: 22586218
references.citation: Circulation. 2006 Jan 24;113(3):446-55
references.pmid: 16432075
references.citation: Z Kardiol. 2002;91 Suppl 3:108-12
references.pmid: 12641024
references.citation: Am J Physiol Heart Circ Physiol. 2002 Oct;283(4):H1462-70
references.pmid: 12234798
references.citation: JACC Cardiovasc Imaging. 2012 Feb;5(2):154-66
references.pmid: 22340821
references.citation: Am J Physiol. 1992 Apr;262(4 Pt 2):H1256-67
references.pmid: 1566907
references.citation: Bull Math Biol. 2008 Nov;70(8):2334-57
references.pmid: 18818972
references.citation: Med Biol Eng Comput. 2005 Jul;43(4):431-5
references.pmid: 16255423
references.citation: Basic Res Cardiol. 1977 Nov-Dec;72(6):636-50
references.pmid: 607933
references.citation: Circulation. 2004 Oct 12;110(15):2137-42
references.pmid: 15466646
references.citation: J Am Coll Cardiol. 2002 May 15;39(10):1630-6
references.pmid: 12020490
references.citation: Circulation. 1992 May;85(5):1899-911
references.pmid: 1572046
references.citation: Biophys J. 2009 May 20;96(10):4035-43
references.pmid: 19450475
references.citation: Am J Physiol Heart Circ Physiol. 2006 Feb;290(2):H878-85
references.pmid: 16126811
references.citation: Lancet. 2012 Feb 4;379(9814):453-60
references.pmid: 22196944
references.citation: JACC Cardiovasc Interv. 2011 Oct;4(10):1079-84
references.pmid: 22017932
references.citation: Circulation. 2001 Jan 16;103(2):184-7
references.pmid: 11208673
references.citation: Am J Physiol Heart Circ Physiol. 2005 May;288(5):H2450-6
references.pmid: 15615846
references.citation: Med Biol Eng Comput. 2013 Jul;51(7):729-39
references.pmid: 23605057
references.citation: N Engl J Med. 2007 Mar 15;356(11):1140-51
references.pmid: 17360992
references.citation: Microcirculation. 2008 Nov;15(8):699-714
references.pmid: 18720227
references.citation: Magn Reson Med. 1993 Apr;29(4):485-97
references.pmid: 8464365
references.citation: Magn Reson Med. 2013 Mar 1;69(3):698-707
references.pmid: 22532435
references.citation: Med Biol Eng Comput. 2009 Feb;47(2):175-88
references.pmid: 19205773
references.citation: Circ Cardiovasc Interv. 2012 Aug 1;5(4):508-14
references.pmid: 22787017
references.citation: Circulation. 2002 Jul 23;106(4):441-6
references.pmid: 12135943
references.citation: Arterioscler Thromb Vasc Biol. 1997 Oct;17(10):2061-5
references.pmid: 9351372
references.citation: Am J Physiol Heart Circ Physiol. 2003 Jun;284(6):H1879-85
references.pmid: 12742819
references.citation: Am J Physiol. 1987 Feb;252(2 Pt 2):H417-33
references.pmid: 3812754
references.citation: Med Phys. 1998 Jan;25(1):73-84
references.pmid: 9472829
references.citation: J Biomech Eng. 1990 Aug;112(3):322-6
references.pmid: 2214715
references.citation: Science. 2002 Mar 1;295(5560):1678-82
references.pmid: 11872832
references.citation: Physiol Rev. 1990 Apr;70(2):331-90
references.pmid: 2181499
references.citation: N Engl J Med. 2007 Feb 22;356(8):830-40
references.pmid: 17314342
references.citation: Ann Biomed Eng. 2010 Oct;38(10):3195-209
references.pmid: 20559732
references.citation: J Am Coll Cardiol. 2009 Oct 6;54(15):1457-66
references.pmid: 19682818
references.citation: Br Med J. 1975 Jan 11;1(5949):76-9
references.pmid: 1109663
references.citation: Am J Physiol Heart Circ Physiol. 2007 May;292(5):H2349-55
references.pmid: 17220185
references.citation: N Engl J Med. 2009 Jan 15;360(3):213-24
references.pmid: 19144937
references.citation: Philos Trans A Math Phys Eng Sci. 2008 Sep 13;366(1878):3137-53
references.pmid: 18559321
references.citation: J Am Coll Cardiol. 2011 Jan 4;57(1):70-5
references.pmid: 21185504
references.citation: Circulation. 2005 Jan 4;111(1):76-82
references.pmid: 15611371
references.citation: Physiol Meas. 2004 Aug;25(4):863-77
references.pmid: 15382827
references.citation: JACC Cardiovasc Imaging. 2013 May;6(5):600-9
references.pmid: 23582358
references.citation: Magn Reson Med. 2011 Nov;66(5):1477-87
references.pmid: 21630344
references.citation: Basic Res Cardiol. 1988 Sep-Oct;83(5):510-24
references.pmid: 3233094
references.citation: Circ Res. 1981 Sep;49(3):584-93
references.pmid: 7261259
references.citation: Circulation. 2009 Dec 1;120(22):2207-13
references.pmid: 19917885
references.citation: J Mol Cell Cardiol. 2012 Apr;52(4):786-93
references.pmid: 21840314
references.citation: J Am Coll Cardiol. 2007 Aug 7;50(6):514-22
references.pmid: 17678734
references.citation: Am J Physiol Heart Circ Physiol. 2001 Aug;281(2):H623-8
references.pmid: 11454565
references.citation: Am J Physiol. 1993 Jul;265(1 Pt 2):H350-65
references.pmid: 8342652
references.citation: Physiol Rev. 2006 Oct;86(4):1263-308
references.pmid: 17015490
references.citation: Prog Biophys Mol Biol. 1998;69(2-3):463-81
references.pmid: 9785951
references.citation: J Biomech. 2012 Mar 15;45(5):850-5
references.pmid: 22154392
references.citation: Catheter Cardiovasc Interv. 2008 Feb 1;71(2):198-204
references.pmid: 18327838
references.citation: IEEE Trans Med Imaging. 2013 Jan;32(1):56-72
references.pmid: 23193311
references.citation: Curr Probl Cardiol. 2011 Sep;36(9):325-68
references.pmid: 21821188
references.citation: J Am Coll Cardiol. 2012 Apr 10;59(15):1392-402
references.pmid: 22154731
references.citation: Radiology. 2008 Nov;249(2):493-500
references.pmid: 18936311
references.citation: J Am Coll Cardiol. 1996 Nov 1;28(5):1154-60
references.pmid: 8890809
references.citation: Med Biol Eng Comput. 2009 Feb;47(2):111-8
references.pmid: 19198914
references.citation: J Biomech. 1991;24(7):527-38
references.pmid: 1880137
references.citation: J Am Coll Cardiol. 2007 May 29;49(21):2105-11
references.pmid: 17531660
references.citation: J Nucl Cardiol. 2013 Apr;20(2):289-96
references.pmid: 23479267
references.citation: J Cardiovasc Magn Reson. 2010 Oct 08;12:57
references.pmid: 20932314
references.citation: JACC Cardiovasc Interv. 2011 Oct;4(10):1093-5
references.pmid: 22017934
references.citation: Circulation. 2006 Sep 19;114(12):1321-41
references.pmid: 16940193
references.citation: Am J Physiol Heart Circ Physiol. 2006 Dec;291(6):H2630-5
references.pmid: 16920817
references.citation: Circ Res. 1978 Aug;43(2):242-53
references.pmid: 668056
references.citation: Circulation. 1993 Apr;87(4):1354-67
references.pmid: 8462157
references.citation: Eur Heart J Cardiovasc Imaging. 2012 Nov;13(11):954-60
references.pmid: 22634739
references.citation: J Hypertens. 2012 Mar;30(3):608-16
references.pmid: 22252479
references.citation: Eur Heart J. 2010 Oct;31(20):2501-55
references.pmid: 20802248
references.citation: N Engl J Med. 2002 Jun 20;346(25):1948-53
references.pmid: 12075055
references.citation: Am J Physiol Heart Circ Physiol. 2010 Mar;298(3):H861-73
references.pmid: 19966048
references.citation: N Engl J Med. 2012 Sep 13;367(11):991-1001
references.pmid: 22924638
references.citation: Nat Rev Mol Cell Biol. 2003 Mar;4(3):237-43
references.pmid: 12612642
references.citation: Med Biol Eng Comput. 1980 Nov;18(6):709-18
references.pmid: 7230917
references.citation: J Biomech. 2013 Jan 18;46(2):229-39
references.pmid: 23237670
references.citation: J Cardiovasc Magn Reson. 2011 May 24;13:28
references.pmid: 21609423
references.citation: Circ Res. 1977 Jul;41(1):99-107
references.pmid: 862148