Perspective on CFD studies of coronary artery disease lesions and hemodynamics: a review.
Coronary artery disease (CAD) is the most common cardiovascular disease. Early diagnosis of CAD's physiological significance is of utmost importance for guiding individualized risk-tailored treatment strategies. In this paper, we first review the state-of-the-art clinical diagnostic indices to quantify the severity of CAD and the associated invasive and noninvasive imaging technologies in order to quantify the anatomical parameters of diameter stenosis, area stenosis, and hemodynamic indices of coronary flow reserve and fractional flow reserve. With the development of computational technologies and CFD methods, tremendous progress has been made in applying image-based CFD simulation techniques to elucidate the effects of hemodynamics in vascular pathophysiology toward the initialization and progression of CAD. So then, we review the advancements of CFD technologies in patient-specific modeling, involving the development of geometry reconstruction, boundary conditions, and fluid-structure interaction. Next, we review the applications of CFD to stenotic sites, in order to compute their hemodynamic parameters and study the relationship between the hemodynamic conditions and the clinical indices, to thereby assess the amount of viable myocardium and candidacy for percutaneous coronary intervention. Finally, we review the strengths and limitations of current researches of applying CFD to CAD studies.
National Heart Center Singapore, Mistri Wing 17, 3rd Hospital Avenue, 168752, Singapore.
Jun-Mei
JM
Zhang
Liang
L
Zhong
Boyang
B
Su
Min
M
Wan
Jinq Shya
JS
Yap
Jasmine P L
JP
Tham
Leok Poh
LP
Chua
Dhanjoo N
DN
Ghista
Ru San
RS
Tan
D000818:Animals; D001783:Blood Flow Velocity; D001794:Blood Pressure; D003198:Computer Simulation; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000503:physiopathology*; D003331:Coronary Vessels / Q000503:physiopathology*; D006801:Humans; D008955:Models, Cardiovascular
CFD; area stenosis (AS); clinical imaging techniques; coronary artery disease (CAD); coronary flow reserve (CFR); diameter stenosis (DS); fractional flow reserve (FFR); hemodynamic parameters (HPs); myocardial ischemia and infarct; percutaneous coronary intervention (PCI)