title: Effect of porous media of the stenosed artery wall to the coronary physiological diagnostic parameter: a computational fluid dynamic analysis.
abstract: Functional assessment of a coronary artery stenosis severity is generally assessed by fractional flow reserve (FFR), which is calculated from pressure measurements across the stenosis. The purpose of this study is to investigate the effect of porous media of the stenosed arterial wall on this diagnostic parameter. To understand the role of porous media on the diagnostic parameter FFR, a 3D computational simulations of the blood flow in rigid and porous stenotic artery wall models are carried out under steady state and transient conditions for three different percentage area stenoses (AS) corresponding to 70% (moderate), 80% (intermediate), and 90% (severe). Blood was modeled as a non Newtonian fluid. The variations of pressure drop across the stenosis and diagnostic parameter were studied in both models. The FFR decreased in proportion to the increase in the severity of the stenosis. The relationship between the percentage AS and the FFR was non linear and inversely related in both the models. The cut-off value of 0.75 for FFR was observed at 81.89% AS for the rigid artery model whereas 83.61% AS for the porous artery wall model. This study demonstrates that the porous media consideration on the stenotic arterial wall plays a substantial role in defining the cut-off value of FFR. We conclude that the effect of porous media on FFR, could lead to misinterpretation of the functional severity of the stenosis in the region of 81.89 %-83.61% AS.
authors.affiliation: Department of Mechanical Engineering, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: grajukm@gmail.com.
authors.forename: Kalimuthu
authors.initials: K
authors.lastname: Govindaraju
authors.affiliation: Department of Mechanical Engineering, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Sarfaraz
authors.initials: S
authors.lastname: Kamangar
authors.affiliation: Department of Mechanical Engineering, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Irfan Anjum
authors.initials: IA
authors.lastname: Badruddin
authors.affiliation: Interventional Cardiology, Royal Bournemouth Hospital, Bournemouth, United Kingdom.
authors.forename: Girish N
authors.initials: GN
authors.lastname: Viswanathan
authors.affiliation: Department of Mechanical Engineering, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: A
authors.initials: A
authors.lastname: Badarudin
authors.affiliation: Department of Mechanical Engineering, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: N J
authors.initials: NJ
authors.lastname: Salman Ahmed
mesh_terms: D003198:Computer Simulation; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000175:diagnosis / Q000473:pathology*; D003331:Coronary Vessels / Q000503:physiopathology / Q000648:ultrastructure*; D018056:Hemorheology; D006801:Humans; D057446:Hydrodynamics; D008955:Models, Cardiovascular; D010539:Permeability; D016062:Porosity; D011312:Pressure; D059289:Vascular Stiffness
keywords: Blood flow; Computational fluid dynamics; Coronary disease; FFR; Porosity and permeability; Stenosis