title: Numerical simulation and clinical implications of stenosis in coronary blood flow.
abstract: Fractional flow reserve (FFR) is the gold standard to guide coronary interventions. However it can only be obtained via invasive angiography. The objective of this study is to propose a noninvasive method to determine FFRCT by combining computed tomography angiographic (CTA) images and computational fluid dynamics (CFD) technique. Utilizing the method, this study explored the effects of diameter stenosis (DS), stenosis length, and location on FFRCT. The baseline left anterior descending (LAD) model was reconstructed from CTA of a healthy porcine heart. A series of models were created by adding an idealized stenosis (with DS from 45% to 75%, stenosis length from 4 mm to 16 mm, and at 4 locations separately). Through numerical simulations, it was found that FFRCT decreased (from 0.89 to 0.74), when DS increased (from 45% to 75%). Similarly, FFRCT decreased with the increase of stenosis length and the stenosis located at proximal position had lower FFRCT than that at distal position. These findings are consistent with clinical observations. Applying the same method on two patients' CTA images yielded FFRCT close to the FFR values obtained via invasive angiography. The proposed noninvasive computation of FFRCT is promising for clinical diagnosis of CAD.
authors.affiliation: National Heart Center Singapore, 5 Hospital Drive, Singapore 169609.
authors.forename: Jun-Mei
authors.identifier: 0000-0002-2257-1803
authors.initials: JM
authors.lastname: Zhang
authors.affiliation: National Heart Center Singapore, 5 Hospital Drive, Singapore 169609 ; Duke-NUS Graduate Medical School Singapore, 8 College Road, Singapore 169857.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhong
authors.affiliation: Department of Biomedical Engineering, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA.
authors.forename: Tong
authors.initials: T
authors.lastname: Luo
authors.affiliation: Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing 100871, China.
authors.forename: Yunlong
authors.initials: Y
authors.lastname: Huo
authors.affiliation: National Heart Center Singapore, 5 Hospital Drive, Singapore 169609 ; Duke-NUS Graduate Medical School Singapore, 8 College Road, Singapore 169857.
authors.forename: Swee Yaw
authors.initials: SY
authors.lastname: Tan
authors.affiliation: National Heart Center Singapore, 5 Hospital Drive, Singapore 169609 ; Duke-NUS Graduate Medical School Singapore, 8 College Road, Singapore 169857.
authors.forename: Aaron Sung Lung
authors.initials: AS
authors.lastname: Wong
authors.affiliation: National Heart Center Singapore, 5 Hospital Drive, Singapore 169609.
authors.forename: Boyang
authors.initials: B
authors.lastname: Su
authors.affiliation: National Heart Center Singapore, 5 Hospital Drive, Singapore 169609.
authors.forename: Min
authors.identifier: 0000-0003-4773-256X
authors.initials: M
authors.lastname: Wan
authors.affiliation: National Heart Center Singapore, 5 Hospital Drive, Singapore 169609.
authors.forename: Xiaodan
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Biomedical Engineering, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA.
authors.forename: Ghassan S
authors.initials: GS
authors.lastname: Kassab
authors.affiliation: Department of Mechanical Engineering, National University of Singapore, 1 Engineering Drive 2, Singapore 117576.
authors.forename: Heow Pueh
authors.identifier: 0000-0002-4380-3888
authors.initials: HP
authors.lastname: Lee
authors.affiliation: Department of Mechanical Engineering, National University of Singapore, 1 Engineering Drive 2, Singapore 117576.
authors.forename: Boo Cheong
authors.initials: BC
authors.lastname: Khoo
authors.affiliation: Fluid Dynamics Department, Institute of High Performance Computing, 1 Fusionopolis Way, No. 16-16 Connexis North, Singapore 138632.
authors.forename: Chang-Wei
authors.initials: CW
authors.lastname: Kang
authors.affiliation: Fluid Dynamics Department, Institute of High Performance Computing, 1 Fusionopolis Way, No. 16-16 Connexis North, Singapore 138632.
authors.forename: Te
authors.identifier: 0000-0003-4732-2990
authors.initials: T
authors.lastname: Ba
authors.affiliation: National Heart Center Singapore, 5 Hospital Drive, Singapore 169609 ; Duke-NUS Graduate Medical School Singapore, 8 College Road, Singapore 169857.
authors.forename: Ru San
authors.initials: RS
authors.lastname: Tan
mesh_terms: D000818:Animals; D001783:Blood Flow Velocity; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000473:pathology / Q000503:physiopathology*; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008955:Models, Cardiovascular; D009206:Myocardium; D013552:Swine