A new CFD based non-invasive method for functional diagnosis of coronary stenosis

Xie, Xinzhou; Zheng, Ming‐Hua; Wen, Didi; Li, Yabing; Xie, Songyun

doi:10.1186/s12938-018-0468-6

Cited by 22 publications

(12 citation statements)

References 44 publications

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“…High‐dimensional models utilize the finite element approach to provide a comprehensive, multiscale, and multiphysics description of spatiotemporal hemodynamics as well as of the fluid–structure interactions between the vascular wall and the blood flow in the 2D or 3D domain. [ 5,6 ] However, their implementation necessitates knowledge of several geometrical, mechanical, and hemodynamic parameters, resulting in elevated computational complexity, which typically limits their application to specific vascular sites and makes them suboptimal in modeling the entire vascular tree. Conversely, low‐dimensional models use analytical methods to capture the global properties of the cardiovascular network and are remarkably less computationally intensive rendering them more suitable for hemodynamic simulations of larger portions of the cardiovascular system.…”

Section: Introductionmentioning

confidence: 99%

Object‐Oriented Lumped‐Parameter Modeling of the Cardiovascular System for Physiological and Pathophysiological Conditions

Rosalia

Ozturk

Story

et al. 2021

Advcd Theory and Sims

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In this work, a lumped‐parameter Windkessel model of the cardiovascular system that simulates biomechanical parameters of the human physiology is presented. The object‐oriented platform provided by the MATLAB‐based modeling environment SIMSCAPE is employed to compute blood pressures and flows in each heart chamber and at various sites of the vascular tree. The hydraulic domain allows the determination of cardiovascular hemodynamics intuitively from geometrical and mechanical properties of the system, while custom elements model the pumping action of the heart and the effects of respiration on blood flow. The model is validated by comparing predicted hemodynamics with normal physiology during both systole and diastole, demonstrating that changes in arterial pressures with breathing are consistent with reported physiological effects of cardiorespiratory coupling. The capabilities of this platform are explored through two exemplary case studies: i) pressure‐overload heart failure due to aortic constriction, validated in vitro and via finite element analysis, and ii) single‐ventricle Fontan physiology, validated in vitro and compared with the clinical literature. This platform provides a practical tool for the calculation of cardiovascular hemodynamics from hydraulic parameters, enabling the intuitive creation of in silico representations of complex circulatory loops, the planning and optimization of medical interventions, and the prediction of clinically relevant patient‐specific hemodynamics.

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Section: Introductionmentioning

confidence: 99%

Object‐Oriented Lumped‐Parameter Modeling of the Cardiovascular System for Physiological and Pathophysiological Conditions

Rosalia

Ozturk

Story

et al. 2021

Advcd Theory and Sims

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“…A lumped parameter model (LPM) with only one resistance was applied for each outlet, in order to confirm the outlet boundaries ( Figure 2 ). A total resistance was allocated to each outlet according to their inverse diameters; then, the pressure value of each outlet was obtained by the LPM model (Murray, 1926 ; Taylor et al, 2013 ; Xie et al, 2018 ). The resistance was initially set to 9.6 mmHg·s /cm 3 , and subsequently reduced to 1/2, 1/3, 1/4, 1/5, and 1/6: the steady flow was simulated six times under six different total resistances for each case.…”

Section: Methods and Methodsmentioning

confidence: 99%

Validation and Diagnostic Performance of a CFD-Based Non-invasive Method for the Diagnosis of Aortic Coarctation

Lin

Zhang

et al. 2020

Front. Neuroinform.

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Purpose: The clinical diagnosis of aorta coarctation (CoA) constitutes a challenge, which is usually tackled by applying the peak systolic pressure gradient (PSPG) method. Recent advances in computational fluid dynamics (CFD) have suggested that multi-detector computed tomography angiography (MDCTA)-based CFD can serve as a non-invasive PSPG measurement. The aim of this study was to validate a new CFD method that does not require any medical examination data other than MDCTA images for the diagnosis of CoA.Materials and methods: Our study included 65 pediatric patients (38 with CoA, and 27 without CoA). All patients underwent cardiac catheterization to confirm if they were suffering from CoA or any other congenital heart disease (CHD). A series of boundary conditions were specified and the simulated results were combined to obtain a stenosis pressure-flow curve. Subsequently, we built a prediction model and evaluated its predictive performance by considering the AUC of the ROC by 5-fold cross-validation.Results: The proposed MDCTA-based CFD method exhibited a good predictive performance in both the training and test sets (average AUC: 0.948 vs. 0.958; average accuracies: 0.881 vs. 0.877). It also had a higher predictive accuracy compared with the non-invasive criteria presented in the European Society of Cardiology (ESC) guidelines (average accuracies: 0.877 vs. 0.539).Conclusion: The new non-invasive CFD-based method presented in this work is a promising approach for the accurate diagnosis of CoA, and will likely benefit clinical decision-making.

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“…Such a mean value would be: R col = 411.6 ± 128.1 mmHg•s/ml. Xie et al [27] adopted a value of 240 mmHg•s/ml for the microvascular resistance distal to a single stenosis. This corresponds to the range of our data.…”

Section: Calculated Capillary and Collateral Resistancesmentioning

confidence: 99%

Impact of Revascularization on the Distal to Proximal Pressure Ratio in Case of Multiple Coronary Stenoses

Anselmi¹,

Verhoye²,

Drochon³

2021

JBiSE

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Objective: In order to take a decision about the revascularization approach to be adopted, it is of fundamental importance to determine whether coronary artery stenoses induce ischemia or not. An index, named (Fractional Flow Reserve), based on pressure measurements has been proposed to this aim and is usually interpreted in terms of flows. The objective of this work is to compute simultaneously pressures and flow rates in the coronary network of patients with three-vessel disease, in order to study more precisely the relationship between these two quantities. Approach: 22 patients have been included in the study. Some pressure and flow rate measurements were collected during by-pass surgery. These clinical data allow determining parameters for a patient's specific model, based on the electric/hydraulic analogy. Collateral pathways are included in the model, as well as the severity of the disease and the impact of revascularization. Main Results: For patients with stenoses on LAD, LCx, LMCA and occlusion of the RCA, the flow rate delivered to the right territory is of course a function of the aortic pressure, the left stenoses severity, and the pressure distal to the thrombosis. But it mainly depends on the capillary and collateral resistances, and on the proportion between them. Abnormal microvascular hemodynamics, may be present in patients with non-hemodynamic significant lesions as assessed by the pressure ratio. Complete revascularization with the 3 grafts is demonstrated to be fully justified. The direction of collateral flows may be reversed, depending on the pressure gradient. In any case, they remain low and become negligible when the 3 grafts are operating. Significance: Surgical decision based only on pressure measurements may miss some real hemodynamic problems due to the considered stenosis. This risk is even greater in case of serial stenoses.

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A new CFD based non-invasive method for functional diagnosis of coronary stenosis

Cited by 22 publications

References 44 publications

Object‐Oriented Lumped‐Parameter Modeling of the Cardiovascular System for Physiological and Pathophysiological Conditions

Object‐Oriented Lumped‐Parameter Modeling of the Cardiovascular System for Physiological and Pathophysiological Conditions

Validation and Diagnostic Performance of a CFD-Based Non-invasive Method for the Diagnosis of Aortic Coarctation

Impact of Revascularization on the Distal to Proximal Pressure Ratio in Case of Multiple Coronary Stenoses

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