Abstract
Coronary artery stenosis is a condition that restricts blood flow to the myocardium, potentially leading to ischemia and acute coronary events. To decide whether an intervention is needed, different criteria can be used, e.g. calculation of fractional flow reserve (FFR). FFR can also be computed based on computer simulations of blood flow (virtual FFR, vFFR). Here we propose an alternative, more direct, metric for assessing the hemodynamic value of stenosis from computational models, the computed volumetric flow drop (VFD). VFD and vFFR are computed for several stenosis locations using a 1D model of the left coronary tree, and also an analytical model is presented to show why FFR value may differ from the true flow reduction. The results show that FFR = 0.8, which is often used as a criterion for stenting, may correspond to a reduction in volumetric flow from less than 10% to almost 30% depending on the stenosis location. The implications are that FFR-based assessment may overestimate the hemodynamic value of stenosis, and it’s preferable to use a more direct metric for simulation-based estimation of stenosis value.
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Acknowledgements
This research was supported by The Russian Science Foundation, Agreement # 20–71-10108 (29.07.2020). Participation in the ICCS conference was supported by the NWO Science Diplomacy Fund project # 483.20.038 "Russian-Dutch Collaboration in Computational Science".
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Svitenkov, A.I., Zun, P.S., Shramko, O.A. (2021). Stenosis Assessment via Volumetric Flow Rate Calculation. In: Paszynski, M., Kranzlmüller, D., Krzhizhanovskaya, V.V., Dongarra, J.J., Sloot, P.M. (eds) Computational Science – ICCS 2021. ICCS 2021. Lecture Notes in Computer Science(), vol 12744. Springer, Cham. https://doi.org/10.1007/978-3-030-77967-2_59
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DOI: https://doi.org/10.1007/978-3-030-77967-2_59
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