Miao Chu1, Clemens von Birgelen2, Yingguang Li3, Jelmer Westra4, Junqing Yang5, Niels R Holm4, Johan H C Reiber3, William Wijns6, Shengxian Tu7. 1. Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China; Shanghai Med-X Engineering Research Center, Shanghai Jiao Tong University, Shanghai, China. 2. Department of Cardiology, Thoraxcentrum Twente, MST, Enschede, The Netherlands. 3. Division of Image Processing, Leiden University Medical Center, The Netherlands. 4. Department of Cardiology, Aarhus University Hospital, Skejby, Denmark. 5. Department of Cardiology, Guangdong General Hospital, Guangzhou, China. 6. The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway, and Saolta University Healthcare Group, Galway, Ireland. 7. Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China; Shanghai Med-X Engineering Research Center, Shanghai Jiao Tong University, Shanghai, China. Electronic address: sxtu@sjtu.edu.cn.
Abstract
BACKGROUND AND AIMS: The relation between FFR and local coronary flow patterns is incompletely understood. We aimed at developing a novel hemodynamic index to quantify disturbed coronary flow, and to investigate its relationship with lesion-associated pressure-drop, and fractional flow reserve (FFR). METHODS: Three-dimensional angiographic reconstruction and computational fluid dynamics were applied to simulate pulsatile coronary flow. Disturbed vorticity index (DVI) was derived to quantify the stenosis-induced flow disturbance. The relation between DVI and pressure-drop was assessed in 9 virtual obstruction models. Furthermore, we evaluated the correlation between DVI, FFR, hyperemic flow velocity, and anatomic parameters in 84 intermediate lesions from 73 patients. RESULTS: In virtual models, DVI increased with increasing flow rate, stenosis severity, and lesion complexity. The correlation between DVI and pressure-drop across all models was excellent (determination coefficient R2 = 0.85, p < 0.001). In vivo, DVI showed a correlation with FFR (rho (ρ) = -0.74, p < 0.001) that was stronger than the relations of FFR with hyperemic flow velocity (ρ = -0.27, p=0.015), lesion length (ρ = -0.36, p=0.001) and percent diameter stenosis (ρ = -0.40, p < 0.001). CONCLUSIONS: DVI, a novel index to quantify disturbed flow, was related to pressure-drop in virtual obstruction models and showed a strong inverse relation with FFR in intermediate lesions in vivo. It supports the prognostic value of FFR and may provide additional information about sources of energy loss when measuring FFR.
BACKGROUND AND AIMS: The relation between FFR and local coronary flow patterns is incompletely understood. We aimed at developing a novel hemodynamic index to quantify disturbed coronary flow, and to investigate its relationship with lesion-associated pressure-drop, and fractional flow reserve (FFR). METHODS: Three-dimensional angiographic reconstruction and computational fluid dynamics were applied to simulate pulsatile coronary flow. Disturbed vorticity index (DVI) was derived to quantify the stenosis-induced flow disturbance. The relation between DVI and pressure-drop was assessed in 9 virtual obstruction models. Furthermore, we evaluated the correlation between DVI, FFR, hyperemic flow velocity, and anatomic parameters in 84 intermediate lesions from 73 patients. RESULTS: In virtual models, DVI increased with increasing flow rate, stenosis severity, and lesion complexity. The correlation between DVI and pressure-drop across all models was excellent (determination coefficient R2 = 0.85, p < 0.001). In vivo, DVI showed a correlation with FFR (rho (ρ) = -0.74, p < 0.001) that was stronger than the relations of FFR with hyperemic flow velocity (ρ = -0.27, p=0.015), lesion length (ρ = -0.36, p=0.001) and percent diameter stenosis (ρ = -0.40, p < 0.001). CONCLUSIONS:DVI, a novel index to quantify disturbed flow, was related to pressure-drop in virtual obstruction models and showed a strong inverse relation with FFR in intermediate lesions in vivo. It supports the prognostic value of FFR and may provide additional information about sources of energy loss when measuring FFR.
Authors: Xinlei Wu; Clemens von Birgelen; Su Zhang; Daixin Ding; Jiayue Huang; Shengxian Tu Journal: Int J Cardiovasc Imaging Date: 2019-05-03 Impact factor: 2.357
Authors: Gábor Tamás Szabó; Áron Üveges; Balázs Tar; András Ágoston; Azzaya Dorj; Csaba Jenei; Rudolf Kolozsvári; Benjamin Csippa; Dániel Czuriga; Zsolt Kőszegi Journal: J Clin Med Date: 2021-04-28 Impact factor: 4.241