Abstract

BackgroundHemodynamic simulation for quantifying fractional flow reserve (FFR) is often performed in a patient-specific geometry of coronary arteries reconstructed from the images from various imaging modalities. Because optical coherence tomography (OCT) images can provide more precise vascular lumen geometry, regardless of stenotic severity, hemodynamic simulation based on OCT images may be effective. The aim of this study is to perform OCT–FFR simulations by coupling a 3D CFD model from geometrically correct OCT images with a LPM based on vessel lengths extracted from CAG data with clinical validations for the present method.MethodsTo simulate coronary hemodynamics, we developed a fast and accurate method that combined a computational fluid dynamics (CFD) model of an OCT-based region of interest (ROI) with a lumped parameter model (LPM) of the coronary microvasculature and veins. Here, the LPM was based on vessel lengths extracted from coronary X-ray angiography (CAG) images. Based on a vessel length-based approach, we describe a theoretical formulation for the total resistance of the LPM from a three-dimensional (3D) CFD model of the ROI.ResultsTo show the utility of this method, we present calculated examples of FFR from OCT images. To validate the OCT-based FFR calculation (OCT–FFR) clinically, we compared the computed OCT–FFR values for 17 vessels of 13 patients with clinically measured FFR (M-FFR) values.ConclusionA novel formulation for the total resistance of LPM is introduced to accurately simulate a 3D CFD model of the ROI. The simulated FFR values compared well with clinically measured ones, showing the accuracy of the method. Moreover, the present method is fast in terms of computational time, enabling clinicians to provide solutions handled within the hospital.

Highlights

  • Hemodynamic simulation for quantifying fractional flow reserve (FFR) is often performed in a patient-specific geometry of coronary arteries reconstructed from the images from various imaging modalities

  • The purpose of this study is to present an efficient and accurate method for performance of optical coherence tomog‐ raphy (OCT)–FFR simulations by coupling a three dimensional (3D) computational fluid dynamics (CFD) model from geometrically correct OCT images with a lumped parameter model (LPM) based on vessel lengths extracted from coronary X-ray angiography (CAG) data

  • In this paper, we present an efficient and accurate method to perform OCT-based FFR calculation (OCT–FFR) simulations by coupling a 3D CFD model from geometrically correct OCT images with a LPM based on vessel lengths extracted from CAG data

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Summary

Introduction

Hemodynamic simulation for quantifying fractional flow reserve (FFR) is often performed in a patient-specific geometry of coronary arteries reconstructed from the images from various imaging modalities. The aim of this study is to perform OCT–FFR simulations by coupling a 3D CFD model from geometrically correct OCT images with a LPM based on vessel lengths extracted from CAG data with clinical validations for the present method. It is important to estimate the resistance values in the LPM For this purpose, they measured the muscle mass quantity, fed by a specific coronary artery, from which the resting blood flow in the artery was estimated, based on a scaling law [3,4,5]. The resistance value of the artery can be computed from the resting flow For this reason, the 3D muscle mass of the left ventricle must be determined to use this method, limiting its application to CT imaging

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