Abstract
Genesis of atherosclerotic lesions in the human arterial system is critically influenced by the fluid mechanics. Applying computational fluid dynamic tools based on accurate coronary physiology derived from conventional biplane angiogram data may be useful in guiding percutaneous coronary interventions. The primary objective of this study is to build and validate a computational framework for accurate personalized 3-dimensional hemodynamic simulation across the complete coronary arterial tree and demonstrate the influence of side branches on coronary hemodynamics by comparing shear stress between coronary models with and without these included. The proposed novel computational framework based on biplane angiography enables significant arterial circulation analysis. This study shows that models that take into account flow through all side branches are required for precise computation of shear stress and pressure gradient whereas models that have only a subset of side branches are inadequate for biomechanical studies as they may overestimate volumetric outflow and shear stress. This study extends the ongoing computational efforts and demonstrates that models based on accurate coronary physiology can improve overall fidelity of biomechanical studies to compute hemodynamic risk-factors.
Highlights
Coronary artery disease is associated with a high rate of morbidity and mortality and is recognized as the leading cause of death worldwide
In order to determine if the 3D coronary artery geometries derived from coronary angiograms are accurate, we utilized imaging datasets from 20 patients who underwent coronary CT angiography (CTA) and coronary angiography testing within one month and were found to have a stenosis in at least one vessel to reconstruct a total of 15 left coronary arteries and 12 right coronary arteries from both imaging modalities
The topological accuracy of the coronary angiogram reconstructions was evaluated by aligning them with the geometries derived from the coronary CTAs, which are considered the gold-standard for 3D reconstructions for computational fluid dynamic (CFD) of the coronary arteries and computing the Hausdorff distance (HD) between these reconstructions
Summary
Coronary artery disease is associated with a high rate of morbidity and mortality and is recognized as the leading cause of death worldwide. Owing to the limited number of patients that undergo CTA and the fact that >1 million coronary angiography procedures are performed annually in the United States, and the high spatial (150–200 mm) and temporal (10 ms) resolution of angiography, 3D anatomic models based on coronary angiograms are favored[12,13,14,15,16,17]. These types of state-of-the-art CFD models enable www.nature.com/scientificreports/.
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