Branch flow distribution approach and its application in the calculation of fractional flow reserve in stenotic coronary artery

Honghui Zhang; Jun Xia; Yinlong Yang; Qingqing Yang; Hongfang Song; Jinjie Xie; Yue Ma; Yang Hou; Aike Qiao; Honghui Zhang; Jun Xia; Yinlong Yang; Qingqing Yang; Hongfang Song; Jinjie Xie; Yue Ma; Yang Hou; Aike Qiao

doi:10.3934/mbe.2021299

Mathematical Biosciences and Engineering

2021, Volume 18, Issue 5: 5978-5994. doi: 10.3934/mbe.2021299

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Branch flow distribution approach and its application in the calculation of fractional flow reserve in stenotic coronary artery

1.
Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
2.
Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Beijing 100124, China
3.
School of Biomedical Engineering, Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing 100069, China
4.
Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
5.
Shengjing Hospital, China Medical University, Shenyang 110001, China

Received: 15 April 2021 Accepted: 23 June 2021 Published: 02 July 2021

Objective
To calculate fractional flow reserve (FFR) based on computed tomography angiography (i.e., FFR_CT) by considering the branch flow distribution in the coronary arteries.

Background
FFR is the gold standard to diagnose myocardial ischemia caused by coronary stenosis. An accurate and noninvasive method for obtaining total coronary blood flow is needed for the calculation of FFR_CT.

Methods
A mathematical model for estimating the coronary blood flow rate and two approaches for setting the patient-specific flow boundary condition were proposed. Coronary branch flow distribution methods based on a volume-flow approach and a diameter-flow approach were employed for the numerical simulation of FFR_CT. The values of simulated FFR_CT for 16 patients were compared with their clinically measured FFR.

Results
The ratio of total coronary blood flow to cardiac output and the myocardial blood flow under the condition of hyperemia were 16.97% and 4.07 mL/min/g, respectively. The errors of FFR_CT compared with clinical data under the volume-flow approach and diameter-flow approach were 10.47% and 11.76%, respectively, the diagnostic accuracies of FFR_CT were 65% and 85%, and the consistencies were 95% and 90%.

Conclusions
The mathematical model for estimating the coronary blood flow rate and the coronary branch flow distribution method can be applied to calculate the value of clinical noninvasive FFR_CT.
- coronary artery disease,
- hemodynamics,
- endovascular intervention,
- catheterization,
- diagnosis
Citation: Honghui Zhang, Jun Xia, Yinlong Yang, Qingqing Yang, Hongfang Song, Jinjie Xie, Yue Ma, Yang Hou, Aike Qiao. Branch flow distribution approach and its application in the calculation of fractional flow reserve in stenotic coronary artery[J]. Mathematical Biosciences and Engineering, 2021, 18(5): 5978-5994. doi: 10.3934/mbe.2021299

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Abstract

Objective

To calculate fractional flow reserve (FFR) based on computed tomography angiography (i.e., FFR_CT) by considering the branch flow distribution in the coronary arteries.

Background

FFR is the gold standard to diagnose myocardial ischemia caused by coronary stenosis. An accurate and noninvasive method for obtaining total coronary blood flow is needed for the calculation of FFR_CT.

Methods

A mathematical model for estimating the coronary blood flow rate and two approaches for setting the patient-specific flow boundary condition were proposed. Coronary branch flow distribution methods based on a volume-flow approach and a diameter-flow approach were employed for the numerical simulation of FFR_CT. The values of simulated FFR_CT for 16 patients were compared with their clinically measured FFR.

Results

The ratio of total coronary blood flow to cardiac output and the myocardial blood flow under the condition of hyperemia were 16.97% and 4.07 mL/min/g, respectively. The errors of FFR_CT compared with clinical data under the volume-flow approach and diameter-flow approach were 10.47% and 11.76%, respectively, the diagnostic accuracies of FFR_CT were 65% and 85%, and the consistencies were 95% and 90%.

Conclusions

The mathematical model for estimating the coronary blood flow rate and the coronary branch flow distribution method can be applied to calculate the value of clinical noninvasive FFR_CT.

References

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