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Published on: April 13, 2015
Estimation of coronary artery hyperemic blood flow based on arterial lumen volume using angiographic images
Sabee Molloi1, David Chalyan, Huy Le
1Department of Radiological Sciences, University of California, Medical Sciences B, B-140, Irvine, CA 92697, USA. symolloi@uci.edu
Insights
This study developed a method to estimate coronary artery hyperemic blood flow using lumen volume in swine. This technique could help assess coronary artery disease severity from angiographic data.
Area of Science:
- Cardiovascular Research
- Medical Imaging
- Biomedical Engineering
Background:
- Visual assessment of coronary artery disease (CAD) has limitations, especially for intermediate lesions.
- Accurate assessment of ischemia caused by coronary lesions is crucial for patient management.
- A functional measure of stenosis severity using angiographic data is needed.
Purpose of the Study:
- To develop a method for estimating hyperemic blood flow in coronary arteries.
- To utilize distal lumen volumes and arterial dimensions for flow estimation.
- To validate the method in a swine animal model.
Main Methods:
- Coronary arteriography was performed in 10 swine following contrast injection.
- A densitometry technique quantified regional flow and lumen volume in vivo during hyperemia.
- Post-mortem cone-beam CT was used on 3 swine hearts to determine lumen volume and arterial length.
Main Results:
- A strong correlation was found between stem hyperemic flow (Q) and crown lumen volume (V): Q = 159.08 V(3/4) (r=0.98).
- Stem hyperemic flow (Q) was also strongly correlated with crown length (L): Q = 2.89 L (r=0.99).
- These relationships were derived using in vivo densitometry and post-mortem CT data.
Conclusions:
- Arterial branch lengths and lumen volumes can predict expected hyperemic flow.
- This predictive capability, combined with measured flow, may enable fractional flow reserve calculation from angiographic data alone.
- The developed method offers a potential non-invasive approach for functional stenosis assessment.
Abstract:
The purpose of this study is to develop a method to estimate the hyperemic blood flow in a coronary artery using the sum of the distal lumen volumes in a swine animal model. The limitations of visually assessing coronary artery disease are well known. These limitations are particularly important in intermediate coronary lesions where it is difficult to determine whether a particular lesion is the cause of ischemia. Therefore, a functional measure of stenosis severity is needed using angiographic image data. Coronary arteriography was performed in 10 swine (Yorkshire, 25-35 kg) after power injection of contrast material into the left main coronary artery. A densitometry technique was used to quantify regional flow and lumen volume in vivo after inducing hyperemia. Additionally, 3 swine hearts were casted and imaged post-mortem using cone-beam CT to obtain the lumen volume and the arterial length of corresponding coronary arteries. Using densitometry, the results showed that the stem hyperemic flow (Q) and the associated crown lumen volume (V) were related by Q = 159.08 V(3/4) (r = 0.98, SEE = 10.59 ml/min). The stem hyperemic flow and the associated crown length (L) using cone-beam CT were related by Q = 2.89 L (r = 0.99, SEE = 8.72 ml/min). These results indicate that measured arterial branch lengths or lumen volumes can potentially be used to predict the expected hyperemic flow in an arterial tree. This, in conjunction with measured hyperemic flow in the presence of a stenosis, could be used to predict fractional flow reserve based entirely on angiographic data.
