The effect of hemodynamic parameters in patient-based coronary artery models with serial stenoses: normal and...

Area of Science:

• Cardiovascular imaging and hemodynamics
• Computational fluid dynamics in medicine
• Medical image analysis and simulation

Background:

• Assessing the hemodynamic significance of coronary artery stenosis (AS) and multiple sequential stenoses (MSS) is challenging, especially in hypertension.
• Physiological assessment of MSS in single-branch coronary arteries requires advanced methods due to inter-stenosis influences.
• Current invasive interventions face limitations in accurately evaluating complex coronary artery disease.

Purpose of the Study:

• To investigate the hemodynamic significance of varying degrees of coronary area of stenosis (AS) and multiple sequential stenoses (MSS).
• To evaluate these hemodynamic effects under both normal and hypertension pressure conditions.
• To develop and validate an open-source computational approach for assessing coronary stenosis severity.

Main Methods:

• Utilized open-source tools for coronary computed tomography angiography (CCTA) image segmentation.
• Performed 3D reconstruction and grid generation for computational modeling.
• Conducted hemodynamic simulations to analyze flow dynamics and pressure gradients.

Main Results:

• Quantified hemodynamic parameters including velocity magnitude and mean arterial pressure difference.
• Established the flow-pressure linear relationship in stenosed coronary arteries.
• Calculated wall shear stress (WSS) and virtual fractional flow reserve (vFFR) for severity assessment.

Conclusions:

• The developed open-source methodology enables accurate prediction and assessment of lumen area severity in MSS coronaries.
• Hemodynamic parameters derived from simulations provide critical insights into the physiological impact of coronary stenosis.
• This approach offers a non-invasive tool for evaluating complex coronary artery disease, aiding clinical decision-making.