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Modelling coronary flows: impact of differently measured inflow boundary conditions on vessel-specific computational
Maurizio Lodi Rizzini1, Alessandro Candreva2, Claudio Chiastra1
1Polito(BIO)Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Torino, Italy.
Insights
Different methods for measuring coronary blood flow rate significantly impact computational fluid dynamics (CFD) simulations. Standardizing these inflow boundary conditions is crucial for reliable coronary hemodynamics analysis.
Area of Science:
- Cardiovascular research
- Biomedical engineering
- Medical imaging
Background:
- Computational fluid dynamics (CFD) simulations of coronary hemodynamics are essential for understanding atherosclerotic disease.
- Assumptions in CFD, particularly inflow boundary conditions (BCs), introduce uncertainty.
- Personalized CFD requires accurate in vivo assessment of coronary artery blood flow rate.
Purpose of the Study:
- To investigate the impact of different in vivo coronary artery blood flow rate assessment techniques on personalized CFD simulations.
- To evaluate how variations in inflow BCs affect hemodynamic quantities like wall shear stress (WSS) and helical flow.
- To determine the robustness of hemodynamic results to different flow rate derivation methods.
Main Methods:
- CFD simulations were performed on coronary angiograms using personalized inflow BCs.
- Four techniques for in vivo flow rate assessment were employed: continuous thermodilution, intravascular Doppler, 3D contrast velocity, and diameter-based scaling law.
- The impact on WSS and helical flow quantities was analyzed.
Main Results:
- Coronary flow rate values varied significantly depending on the technique used (e.g., continuous thermodilution yielded higher values).
- These flow rate differences led to altered surface-averaged WSS magnitude and helical blood flow intensity.
- However, luminal surface areas with low WSS and specific helical flow features remained consistent across techniques.
Conclusions:
- No single coronary blood flow rate derivation technique is currently a clinical gold standard.
- Inflow BCs demonstrably influence computational hemodynamic outcomes in personalized CFD.
- Standardization of flow rate assessment is recommended for reproducible coronary hemodynamics simulations.
Background And Objectives:
The translation of hemodynamic quantities based on wall shear stress (WSS) or intravascular helical flow into clinical biomarkers of coronary atherosclerotic disease is still hampered by the assumptions/idealizations required by the computational fluid dynamics (CFD) simulations of the coronary hemodynamics. In the resulting budget of uncertainty, inflow boundary conditions (BCs) play a primary role. Accordingly, in this study we investigated the impact of the approach adopted for in vivo coronary artery blood flow rate assessment on personalized CFD simulations where blood flow rate is used as inflow BC.
Methods:
CFD simulations were carried out on coronary angiograms by applying personalized inflow BCs derived from four different techniques assessing in vivo surrogates of flow rate: continuous thermodilution, intravascular Doppler, frame count-based 3D contrast velocity, and diameter-based scaling law. The impact of inflow BCs on coronary hemodynamics was evaluated in terms of WSS- and helicity-based quantities.
Results:
As main findings, we report that: (i) coronary flow rate values may differ based on the applied flow derivation technique, as continuous thermodilution provided higher flow rate values than intravascular Doppler and diameter-based scaling law (p = 0.0014 and p = 0.0023, respectively); (ii) such intrasubject differences in flow rate values lead to different surface-averaged values of WSS magnitude and helical blood flow intensity (p<0.0020); (iii) luminal surface areas exposed to low WSS and helical flow topological features showed robustness to the flow rate values.
Conclusions:
Although the absence of a clinically applicable gold standard approach prevents a general recommendation for one coronary blood flow rate derivation technique, our findings indicate that the inflow BC may impact computational hemodynamic results, suggesting that a standardization would be desirable to provide comparable results among personalized CFD simulations of the coronary hemodynamics.
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