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Lumped-parameter model as a non-invasive tool to assess coronary blood flow in AAOCA patients
Valentina Ceserani1, Mauro Lo Rito2, Mauro Luca Agnifili3
1Department of Civil Engineering and Architecture, University of Pavia, 20100, Pavia, Italy.
Insights
Anomalous aortic origin of the coronary artery (AAOCA) poses sudden cardiac death risks. A new patient-specific model accurately quantifies coronary blood flow (CBF) in AAOCA, aiding risk assessment.
Area of Science:
- Cardiovascular Medicine
- Biomedical Engineering
- Medical Imaging
Background:
- Anomalous aortic origin of the coronary artery (AAOCA) is a rare condition linked to sudden cardiac death, particularly in young individuals during physical exertion.
- Current clinical tests are insufficient for assessing ischemic risk in AAOCA patients.
- Previous computational simulations for coronary blood flow (CBF) in AAOCA relied on generalized data, limiting their clinical applicability.
Purpose of the Study:
- To develop a patient-specific computational model for accurately assessing coronary blood flow (CBF) in individuals with anomalous aortic origin of the coronary artery (AAOCA).
- To overcome the limitations of using literature-derived data by incorporating patient-specific imaging and in-vivo hemodynamic data.
- To establish a reliable method for quantifying CBF in AAOCA for improved clinical risk stratification.
Main Methods:
- Development of a fully patient-specific lumped parameter model.
- Integration of clinical imaging data (e.g., CT, MRI) specific to AAOCA patients.
- Utilization of in-vivo data from invasive coronary functional assessment to calibrate and validate the model under different hemodynamic conditions.
Main Results:
- The developed lumped parameter model accurately mimics the effective coronary behavior in AAOCA patients.
- The model successfully estimates coronary blood flow (CBF) by replicating in-vivo hemodynamic conditions.
- High accuracy in quantifying CBF was achieved, demonstrating the model's potential utility.
Conclusions:
- The patient-specific lumped parameter model offers a valuable tool for quantifying coronary blood flow (CBF) in anomalous aortic origin of the coronary artery (AAOCA).
- This approach represents a significant step towards clinical application for improved patient care and risk management in AAOCA.
- Further validation and integration into clinical workflows are warranted to fully realize the potential of this diagnostic approach.
Abstract:
Anomalous aortic origin of the coronary artery (AAOCA) is a rare disease associated with sudden cardiac death, usually related to physical effort in young people. Clinical routine tests fail to assess the ischemic risk, calling for novel diagnostic approaches. To this aim, some recent studies propose to assess the coronary blood flow (CBF) in AAOCA by computational simulations but they are limited by the use of data from literature retrieved from normal subjects. To overcome this limitation and obtain a reliable assessment of CBF, we developed a fully patient-specific lumped parameter model based on clinical imaging and in-vivo data retrieved during invasive coronary functional assessment of subjects with AAOCA. In such a way, we can estimate the CBF replicating the two hemodynamic conditions in-vivo analyzed. The model can mimic the effective coronary behavior with high accuracy and could be a valuable tool to quantify CBF in AAOCA. It represents the first step required to move toward a future clinical application with the aim of improving patient care. The study was registered at Clinicaltrial.gov with (ID: NCT05159791, date 2021-12-16).
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