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Reliability of characterising coronary artery flow with the flow-split outflow strategy: Comparison against the

Mingzi Zhang1, Hamed Keramati1, Ramtin Gharleghi1

  • 1Sydney Vascular Modelling Group, School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW 2052, Australia.

Computer Methods and Programs in Biomedicine
|February 16, 2025
PubMed

Insights

Simplified flow-split models accurately predict coronary haemodynamics at rest but overestimate wall shear stress and underestimate fractional flow reserve during hyperaemia, especially in severe stenoses. Multiscale simulations are recommended for hyperaemic conditions.

Area of Science:

  • Computational fluid dynamics
  • Cardiovascular science
  • Medical imaging

Background:

  • Patient-specific computational modeling of coronary haemodynamics is crucial but often impractical due to resource constraints.
  • This limitation hinders extensive simulations, particularly for complex diseased arterial conditions.

Purpose of the Study:

  • To compare coronary haemodynamics using a simplified flow-split strategy against computationally intensive multiscale simulations.
  • The study evaluated these methods under resting and hyperaemic conditions in coronary arteries with varying stenosis severity.

Main Methods:

  • Six patient-specific left coronary artery trees with mild (<50%) and severe (>70%) stenoses were reconstructed.
  • Both 0D-3D coupled multiscale models and flow-split approaches with exponents (2.0-3.0) were employed for simulation.
  • Key haemodynamic metrics were statistically compared between the two simulation methods.

Main Results:

  • Flow-split and multiscale simulations showed no significant differences under resting conditions, irrespective of stenosis severity.
  • Under hyperaemic conditions, flow-split methods significantly overestimated time-averaged wall shear stress and underestimated fractional flow reserve.
  • Discrepancies were more pronounced in severe stenoses, and varying the flow-split exponent did not significantly alter results.

Conclusions:

  • Flow-split strategies (exponents 2.0-3.0) are suitable for modeling stenosed coronaries under resting conditions.
  • Multiscale simulations are recommended for accurate modeling of hyperaemic conditions, particularly in severely stenosed arteries.
Abstract

Keywords:
Computational fluid dynamicsCoronary blood flowCoronary stenosisFlow-split outflow strategiesMultiscale Simulation

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