open access
Simplified coronary flow reserve calculations based on three-dimensional coronary reconstruction and intracoronary pressure data


- Department of Hydrodynamic Systems, Budapest University of Technology and Economics, Budapest, Hungary
- Division of Cardiology, Faculty of Medicine, University of Debrecen, Hungary
- Szabolcs-Szatmár-Bereg County Hospitals and University Teaching Hospital, Nyíregyháza, Hungary
- Kálmán Laki Doctoral School of Biomedical and Clinical Sciences, University of Debrecen, Hungary
- Heart Institute, Medical School, University of Pécs, Hungary
open access
Abstract
Background: Measurements of fractional flow reserve (FFR) and/or coronary flow reserve (CFR) are widely used for hemodynamic characterization of coronary lesions. The frequent combination of the epicardial and microvascular disease may indicate a need for complex hemodynamic evaluation of coronary lesions. This study aims at validating the calculation of CFR based on a simple hemodynamic model to detailed computational fluid dynamics (CFD) analysis.
Methods: Three-dimensional (3D) morphological data and pressure values from FFR measurements were used to calculate the target vessel. Nine patients with one intermediate stenosis each, measured by pressure wire, were included in this study.
Results: A correlation was found between the determined CFR from simple equations and from a steady flow simulation (r = 0.984, p < 10−5). There was a significant correlation between the CFR values calculated by transient and steady flow simulations (r = 0.94, p < 10−3).
Conclusions: Feasibility was demonstrated of a simple hemodynamic calculation of CFR based on 3D-angiography and intracoronary pressure measurements. A simultaneous determination of both the FFR and CFR values provides the capability to diagnose microvascular dysfunction: the CFR/FFR ratio characterizes the microvascular reserve.
Abstract
Background: Measurements of fractional flow reserve (FFR) and/or coronary flow reserve (CFR) are widely used for hemodynamic characterization of coronary lesions. The frequent combination of the epicardial and microvascular disease may indicate a need for complex hemodynamic evaluation of coronary lesions. This study aims at validating the calculation of CFR based on a simple hemodynamic model to detailed computational fluid dynamics (CFD) analysis.
Methods: Three-dimensional (3D) morphological data and pressure values from FFR measurements were used to calculate the target vessel. Nine patients with one intermediate stenosis each, measured by pressure wire, were included in this study.
Results: A correlation was found between the determined CFR from simple equations and from a steady flow simulation (r = 0.984, p < 10−5). There was a significant correlation between the CFR values calculated by transient and steady flow simulations (r = 0.94, p < 10−3).
Conclusions: Feasibility was demonstrated of a simple hemodynamic calculation of CFR based on 3D-angiography and intracoronary pressure measurements. A simultaneous determination of both the FFR and CFR values provides the capability to diagnose microvascular dysfunction: the CFR/FFR ratio characterizes the microvascular reserve.
Keywords
coronary flow reserve, fractional flow reserve, microvascular function, three-dimensional reconstruction


Title
Simplified coronary flow reserve calculations based on three-dimensional coronary reconstruction and intracoronary pressure data
Journal
Issue
Article type
Original Article
Pages
516-525
Published online
2021-09-30
Page views
2442
Article views/downloads
757
DOI
Pubmed
Bibliographic record
Cardiol J 2023;30(4):516-525.
Keywords
coronary flow reserve
fractional flow reserve
microvascular function
three-dimensional reconstruction
Authors
Benjamin Csippa
Áron Üveges
Dániel Gyürki
Csaba Jenei
Balázs Tar
Balázs Bugarin-Horváth
Gábor Tamás Szabó
András Komócsi
György Paál
Zsolt Kőszegi


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