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open access

Vol 30, No 4 (2023)
Original Article
Submitted: 2021-06-06
Accepted: 2021-07-15
Published online: 2021-09-30
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Simplified coronary flow reserve calculations based on three-dimensional coronary reconstruction and intracoronary pressure data

Benjamin Csippa1, Áron Üveges234, Dániel Gyürki1, Csaba Jenei24, Balázs Tar34, Balázs Bugarin-Horváth3, Gábor Tamás Szabó24, András Komócsi5, György Paál1, Zsolt Kőszegi234
DOI: 10.5603/CJ.a2021.0117
·
Pubmed: 34622434
·
Cardiol J 2023;30(4):516-525.
Affiliations
  1. Department of Hydrodynamic Systems, Budapest University of Technology and Economics, Budapest, Hungary
  2. Division of Cardiology, Faculty of Medicine, University of Debrecen, Hungary
  3. Szabolcs-Szatmár-Bereg County Hospitals and University Teaching Hospital, Nyíregyháza, Hungary
  4. Kálmán Laki Doctoral School of Biomedical and Clinical Sciences, University of Debrecen, Hungary
  5. Heart Institute, Medical School, University of Pécs, Hungary

open access

Vol 30, No 4 (2023)
Original articles — Interventional cardiology
Submitted: 2021-06-06
Accepted: 2021-07-15
Published online: 2021-09-30

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.

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Keywords

coronary flow reserve, fractional flow reserve, microvascular function, three-dimensional reconstruction

About this article
Title

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

Journal

Cardiology Journal

Issue

Vol 30, No 4 (2023)

Article type

Original Article

Pages

516-525

Published online

2021-09-30

Page views

2442

Article views/downloads

757

DOI

10.5603/CJ.a2021.0117

Pubmed

34622434

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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