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充血状态下左冠状动脉的患者特异性三维血流动力学建模。

Patient-specific 3D hemodynamics modelling of left coronary artery under hyperemic conditions.

作者信息

Kamangar Sarfaraz, Badruddin Irfan Anjum, Govindaraju Kalimuthu, Nik-Ghazali N, Badarudin A, Viswanathan Girish N, Ahmed N J Salman, Khan T M Yunus

机构信息

Department of Mechanical Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia.

Department of Mechanical and Industrial Engineering, Mekelle University, Mekelle, Ethiopia.

出版信息

Med Biol Eng Comput. 2017 Aug;55(8):1451-1461. doi: 10.1007/s11517-016-1604-8. Epub 2016 Dec 21.

Abstract

The purpose of this study is to investigate the effect of various degrees of percentage stenosis on hemodynamic parameters during the hyperemic flow condition. 3D patient-specific coronary artery models were generated based on the CT scan data using MIMICS-18. Numerical simulation was performed for normal and stenosed coronary artery models of 70, 80 and 90% AS (area stenosis). Pressure, velocity, wall shear stress and fractional flow reserve (FFR) were measured and compared with the normal coronary artery model during the cardiac cycle. The results show that, as the percentage AS increase, the pressure drop increases as compared with the normal coronary artery model. Considerable elevation of velocity was observed as the percentage AS increases. The results also demonstrate a recirculation zone immediate after the stenosis which could lead to further progression of stenosis in the flow-disturbed area. Highest wall shear stress was observed for 90% AS as compared to other models that could result in the rupture of coronary artery. The FFR of 90% AS is found to be considerably low.

摘要

本研究的目的是探讨充血血流状态下不同程度的狭窄百分比对血流动力学参数的影响。基于CT扫描数据,使用MIMICS-18生成了三维个体化冠状动脉模型。对正常以及70%、80%和90%面积狭窄(AS)的狭窄冠状动脉模型进行了数值模拟。在心动周期中测量压力、速度、壁面剪应力和血流储备分数(FFR),并与正常冠状动脉模型进行比较。结果表明,随着AS百分比的增加,与正常冠状动脉模型相比,压力降增加。随着AS百分比的增加,观察到速度显著升高。结果还表明,狭窄后立即出现一个再循环区域,这可能导致血流受干扰区域的狭窄进一步进展。与其他模型相比,90%AS模型观察到的壁面剪应力最高,这可能导致冠状动脉破裂。发现90%AS模型的FFR相当低。

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