Kittaka Daisuke, Sato Hisaya, Nakai Yuichi, Kato Kyoichi
Department of Radiological Technology, Showa University Hospital Tokyo Japan.
Showa University Graduate School of Health Sciences Tokyo Japan.
Circ Rep. 2020 Sep 25;2(10):545-551. doi: 10.1253/circrep.CR-20-0078.
Fractional flow reserve (FFR) is used to evaluate the need for percutaneous coronary intervention (PCI) in cases of moderate stenosis of the coronary artery. Recently, diagnostic imaging support with computational fluid dynamics (CFD) analysis has been garnering attention. This study defines the relationship between FFR conducted for cardiac catheterization and CFD analyses conducted using coronary computed tomography (CT) for moderate stenosis, in addition to considering whether wall pressure (WP) and wall shear stress (WSS) can be used to evaluate ischemia. Cases in which FFR was measured via coronary CT and cardiac catheterization was performed within 3 months were collected retrospectively. In the CFD analysis, WP and WSS were calculated and compared with FFR. Three groups were created to compare results of CFD analysis and FFR values according to the location of the stenosis: the right coronary artery, the left anterior descending artery, and the left circumflex artery. There was a correlation between FFR and WSS according to CFD analysis for moderate stenosis of the coronary artery, with a cut-off value for treatment able to be calculated. The results of this study suggest that ischemia can be evaluated by conducting CFD analysis (WSS) using coronary CT.
血流储备分数(FFR)用于评估冠状动脉中度狭窄时经皮冠状动脉介入治疗(PCI)的必要性。最近,基于计算流体动力学(CFD)分析的诊断成像支持受到了关注。本研究除了考虑壁面压力(WP)和壁面切应力(WSS)是否可用于评估缺血外,还定义了用于心脏导管插入术的FFR与使用冠状动脉计算机断层扫描(CT)对中度狭窄进行的CFD分析之间的关系。回顾性收集通过冠状动脉CT测量FFR且在3个月内进行心脏导管插入术的病例。在CFD分析中,计算WP和WSS并与FFR进行比较。根据狭窄部位创建了三组来比较CFD分析结果和FFR值:右冠状动脉、左前降支动脉和左旋支动脉。对于冠状动脉中度狭窄,根据CFD分析,FFR与WSS之间存在相关性,能够计算出治疗的临界值。本研究结果表明,使用冠状动脉CT进行CFD分析(WSS)可评估缺血情况。