Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China.
Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Beijing 100124, China.
Math Biosci Eng. 2021 Jul 2;18(5):5978-5994. doi: 10.3934/mbe.2021299.
To calculate fractional flow reserve (FFR) based on computed tomography angiography (i.e., FFRCT) by considering the branch flow distribution in the coronary arteries.
FFR is the gold standard to diagnose myocardial ischemia caused by coronary stenosis. An accurate and noninvasive method for obtaining total coronary blood flow is needed for the calculation of FFRCT.
A mathematical model for estimating the coronary blood flow rate and two approaches for setting the patient-specific flow boundary condition were proposed. Coronary branch flow distribution methods based on a volume-flow approach and a diameter-flow approach were employed for the numerical simulation of FFRCT. The values of simulated FFRCT for 16 patients were compared with their clinically measured FFR.
The ratio of total coronary blood flow to cardiac output and the myocardial blood flow under the condition of hyperemia were 16.97% and 4.07 mL/min/g, respectively. The errors of FFRCT compared with clinical data under the volume-flow approach and diameter-flow approach were 10.47% and 11.76%, respectively, the diagnostic accuracies of FFRCT were 65% and 85%, and the consistencies were 95% and 90%.
The mathematical model for estimating the coronary blood flow rate and the coronary branch flow distribution method can be applied to calculate the value of clinical noninvasive FFRCT.
通过考虑冠状动脉分支血流分布，计算基于计算机断层血管造影（即 FFRCT）的分流量比值（FFR）。
FFR 是诊断冠状动脉狭窄引起心肌缺血的金标准。为了计算 FFRCT，需要一种准确且无创的方法来获取总冠状动脉血流量。
提出了一种估算冠状动脉血流速率的数学模型和两种设定患者特定血流边界条件的方法。采用基于容积流量法和直径流量法的冠状动脉分支血流分布方法进行 FFRCT 的数值模拟。将 16 例患者的模拟 FFRCT 值与临床测量的 FFR 进行比较。
总冠状动脉血流量与心输出量的比值和充血状态下的心肌血流量分别为 16.97%和 4.07mL/min/g。在容积流量法和直径流量法下，FFRCT 与临床数据的误差分别为 10.47%和 11.76%，FFRCT 的诊断准确性分别为 65%和 85%，一致性分别为 95%和 90%。
估算冠状动脉血流速率的数学模型和冠状动脉分支血流分布方法可用于计算临床无创 FFRCT 的值。
