Department of Civil Engineering and Architecture, University of Pavia, 20100, Pavia, Italy.
Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, 20097, San Donato Milanese, Italy.
Sci Rep. 2023 Oct 14;13(1):17448. doi: 10.1038/s41598-023-44568-8.
Anomalous aortic origin of the coronary artery (AAOCA) is a rare disease associated with sudden cardiac death, usually related to physical effort in young people. Clinical routine tests fail to assess the ischemic risk, calling for novel diagnostic approaches. To this aim, some recent studies propose to assess the coronary blood flow (CBF) in AAOCA by computational simulations but they are limited by the use of data from literature retrieved from normal subjects. To overcome this limitation and obtain a reliable assessment of CBF, we developed a fully patient-specific lumped parameter model based on clinical imaging and in-vivo data retrieved during invasive coronary functional assessment of subjects with AAOCA. In such a way, we can estimate the CBF replicating the two hemodynamic conditions in-vivo analyzed. The model can mimic the effective coronary behavior with high accuracy and could be a valuable tool to quantify CBF in AAOCA. It represents the first step required to move toward a future clinical application with the aim of improving patient care. The study was registered at Clinicaltrial.gov with (ID: NCT05159791, date 2021-12-16).
冠状动脉异常起源(AAOCA)是一种罕见的疾病,与年轻人的体力活动有关,通常与心脏性猝死相关。临床常规检查未能评估缺血风险,因此需要新的诊断方法。为此,一些最近的研究提出通过计算模拟来评估 AAOCA 的冠状动脉血流(CBF),但它们受到从正常受试者文献中检索的数据的限制。为了克服这一限制并获得 CBF 的可靠评估,我们基于从 AAOCA 受试者的有创冠状动脉功能评估中获取的临床成像和体内数据,开发了一个完全基于患者个体的集总参数模型。通过这种方式,我们可以通过复制体内分析的两种血流动力学条件来估计 CBF。该模型可以非常准确地模拟有效的冠状动脉行为,并且可能是量化 AAOCA 中 CBF 的有价值的工具。它代表了朝着未来临床应用迈出的第一步,旨在改善患者护理。该研究已在 Clinicaltrial.gov 上注册(注册号:NCT05159791,日期:2021 年 12 月 16 日)。