Evaluation of intracoronary hemodynamics identifies perturbations in vorticity.
| Title: | Evaluation of intracoronary hemodynamics identifies perturbations in vorticity. |
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| Authors: | Vardhan, Madhurima, Gounley, John, Chen, S. James, Nair, Priya, Wei Wei, Hegele, Luiz, Kusner, Jonathan, Kahn, Andrew M., Frakes, David, Leopold, Jane A., Randles, Amanda |
| Source: | Frontiers in Systems Biology; 11/9/2022, Vol. 2, p1-12, 12p |
| Subject Terms: | VORTEX motion, COMPUTATIONAL fluid dynamics, CORONARY vasospasm, PARTICLE image velocimetry, HEMODYNAMICS, FLOW velocity, CORONARY artery stenosis |
| Abstract: | Background and objective: Coronary artery disease (CAD) is highly prevalent and associated with adverse events. Challenges have emerged in the treatment of intermediate coronary artery stenoses. These lesions are often interrogated with fractional flow reserve (FFR) testing to determine if a stenosis is likely to be causative for ischemia in a cardiac territory. This invasive test requires insertion of a pressure wire into a coronary vessel. Recently computational fluid dynamics (CFD) has been used to noninvasively assess fractional flow reserve in vessels reconstructed from medical imaging data. However, many of these simulations are unable to provide additional information about intravascular hemodynamics, including velocity, endothelial shear stress (ESS), and vorticity. We hypothesized that vorticity, which has demonstrated utility in the assessment of ventricular and aortic diseases, would also be an important hemodynamic factor in CAD. Methods: Three-dimensional (3D), patient-specific coronary artery geometries that included all vessels >1mmin diameter were created from angiography data obtained from 10 patients who underwent diagnostic angiography and FFR testing (n = 9). A massively parallel CFD solver (HARVEY) was used to calculate coronary hemodynamic parameters including pressure, velocity, ESS, and vorticity. These simulations were validated by comparing velocity flow fields from simulation to both velocities derived from in vitro particle image velocimetry and to invasively acquired pressure wire-based data from clinical testing. Results: There was strong agreement between findings from CFD simulations and particle image velocimetry experimental testing (ρ < 0.01). CFD-FFR was also highly correlated with invasively measured FFR (ρ = 0.77, p = 0.01) with an average error of 5.9 ± 0.1%. CFD-FFR also had a strong inverse correlation with the vorticity (ρ = -0.86, p = 0.001). Simulations to determine the effect of the coronary stenosis on intravascular hemodynamics demonstrated significant differences in velocity and vorticity (both p < 0.05). Further evaluation of an angiographically normal appearing non-FFR coronary vessel in patients with CAD also demonstrated differences in vorticity when compared with FFR vessels (p < 0.05). Conclusion: The use of highly accurate 3D CFD-derived intravascular hemodynamics provides additional information beyond pressure measurements that can be used to calculate FFR. Vorticity is one parameter that is modified by a coronary stenosis and appears to be abnormal in angiographically normal vessels in patients with CAD, highlighting a possible use-case in preventative screening for early coronary disease. [ABSTRACT FROM AUTHOR] |
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| Database: | Complementary Index |
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| Items | – Name: Title Label: Title Group: Ti Data: Evaluation of intracoronary hemodynamics identifies perturbations in vorticity. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Vardhan%2C+Madhurima%22">Vardhan, Madhurima</searchLink><br /><searchLink fieldCode="AR" term="%22Gounley%2C+John%22">Gounley, John</searchLink><br /><searchLink fieldCode="AR" term="%22Chen%2C+S%2E+James%22">Chen, S. James</searchLink><br /><searchLink fieldCode="AR" term="%22Nair%2C+Priya%22">Nair, Priya</searchLink><br /><searchLink fieldCode="AR" term="%22Wei+Wei%22">Wei Wei</searchLink><br /><searchLink fieldCode="AR" term="%22Hegele%2C+Luiz%22">Hegele, Luiz</searchLink><br /><searchLink fieldCode="AR" term="%22Kusner%2C+Jonathan%22">Kusner, Jonathan</searchLink><br /><searchLink fieldCode="AR" term="%22Kahn%2C+Andrew+M%2E%22">Kahn, Andrew M.</searchLink><br /><searchLink fieldCode="AR" term="%22Frakes%2C+David%22">Frakes, David</searchLink><br /><searchLink fieldCode="AR" term="%22Leopold%2C+Jane+A%2E%22">Leopold, Jane A.</searchLink><br /><searchLink fieldCode="AR" term="%22Randles%2C+Amanda%22">Randles, Amanda</searchLink> – Name: TitleSource Label: Source Group: Src Data: Frontiers in Systems Biology; 11/9/2022, Vol. 2, p1-12, 12p – Name: Subject Label: Subject Terms Group: Su Data: <searchLink fieldCode="DE" term="%22VORTEX+motion%22">VORTEX motion</searchLink><br /><searchLink fieldCode="DE" term="%22COMPUTATIONAL+fluid+dynamics%22">COMPUTATIONAL fluid dynamics</searchLink><br /><searchLink fieldCode="DE" term="%22CORONARY+vasospasm%22">CORONARY vasospasm</searchLink><br /><searchLink fieldCode="DE" term="%22PARTICLE+image+velocimetry%22">PARTICLE image velocimetry</searchLink><br /><searchLink fieldCode="DE" term="%22HEMODYNAMICS%22">HEMODYNAMICS</searchLink><br /><searchLink fieldCode="DE" term="%22FLOW+velocity%22">FLOW velocity</searchLink><br /><searchLink fieldCode="DE" term="%22CORONARY+artery+stenosis%22">CORONARY artery stenosis</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background and objective: Coronary artery disease (CAD) is highly prevalent and associated with adverse events. Challenges have emerged in the treatment of intermediate coronary artery stenoses. These lesions are often interrogated with fractional flow reserve (FFR) testing to determine if a stenosis is likely to be causative for ischemia in a cardiac territory. This invasive test requires insertion of a pressure wire into a coronary vessel. Recently computational fluid dynamics (CFD) has been used to noninvasively assess fractional flow reserve in vessels reconstructed from medical imaging data. However, many of these simulations are unable to provide additional information about intravascular hemodynamics, including velocity, endothelial shear stress (ESS), and vorticity. We hypothesized that vorticity, which has demonstrated utility in the assessment of ventricular and aortic diseases, would also be an important hemodynamic factor in CAD. Methods: Three-dimensional (3D), patient-specific coronary artery geometries that included all vessels >1mmin diameter were created from angiography data obtained from 10 patients who underwent diagnostic angiography and FFR testing (n = 9). A massively parallel CFD solver (HARVEY) was used to calculate coronary hemodynamic parameters including pressure, velocity, ESS, and vorticity. These simulations were validated by comparing velocity flow fields from simulation to both velocities derived from in vitro particle image velocimetry and to invasively acquired pressure wire-based data from clinical testing. Results: There was strong agreement between findings from CFD simulations and particle image velocimetry experimental testing (ρ < 0.01). CFD-FFR was also highly correlated with invasively measured FFR (ρ = 0.77, p = 0.01) with an average error of 5.9 ± 0.1%. CFD-FFR also had a strong inverse correlation with the vorticity (ρ = -0.86, p = 0.001). Simulations to determine the effect of the coronary stenosis on intravascular hemodynamics demonstrated significant differences in velocity and vorticity (both p < 0.05). Further evaluation of an angiographically normal appearing non-FFR coronary vessel in patients with CAD also demonstrated differences in vorticity when compared with FFR vessels (p < 0.05). Conclusion: The use of highly accurate 3D CFD-derived intravascular hemodynamics provides additional information beyond pressure measurements that can be used to calculate FFR. Vorticity is one parameter that is modified by a coronary stenosis and appears to be abnormal in angiographically normal vessels in patients with CAD, highlighting a possible use-case in preventative screening for early coronary disease. [ABSTRACT FROM AUTHOR] – Name: Abstract Label: Group: Ab Data: <i>Copyright of Frontiers in Systems Biology is the property of Frontiers Media S.A. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.3389/fsysb.2022.930396 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 12 StartPage: 1 Subjects: – SubjectFull: VORTEX motion Type: general – SubjectFull: COMPUTATIONAL fluid dynamics Type: general – SubjectFull: CORONARY vasospasm Type: general – SubjectFull: PARTICLE image velocimetry Type: general – SubjectFull: HEMODYNAMICS Type: general – SubjectFull: FLOW velocity Type: general – SubjectFull: CORONARY artery stenosis Type: general Titles: – TitleFull: Evaluation of intracoronary hemodynamics identifies perturbations in vorticity. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Vardhan, Madhurima – PersonEntity: Name: NameFull: Gounley, John – PersonEntity: Name: NameFull: Chen, S. James – PersonEntity: Name: NameFull: Nair, Priya – PersonEntity: Name: NameFull: Wei Wei – PersonEntity: Name: NameFull: Hegele, Luiz – PersonEntity: Name: NameFull: Kusner, Jonathan – PersonEntity: Name: NameFull: Kahn, Andrew M. – PersonEntity: Name: NameFull: Frakes, David – PersonEntity: Name: NameFull: Leopold, Jane A. – PersonEntity: Name: NameFull: Randles, Amanda IsPartOfRelationships: – BibEntity: Dates: – D: 09 M: 11 Text: 11/9/2022 Type: published Y: 2022 Identifiers: – Type: issn-print Value: 26740702 Numbering: – Type: volume Value: 2 Titles: – TitleFull: Frontiers in Systems Biology Type: main |
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