Coronary CT angiography-based estimation of myocardial perfusion territories for coronary artery FFR and wall shear stress simulation

Abstract This study aims to apply a CCTA-derived territory-based patient-specific estimation of boundary conditions for coronary artery fractional flow reserve (FFR) and wall shear stress (WSS) simulation. The non-invasive simulation can help diagnose the significance of coronary stenosis and the li...

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Autores principales:	Yu-Fang Hsieh, Chih-Kuo Lee, Weichung Wang, Yu-Cheng Huang, Wen-Jeng Lee, Tzung-Dau Wang, Cheng-Ying Chou
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8ef15ad3bc894bb68da4ef35c5fcdd7d
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spelling	oai:doaj.org-article:8ef15ad3bc894bb68da4ef35c5fcdd7d2021-12-02T15:23:08ZCoronary CT angiography-based estimation of myocardial perfusion territories for coronary artery FFR and wall shear stress simulation10.1038/s41598-021-93237-12045-2322https://doaj.org/article/8ef15ad3bc894bb68da4ef35c5fcdd7d2021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93237-1https://doaj.org/toc/2045-2322Abstract This study aims to apply a CCTA-derived territory-based patient-specific estimation of boundary conditions for coronary artery fractional flow reserve (FFR) and wall shear stress (WSS) simulation. The non-invasive simulation can help diagnose the significance of coronary stenosis and the likelihood of myocardial ischemia. FFR is often regarded as the gold standard to evaluate the functional significance of stenosis in coronary arteries. In another aspect, proximal wall shear stress ( $$\mathrm{{WSS}_{prox}}$$ WSS prox ) can also be an indicator of plaque vulnerability. During the simulation process, the mass flow rate of the blood in coronary arteries is one of the most important boundary conditions. This study utilized the myocardium territory to estimate and allocate the mass flow rate. 20 patients are included in this study. From the knowledge of anatomical information of coronary arteries and the myocardium, the territory-based FFR and the $$\mathrm{{WSS}_{prox}}$$ WSS prox can both be derived from fluid dynamics simulations. Applying the threshold of distinguishing between significant and non-significant stenosis, the territory-based method can reach the accuracy, sensitivity, and specificity of 0.88, 0.90, and 0.80, respectively. For significantly stenotic cases ( $$\mathrm{FFR}_{m}$$ FFR m $$\le$$ ≤ 0.80), the vessels usually have higher wall shear stress in the proximal region of the lesion.Yu-Fang HsiehChih-Kuo LeeWeichung WangYu-Cheng HuangWen-Jeng LeeTzung-Dau WangCheng-Ying ChouNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yu-Fang Hsieh Chih-Kuo Lee Weichung Wang Yu-Cheng Huang Wen-Jeng Lee Tzung-Dau Wang Cheng-Ying Chou Coronary CT angiography-based estimation of myocardial perfusion territories for coronary artery FFR and wall shear stress simulation
description	Abstract This study aims to apply a CCTA-derived territory-based patient-specific estimation of boundary conditions for coronary artery fractional flow reserve (FFR) and wall shear stress (WSS) simulation. The non-invasive simulation can help diagnose the significance of coronary stenosis and the likelihood of myocardial ischemia. FFR is often regarded as the gold standard to evaluate the functional significance of stenosis in coronary arteries. In another aspect, proximal wall shear stress ( $$\mathrm{{WSS}_{prox}}$$ WSS prox ) can also be an indicator of plaque vulnerability. During the simulation process, the mass flow rate of the blood in coronary arteries is one of the most important boundary conditions. This study utilized the myocardium territory to estimate and allocate the mass flow rate. 20 patients are included in this study. From the knowledge of anatomical information of coronary arteries and the myocardium, the territory-based FFR and the $$\mathrm{{WSS}_{prox}}$$ WSS prox can both be derived from fluid dynamics simulations. Applying the threshold of distinguishing between significant and non-significant stenosis, the territory-based method can reach the accuracy, sensitivity, and specificity of 0.88, 0.90, and 0.80, respectively. For significantly stenotic cases ( $$\mathrm{FFR}_{m}$$ FFR m $$\le$$ ≤ 0.80), the vessels usually have higher wall shear stress in the proximal region of the lesion.
format	article
author	Yu-Fang Hsieh Chih-Kuo Lee Weichung Wang Yu-Cheng Huang Wen-Jeng Lee Tzung-Dau Wang Cheng-Ying Chou
author_facet	Yu-Fang Hsieh Chih-Kuo Lee Weichung Wang Yu-Cheng Huang Wen-Jeng Lee Tzung-Dau Wang Cheng-Ying Chou
author_sort	Yu-Fang Hsieh
title	Coronary CT angiography-based estimation of myocardial perfusion territories for coronary artery FFR and wall shear stress simulation
title_short	Coronary CT angiography-based estimation of myocardial perfusion territories for coronary artery FFR and wall shear stress simulation
title_full	Coronary CT angiography-based estimation of myocardial perfusion territories for coronary artery FFR and wall shear stress simulation
title_fullStr	Coronary CT angiography-based estimation of myocardial perfusion territories for coronary artery FFR and wall shear stress simulation
title_full_unstemmed	Coronary CT angiography-based estimation of myocardial perfusion territories for coronary artery FFR and wall shear stress simulation
title_sort	coronary ct angiography-based estimation of myocardial perfusion territories for coronary artery ffr and wall shear stress simulation
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/8ef15ad3bc894bb68da4ef35c5fcdd7d
work_keys_str_mv	AT yufanghsieh coronaryctangiographybasedestimationofmyocardialperfusionterritoriesforcoronaryarteryffrandwallshearstresssimulation AT chihkuolee coronaryctangiographybasedestimationofmyocardialperfusionterritoriesforcoronaryarteryffrandwallshearstresssimulation AT weichungwang coronaryctangiographybasedestimationofmyocardialperfusionterritoriesforcoronaryarteryffrandwallshearstresssimulation AT yuchenghuang coronaryctangiographybasedestimationofmyocardialperfusionterritoriesforcoronaryarteryffrandwallshearstresssimulation AT wenjenglee coronaryctangiographybasedestimationofmyocardialperfusionterritoriesforcoronaryarteryffrandwallshearstresssimulation AT tzungdauwang coronaryctangiographybasedestimationofmyocardialperfusionterritoriesforcoronaryarteryffrandwallshearstresssimulation AT chengyingchou coronaryctangiographybasedestimationofmyocardialperfusionterritoriesforcoronaryarteryffrandwallshearstresssimulation
_version_	1718387338225123328

Coronary CT angiography-based estimation of myocardial perfusion territories for coronary artery FFR and wall shear stress simulation

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