Document Detail

Characterizing momentum change and viscous loss of a hemodynamic endpoint in assessment of coronary lesions.
MedLine Citation:
PMID:  16530204     Owner:  NLM     Status:  MEDLINE    
Myocardial fractional flow reserve (FFR(myo)) and coronary flow reserve (CFR), measured with guidewire, and quantitative angiography (QA) are widely used in combination to distinguish ischemic from non-ischemic coronary stenoses. Recent studies have shown that simultaneous measurements of FFR(myo) and CFR are recommended to dissociate conduit epicardial coronary stenoses from distal resistance microvascular disease. In this study, a more comprehensive diagnostic parameter, named as lesion flow coefficient, c, is proposed. The coefficient, c, which accounts for mean pressure drop, Delta p, mean coronary flow, Q, and percentage area stenosis, can be used to assess the hemodynamic severity of a coronary artery stenoses. Importantly, the contribution of viscous loss and loss due to momentum change for several lesion sizes can be distinguished using c. FFR(myo), CFR and c were calculated for pre-angioplasty, intermediate and post-angioplasty epicardial lesions, without microvascular disease. While hyperemic c decreased from 0.65 for pre-angioplasty to 0.48 for post-angioplasty lesion with guidewire of size 0.35 mm, FFR(myo) increased from 0.52 to 0.87, and CFR increased from 1.72 to 3.45, respectively. Thus, reduced loss produced by momentum change due to lower percentage area stenosis decreased c. For post-angioplasty lesion, c decreased from 0.55 to 0.48 with the insertion of guidewire. Hence, increased viscous loss due to the presence of guidewire decreased c compared with a lesion without guidewire. Further, c showed a linear relationship with FFR(myo), CFR and percentage area stenosis for pre-angioplasty, intermediate and post-angioplasty lesion. These baseline values of c were developed from fluid dynamics fundamentals for focal lesions, and provided a single hemodynamic endpoint to evaluate coronary stenosis severity.
Rupak K Banerjee; Abhijit Sinha Roy; Lloyd H Back; Martin R Back; Saeb F Khoury; Ronald W Millard
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-03-10
Journal Detail:
Title:  Journal of biomechanics     Volume:  40     ISSN:  0021-9290     ISO Abbreviation:  J Biomech     Publication Date:  2007  
Date Detail:
Created Date:  2007-01-22     Completed Date:  2007-03-20     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0157375     Medline TA:  J Biomech     Country:  United States    
Other Details:
Languages:  eng     Pagination:  652-62     Citation Subset:  IM    
Department of Mechanical Engineering, University of Cincinnati, Cincinnati, OH, USA. Rupak.Banerjee@UC.Edu
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MeSH Terms
Coronary Artery Disease / physiopathology*
Models, Biological*

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