Characterizing momentum change and viscous loss of a hemodynamic endpoint in assessment of coronary lesions

Journal of Biomechanics
Rupak K BanerjeeRonald W Millard

Abstract

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...Continue Reading

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Citations

Aug 30, 2008·Biomedical Engineering Online·Rupak K BanerjeeSaeb F Khoury
May 9, 2014·Annals of Biomedical Engineering·Kranthi K KolliR K Banerjee
Oct 2, 2015·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Kranthi K KolliTarek A Helmy
Jun 19, 2012·Physica Medica : PM : an International Journal Devoted to the Applications of Physics to Medicine and Biology : Official Journal of the Italian Association of Biomedical Physics (AIFB)·Kalimuthu GovindarajuA Badarudin
Sep 25, 2009·Journal of Biomechanics·Srikara Viswanath PeelukhanaRupak K Banerjee
Jun 21, 2013·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Kranthi K KolliMohamed A Effat
Apr 8, 2016·Computer Methods in Biomechanics and Biomedical Engineering·Kalimuthu GovindarajuAbdullah A A A Al-Rashed
Jan 11, 2011·Journal of Biomechanics·Bhaskar Chandra KonalaRupak K Banerjee
Mar 24, 2018·Biomedical Engineering Online·Xinzhou XieSongyun Xie
Dec 24, 2013·Journal of Biomechanical Engineering·Gavin A D'SouzaRupak K Banerjee
Jan 31, 2012·American Journal of Physiology. Heart and Circulatory Physiology·S V PeelukhanaA Irif

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