Mathematical modeling of coronary blood flow to assess the functional significance of stenotic lesion by computed tomography

Ternovoy S.K., Chepovskiy A.M., Veselova T.N., Borisenko V.V., Serova N.S.

Invasive coronary angiography (CAG) with simultaneous measurement of fractional blood flow reserve (FFR) is a reference method for assessing the functional significance of coronary artery stenotic lesions in patients with coronary heart disease (CHD). Computed tomographic angiography (CTA) as an alternative non-invasive method of visualization of the coronary bed has high diagnostic accuracy and is included in the algorithm for examining patients with low and medium-risk coronary artery disease.

Purpose. To describe the mathematical principles and results of clinical validation of FFRCTA to assess myocardial ischemia.

Material and methods. Data analysis of domestic and foreign literature, scientific publications, electronic resources.

Results. With the help of mathematical modeling of the coronary blood flow using the laws of hydrodynamics, it became possible to calculate the FFR using data from the CTA (FFR CTA). The results of the large multicenter research DISCOVER-FLOW, DeFACTO and PLATFORM confirmed the diagnostic accuracy of FFRCTA compared to the invasive FFR.

Conclusion. Modern developments in the field of CTA and mathematical modeling allow us to expand the scope of the standard study of the coronary tree, which includes an assessment of not only anatomical, but also functional parameters.

1  - I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University).

2 - National Medical Research Center of

Cardiology.

3 - National Research University “Higher School of Economics”.

4  - Lomonosov Moscow State University.

Moscow, Russia.

 

Keywords: fractional blood flow reserve (FFR), coronary arteries, computed tomographic angiography (CTA), mathematical modeling.


Corresponding author:  Kryuchkov I.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Ternovoy S.K., Chepovskiy A.M., Veselova T.N., Borisenko V.V., Serova N.S. Mathematical modeling of coronary blood flow to assess the functional significance of stenotic lesion by computed tomography. REJR 2019; 9(2):205-212. DOI:10.21569/2222-7415-2019-9-2-205-212.

.

Received:        18.05.19 Accepted:       14.06.19