Computational Assessment of Hemodynamic Significance in Patients with Intramural Anomalous Aortic Origin of the Coronary Artery Using Virtually Derived Fractional Flow Reserve and Downstream Microvascular Resistance.
Computational Assessment of Hemodynamic Significance in Patients with Intramural Anomalous Aortic Origin of the Coronary Artery Using Virtually Derived Fractional Flow Reserve and Downstream Microvascular Resistance.
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使用虚拟导出的血流储备分数和下游微血管阻力对冠状动脉壁内主动脉起源异常患者的血流动力学意义进行计算评估。
DOI：
10.1115/1.4052368
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
J. Ladisa
中科院分区：
文献类型：
--
作者：
A. Razavi;Shagun Sachdeva;P. Frommelt;J. Ladisa
冠状动脉主动脉起源异常（AAOCA）是年轻运动员心源性猝死的第二常见原因。这些患者缺血的假设机制之一是异常动脉受到壁内或动脉间的横向压迫。异常动脉狭窄的存在将导致下游阻力的生理变化，应将其纳入可能的临床后果的计算评估中。在当前的研究中，我们在代表性患者模型的壁内过程中创建了不同的压缩水平，即近端狭窄，并计算了虚拟血流储备分数（vFFR）。模型还包括远端充血微血管阻力 (HMR) 对 vFFR 的影响。我们的结果与类似的 FFR 研究一致，表明 FFR 随着 HMR 的增加而增加，并且根据 HMR，不同的压缩级别可能具有相似的 FFR。例如，HSR：1.0-1.3 和 HMR：2.30 mmHg/cm/s 时的 vFFR 为 0.68，接近 HSR：0.6-0.7 和 HMR：1.6 mmHg/cm/s 时的 vFFR，即 0.7。目前的研究结果表明，通过 FFR 对异常冠状动脉进行功能评估时，除了近端狭窄的影响外，还应考虑狭窄远端的血管阻力，并为实现这些重要考虑因素提供计算方法。
Anomalous aortic origin of a coronary artery (AAOCA) is the second most common cause of sudden cardiac death in young athletes. One of the hypothesized mechanisms of ischemia in these patients is the lateral compression of the anomalous artery with an intramural or interarterial course. The presence of a narrowing in the anomalous artery will cause physiologic changes in downstream resistance that should be included for computational assessment of possible clinical ramifications. In the current study, we created different compression levels, i.e., proximal narrowing, in the intramural course of a representative patient model and calculated virtual fractional flow reserve (vFFR). Models also included the effect of the distal hyperemic microvascular resistance (HMR) on vFFR. Our results were in agreement with similar FFR studies indicating that FFR was increased with increasing HMR, and that different compression levels could have similar FFR depending on the HMR. For example, vFFR at HSR:1.0-1.3 and HMR: 2.30 mmHg/cm/s is 0.68 and close to vFFR at HSR:0.6-0.7 and HMR: 1.6 mmHg/cm/s, which is 0.7. The current findings suggest that functional assessment of anomalous coronary arteries through FFR should consider the vascular resistance distal to the narrowing in addition to the impact of a proximal narrowing and provides computational approaches for implementation of these important considerations.
DOI：
10.1115/1.4004996
发表时间：
2011-09-01
影响因子：
1.7
作者：
LaDisa, John F., Jr.;Figueroa, C. Alberto;Taylor, Charles A.
通讯作者：
Taylor, Charles A.
影响因子：
0.3
作者：
LaDisa JF Jr;Dholakia RJ;Figueroa CA;Vignon-Clementel IE;Chan FP;Samyn MM;Cava JR;Taylor CA;Feinstein JA
通讯作者：
Feinstein JA