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Author:

Ge, Xinyang (Ge, Xinyang.) | Liu, Youjun (Liu, Youjun.) | Tu, Shengxian (Tu, Shengxian.) | Simakov, Sergey (Simakov, Sergey.) | Vassilevski, Yuri (Vassilevski, Yuri.) | Liang, Fuyou (Liang, Fuyou.)

Indexed by:

EI Scopus SCIE PubMed

Abstract:

Although fractional flow reserve (FFR) and coronary flow reserve (CFR) are both frequently used to assess the functional severity of coronary artery stenosis, discordant results of diagnosis between FFR and CFR in some patient cohorts have been reported. In the present study, a computational model was employed to quantify the impacts of various pathophysiological factors on FFR and CFR. In addition, a hyperemic myocardial ischemic index (HMIx) was proposed as a reference for comparing the diagnostic performances of FFR and CFR. Obtained results showed that CFR was more susceptible than FFR to the influence of many pathophysiological factors unrelated to coronary artery stenosis. In particular, the numerical study proved that increasing hyperemic coronary microvascular resistance significantly elevated FFR while reducing CFR despite fixed severity of coronary artery stenosis, whereas introducing aortic valve disease only caused a significant decrease in CFR with little influence on FFR. These results provided theoretical evidence for explaining some clinical observations, such as the increased risk of discordant diagnostic results between FFR and CFR in patients with increased hyperemic microvascular resistance, and significant increase in CFR after surgical relief of severe aortic valve disease. When evaluated with respect to the predictive value for hyperemic myocardial ischemia, the performance of FFR was found to be considerably compromised in the presence of severe coronary vasodilation dysfunction or aortic valve disease, whereas the relationship between CFR and HMIx remained relatively stable, suggesting that CFR may be a more reliable indicator of myocardial ischemia under complex pathophysiological conditions.

Keyword:

microvascular dilation dysfunction CFR FFR aortic valve disease numerical simulation myocardial ischemia

Author Community:

  • [ 1 ] [Ge, Xinyang]Shanghai Jiao Tong Univ, Sch Naval Architecture Ocean & Civil Engn, 800 Dongchuan Rd, Shanghai 200240, Peoples R China
  • [ 2 ] [Liang, Fuyou]Shanghai Jiao Tong Univ, Sch Naval Architecture Ocean & Civil Engn, 800 Dongchuan Rd, Shanghai 200240, Peoples R China
  • [ 3 ] [Ge, Xinyang]Shanghai Jiao Tong Univ, Collaborat Innovat Ctr Adv Ship & Deep Sea Explor, Shanghai 200240, Peoples R China
  • [ 4 ] [Liang, Fuyou]Shanghai Jiao Tong Univ, Collaborat Innovat Ctr Adv Ship & Deep Sea Explor, Shanghai 200240, Peoples R China
  • [ 5 ] [Liu, Youjun]Beijing Univ Technol, Coll Life Sci & Bioengn, Beijing 100124, Peoples R China
  • [ 6 ] [Tu, Shengxian]Shanghai Jiao Tong Univ, Sch Biomed Engn, Med X Res Inst, Shanghai 200030, Peoples R China
  • [ 7 ] [Simakov, Sergey]Moscow Inst Phys & Technol, Dolgoprudnyi 141700, Russia
  • [ 8 ] [Vassilevski, Yuri]Moscow Inst Phys & Technol, Dolgoprudnyi 141700, Russia
  • [ 9 ] [Simakov, Sergey]Sechenov Univ, Inst Personalized Med, Moscow 119991, Russia
  • [ 10 ] [Vassilevski, Yuri]Sechenov Univ, Inst Personalized Med, Moscow 119991, Russia
  • [ 11 ] [Liang, Fuyou]Sechenov Univ, Inst Personalized Med, Moscow 119991, Russia
  • [ 12 ] [Vassilevski, Yuri]Russian Acad Sci, Inst Numer Math, Moscow 119333, Russia

Reprint Author's Address:

  • [Liang, Fuyou]Shanghai Jiao Tong Univ, Sch Naval Architecture Ocean & Civil Engn, 800 Dongchuan Rd, Shanghai 200240, Peoples R China

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Source :

INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING

ISSN: 2040-7939

Year: 2021

Issue: 11

Volume: 37

2 . 1 0 0

JCR@2022

ESI Discipline: COMPUTER SCIENCE;

ESI HC Threshold:87

JCR Journal Grade:2

Cited Count:

WoS CC Cited Count: 22

SCOPUS Cited Count:

ESI Highly Cited Papers on the List: 0 Unfold All

WanFang Cited Count:

Chinese Cited Count:

30 Days PV: 2

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