冠状动脉狭窄几何构型对血流储备分数影响的有限元分析

doi:10.3969/j.issn.0258-8021. 2015. 02.010

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摘要探讨冠状动脉狭窄血管的不同几何构型对血流储备分数的影响，即狭窄率、狭窄长度、狭窄个数、狭窄弧度、狭窄偏移对血流储备分数的影响。利用三维建模软件，建立具有临床依据的、不同狭窄情况的冠脉血管；利用计算流体力学方法，对冠脉中的定常流动进行数值模拟，入口施加定常流速度，出口施加恒定压力；利用流体动力学虚拟仿真分析软件，进行有限元数值模拟，计算后得到狭窄血管远端和近端的压力和压差，进而分析不同模型的血流储备分数。通过对每个影响因素及其对应的血流储备分数进行分析，得到该因素对血流储备分数的影响大小。结果表明，狭窄率越大、狭窄长度越大、狭窄个数越多、狭窄形状不规则、狭窄偏移越大，该狭窄对应的血流储备分数值就越小，则该狭窄就越容易引起心肌缺血，其中狭窄率和狭窄个数的影响最大。当狭窄率超过70%、狭窄个数达到两个或者更多、形状出现不规则时，该段血管的血流储备分数值小于080的可能性就非常大，心肌缺血很有可能出现。狭窄率、狭窄长度、狭窄个数、狭窄弧度、狭窄偏移对血流储备分数的影响显著，其中对血流储备分数影响最大的是狭窄率和狭窄个数，而相邻狭窄之间的距离对其影响不明显。

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	乔爱科^1#*侯映映¹ 侯阳²

关键词 ：血流储备分数, 冠状动脉狭窄, 有限元分析, 血流动力学

Abstract：In this paper, the influence of morphology of coronary artery stenosis on fractional flow reserve(FFR) was investigated.The stenosis ratio, length, number, arc, and offset were included in the morphology of coronary artery stenosis.Different idealized models of coronary artery stenosis based on clinical data were established in Pro/Engineering. Numerical simulations were carried out to analyze the hemodynamic parameters of the models.A steady blood flow velocity was assigned at the inlet. A constant pressure was assigned at the outlet. The CFX finite element numerical simulation was used to calculate the models. Then the pressure value at the distal end and proximal end of the stenosis was extracted for FFR analysis. The influence of factors on FFR was investigated by analyzing each factors and their corresponding fractional flow reserve. The stenosis is more likely to cause myocardial ischemia when the stenosis has larger ratio, longer size, more number, more irregular shape and bigger offset. Among the factors, the stenosis ratio and length affect the FFR value more strongly.It will be likely to cause FFR less than 080 and lead to myocardial ischemia when the stenosis ratio surpasses 70%, the number of stenosis is more than two with irregular shapes. The stenosis ratio, length, number, stenosis arc, and the stenosis offset have significant effect on FFR where the stenosis ratio and the number of stenosis have the most significant influence, while the distance between adjacent stenosis has little influence on FFR.

Key words： fractional flow reserve coronary artery stenosis finite element analysis hemodynamics

基金资助:国家自然科学基金（81301221, 11472022）；辽宁省教育厅高等学校创新团队项目（LT2014017）

引用本文:

乔爱科^1#*侯映映¹ 侯阳². 冠状动脉狭窄几何构型对血流储备分数影响的有限元分析[J]. 中国生物医学工程学报, 2015, 34(2): 198-203.
Qiao Aike^1#*Hou Yingying¹ Hou Yang^2. Finite Element Analysis of the Influence of Morphology of Coronary Artery Stenosis on Fractional Flow Reserve. journal1, 2015, 34(2): 198-203.

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http://cjbme.csbme.org/CN/ 10.3969/j.issn.0258-8021. 2015. 02.010 或 http://cjbme.csbme.org/CN/Y2015/V34/I2/198

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