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

Abstract
Figure/Table
References (0)
Related Citation (3)

Download: PDF (2388 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

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

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Qiao Aike^1#*Hou Yingying¹ Hou Yang^2

Cite this article:

Qiao Aike^1#*Hou Yingying¹ Hou Yang^2. Finite Element Analysis of the Influence of Morphology of Coronary Artery Stenosis on Fractional Flow Reserve[J]. journal1, 2015, 34(2): 198-203.

URL:

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

［1］林运，白净. 冠状动脉粥样硬化性心脏病预防研究现状［J］. 中国循证心血管医学杂志,2009,1(4):252-253.
［2］陈中青，贾邵斌，房瑞祥. 经胸超声心动图测定管状动脉血流储备对冠脉狭窄的诊断价值［J］. 宁夏医科大学学报,2009, 31(3):302-304.
［3］刘亚斌，韩雅玲，荆全民，等. 4种无创性检查及其组合对冠心病诊断的辅助作用研究［J］. 中国实用内科杂志,2011,31(12):930-933. 
［4］张永珍，郭丽君. 冠脉内血流动力学检测基础及临床应用研究进展［J］. 临床内科杂志,2010,27（7）：443-445.
［5］杨娅，李治安，王丽君. 无创性冠状动脉血流显像检测冠状动脉血流储备在冠状动脉造影正常患者中的临床应用研究［J］. 临床超声医学杂志, 2006,8(3): 139-142.
［6］Taylor CA, Fonte TA, Min JK, et al. Computational fluid dynamics applied to cardiac computed tomography for noninvasive quantification of fractional flow reserve ［J］. Journal of the American College of Cardiology, 2013, 61 (22): 2233-2241.
［7］魏广和,李清贤,李桂玲，等. 冠心病无创性检查与冠状动脉造影诊断价值的对比分析［J］. 济宁医学院学报,2004,27(3):28-29.
［8］龙曼云,综述,朱立光. 冠心病无创性检查的研究进展［J］. 心血管病进展, 2007,28(3).477-480.
［9］Nakazato R, Park HB, Berman DS, et al. Noninvasive fractional flow reserve derived from CT angiography (FFR-CT) for coronary lesions of intermediate stenosis severity: results from the DeFACTO study ［J］. Journal of the American Heart Association, 2013, 6(6)： 881-889.
［10］Manesh R, Patel MD. Detecting obstructive coronary disease with
CT angiography and noninvasive fractional flow reserve ［J］. Journal of the American Medical Association, 2012, 12(308):1269-1270.
［11］王勇. 心肌血流储备分数在冠心病诊断及介入治疗中的应用［J］. 国际心血管病杂志,2010,37(2):65-71.
［12］Hamilos M, Peace A, Kochiadakis G, et al. Fractional flow reserve An indispensable diagnostic tool in the cardiac catheterization laboratory ［J］. Hellenic J Cardiol, 2010, 51(2):133-141.
［13］Pijls NH, Vanson JA, Kirkeeide RL, et al. Experimental basis of determining maximum coronary, myocardial, and collateral blood flow by pressure measurements for assessing functional stenosis severity before and after percutaneous transluminal coronary angioplasty［J］. Circulation, 1993, 87(4):1354－1367.
［14］李飞，孙红梅，高峰，等. 血流储备分数测定在多支多处冠状动脉病变的应用［J］. 昆明医科大学学报，2013，34(5):117-120.
［15］张俊杰，陈绍良. 血流储备分数在冠心病介入诊治中的应用国外医学［J］. 心血管疾病分册, 2004,05:273-275.
［16］Koo BK, Erglis A, Doh JH, et al. Diagnosis of ischemiacausing coronary stenosis by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms. ［J］. Journal of the American College of Cardiology, 2011, 58 (19):1989-1997.
［17］James K, Min JK, Leipsic J, et al. Diagnostic accuracy of fractional flow reserve from anatomic CT angiography ［J］. Journal of the American Medical Association, 201212(308):1237-1245.
［18］李建平. 冠脉血流储备分数［D］. 北京：北京大学第一医院, 2010.
［19］初博, 乔爱科. 搭桥术治疗DeBakey Ⅲ型主动脉夹层的流固耦合数值模拟［J］. 医用生物力学，2012，27(4):386-391.
［20］Sun A, Fan Y, Deng X. Numerical study of hemodynamics at coronary bifurcation with and without swirling flow ［C］// 6th World Congress of Biomechanics (WCB 2010). Singapore: Springer Heidelberg, 2010: 1428-1430.
［21］陈曦，蒋文涛，樊瑜波，等. 药物洗脱支架连接筋对流场和浓度场影响的血流动力学数值研究［J］. 航天医学与医学工程，2010,23(6) : 440-444．
［22］史云桃，林松. 探讨心肌血流储备分数与心外膜冠状动脉狭窄程度相关性［J］. 黑龙江医药，2012,25(1):53-54.
［23］Van de Hoef TP, Nolte F, EchavarrlaPinto M, et al. Impact of hyperaemic microvascular resistance on fractional flow reserve measurements in patients with stable coronary artery disease: insights from combined stenosis and microvascular resistance assessment ［J］. Heart, 2014, 11(4):123-124.
［24］刘修健，蔺嫦燕. 冠脉分叉病变及支架后再狭窄的血流动力学研究进展［J］. 中国生物医学工程学报，2012, 31(3): 446-450.