Computational fluid dynamics as supporting technology for coronary artery disease diagnosis and treatment: an international survey

Abstract

BackgroundComputational fluid dynamics (CFD) is emerging as an effective technology able to improve procedural outcomes and enhance clinical decision-making in patients with coronary artery disease (CAD). The present study aims to assess the state of knowledge, use and clinical acceptability of CFD in the diagnosis and treatment of CAD.MethodsWe realized a 20-questions international, anonymous, cross-sectional survey to cardiologists to test their knowledge and confidence on CFD as a technology applied to patients suffering from CAD. Responses were recorded between May 18, 2022, and June 12, 2022.ResultsA total of 466 interventional cardiologists (mean age 48.4 ± 8.3 years, males 362), from 42 different countries completed the survey, for a response rate of 45.9%. Of these, 66.6% declared to be familiar with the term CFD, especially for optimization of existing interventional techniques (16.1%) and assessment of hemodynamic quantities related with CAD (13.7%). About 30% of respondents correctly answered to the questions exploring their knowledge on the pathophysiological role of some CFD-derived quantities such as wall shear stress and helical flow in coronary arteries. Among respondents, 85.9% would consider patient-specific CFD-based analysis in daily interventional practice while 94.2% declared to be interested in receiving a brief foundation course on the basic CFD principles. Finally, 87.7% of respondents declared to be interested in a cath-lab software able to conduct affordable CFD-based analyses at the point-of-care.ConclusionsInterventional cardiologists reported to be profoundly interested in adopting CFD simulations as a technology supporting decision making in the treatment of CAD in daily practice.

Predicting Lipid-Rich Plaque Progression in Coronary Arteries Using Multimodal Imaging and Wall Shear Stress Signatures

“…The findings of this work contribute to pointing out the translational potential of CFD as a technology able to provide insights into vascular biology and to support decision-making in the treatment of CAD in daily clinical practice. 43 , 44 The current computer power and the increasingly realistic, personalized computer simulation of coronary hemodynamics enable to capture complex WSS signatures influencing coronary vascular pathogenesis, 21 , 43 highlighting regions at risk of plaque progression. Recent evidence demonstrating the feasibility of independent management by clinicians of CFD for CAD-related predictions, 21 combined with the profound interest recently expressed by interventional cardiologists in utilizing CFD simulations for the CAD management, 44 make the clinical translation of computational models a tangible near-future scenario.…”