Effect of porous media of the stenosed artery wall to the coronary physiological diagnostic parameter: A computational fluid dynamic analysis

Govindaraju, Kalimuthu; Kamangar, Sarfaraz; Badruddin, Irfan Anjum; Viswanathan, Girish; Badarudin, A.; Salman, Ahmet Bedii

doi:10.1016/j.atherosclerosis.2014.01.043

Cited by 30 publications

(9 citation statements)

References 36 publications

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“…In line with our studies, the importance of a combined approach of assessing both coronary pressure and flow has been reported by others as basis for the understanding of coronary physiology (van de Hoef et al, 2012;Shlofmitz and Jeremias, 2017;Gould, 2018;Stegehuis et al, 2018). In recent years, CDPs have been recognized as possible alternate coronary diagnostic parameters by other researchers (Govindaraju et al, 2014;Drenjancevic et al, 2015;Fearon, 2015;Johnson et al, 2015;Garcia et al, 2019).…”

Section: Introductionsupporting

confidence: 87%

Comparison Between 5- and 1-Year Outcomes Using Cutoff Values of Pressure Drop Coefficient and Fractional Flow Reserve for Diagnosing Coronary Artery Diseases

et al. 2021

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BackgroundThe current pressure-based coronary diagnostic index, fractional flow reserve (FFR), has a limited efficacy in the presence of microvascular disease (MVD). To overcome the limitations of FFR, the objective is to assess the recently introduced pressure drop coefficient (CDP), a fundamental fluid dynamics-based combined pressure–flow index.MethodsWe hypothesize that CDP will result in improved clinical outcomes in comparison to FFR. To test the hypothesis, chi-square test was performed to compare the percent major adverse cardiac events (%MACE) at 5 years between (a) FFR < 0.75 and CDP > 27.9 and (b) FFR < 0.80 and CDP > 25.4 groups using a prospective cohort study. Furthermore, Kaplan–Meier survival curves were compared between the FFR and CDP groups. The results were considered statistically significant for p < 0.05. The outcomes of the CDP arm were presumptive as clinical decision was solely based on the FFR.ResultsFor the complete patient group, the %MACE in the CDP > 27.9 group (10 out of 35, 29%) was lower in comparison to the FFR < 0.75 group (11 out of 20, 55%), and the difference was near significant (p = 0.05). The survival analysis showed a significantly higher survival rate (p = 0.01) in the CDP > 27.9 group (n = 35) when compared to the FFR < 0.75 group (n = 20). The results remained similar for the FFR = 0.80 cutoff. The comparison of the 5-year MACE outcomes with the 1-year outcomes for the complete patient group showed similar trends, with a higher statistical significance for a longer follow-up period of 5 years.ConclusionBased on the MACE and survival analysis outcomes, CDP could possibly be an alternate diagnostic index for decision-making in the cardiac catheterization laboratory.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT01719016.

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Section: Introductionsupporting

confidence: 87%

Comparison Between 5- and 1-Year Outcomes Using Cutoff Values of Pressure Drop Coefficient and Fractional Flow Reserve for Diagnosing Coronary Artery Diseases

et al. 2021

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“…where λ (time constant) = 3.313s; n(power law index) = 0.3568, μ 0 (low shear viscosity) = 0.56P, μ ∞ (high shear viscosity) = 0.0345P and the density of the blood (ρ) is assumed as 1050 kg/m 3 (Govindaraju et al 2014;Peelukhana et al 2009). Finite volume software ANSYS CFX 14.5 (ANSYS Inc) was used for flow simulations.…”

Section: Computational Modellingmentioning

confidence: 99%

The Influence of Geometrical Shapes of Stenosis on the Blood Flow in Stenosed Artery

Kamangar

Badruddin

Ahamad

et al. 2017

JSM

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The present work was carried out to investigate the blood flow behavior and the severity of blockage caused in the arterial passage due to the different geometries such as elliptical, trapezium and triangular shapes of stenosis. The study was conducted with respect to various sizes of stenosis in terms of 70%, 80% and 90% area blockage of the arterial blood flow. The study was carried out numerically with the help of advance computational fluid dynamic software. It was found that the shape of the stenosis plays an important role in overall pressure drop across the blockage region of artery. The highest level of pressure drop was observed for trapezoidal shape of stenosis followed by elliptical and then by triangular shaped stenosis. The wall shear stress across the stenosis is great for trapezoidal shape followed by triangular and elliptical stenosis for same blockage area in the artery.

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“…Plenty of research concentrating on the grey zone reported that the FFR value has been recorded with variation due to the insertion of guide wire [10] and downstream collateral flows [11] and by some other factors such as microvascular resistance, aortic and coronary outflow pressure [12], porous arterial wall [13], and blood flow through arterial wall compliance, and plaque characteristics significantly affect the FFR value [14] thus giving rise to the misinterpretation of the functional severity of the stenosis in the grey zone. It is also reported that the length of lesion and diameter are important geometrical variables which significantly affect the FFR.…”

Section: Introductionmentioning

confidence: 99%

Numerical Investigation of the Effect of Stenosis Geometry on the Coronary Diagnostic Parameters

Kamangar

Govindaraju

Badruddin

et al. 2014

The Scientific World Journal

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The present study deals with the functional severity of a coronary artery stenosis assessed by the fractional flow reserve (FFR). The effects of different geometrical shapes of lesion on the diagnostic parameters are unknown. In this study, 3D computational simulation of blood flow in three different geometrical shapes of stenosis (triangular, elliptical, and trapezium) is considered in steady and transient conditions for 70% (moderate), 80% (intermediate), and 90% (severe) area stenosis (AS). For a given percentage AS, the variation of diagnostic parameters which are derived from pressure drop across the stenosis was found in three different geometrical shapes of stenosis and it was observed that FFR is higher in triangular shape and lower in trapezium shape. The pressure drop coefficient (CDP) was higher in trapezium shape and lower in triangular model whereas the LFC shows opposite trend. From the clinical perspective, the relationship between percentage AS and FFR is linear and inversely related in all the three models. A cut-off value of 0.75 for FFR was observed at 76.5% AS in trapezium model, 79.5% in elliptical model, and 82.7% AS for the triangular shaped model. The misinterpretation of the functional severity of the stenosis is in the region of 76.5%-82.7 % AS from different shapes of stenosis models.

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Effect of porous media of the stenosed artery wall to the coronary physiological diagnostic parameter: A computational fluid dynamic analysis

Cited by 30 publications

References 36 publications

Comparison Between 5- and 1-Year Outcomes Using Cutoff Values of Pressure Drop Coefficient and Fractional Flow Reserve for Diagnosing Coronary Artery Diseases

Comparison Between 5- and 1-Year Outcomes Using Cutoff Values of Pressure Drop Coefficient and Fractional Flow Reserve for Diagnosing Coronary Artery Diseases

The Influence of Geometrical Shapes of Stenosis on the Blood Flow in Stenosed Artery

Numerical Investigation of the Effect of Stenosis Geometry on the Coronary Diagnostic Parameters

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