“…Hyperemic microvascular resistance HMR involves the coronary microvasculature downstream from the lesion. It increases in situations such as diffuse coronary disease, acute myocardial infarction [24], cardiac hypertrophy [25] or reduced vasodilatory capacity [26]. Our mathematical model establishes that FFR increases with increasing HMR, all other parameters being equal, as reported by Meuwissen et al .…”
ObjectiveThe aim was threefold: 1) expound the independent physiological parameters that drive FFR, 2) elucidate contradictory conclusions between fractional flow reserve (FFR) and coronary flow reserve (CFR), and 3) highlight the need of both FFR and CFR in clinical decision making. Simple explicit theoretical models were supported by coronary data analyzed retrospectively.MethodologyFFR was expressed as a function of pressure loss coefficient, aortic pressure and hyperemic coronary microvascular resistance. The FFR-CFR relationship was also demonstrated mathematically and was shown to be exclusively dependent upon the coronary microvascular resistances. The equations were validated in a first series of 199 lesions whose pressures and distal velocities were monitored. A second dataset of 75 lesions with pre- and post-PCI measures of FFR and CFR was also analyzed to investigate the clinical impact of our hemodynamic reasoning.ResultsHyperemic coronary microvascular resistance and pressure loss coefficient had comparable impacts (45% and 49%) on FFR. There was a good concordance (y = 0.96 x − 0.02, r2 = 0.97) between measured CFR and CFR predicted by FFR and coronary resistances. In patients with CFR < 2 and CFR/FFR ≥ 2, post-PCI CFR was significantly >2 (p < 0.001), whereas it was not (p = 0.94) in patients with CFR < 2 and CFR/FFR < 2.ConclusionThe FFR behavior and FFR-CFR relationship are predictable from basic hemodynamics. Conflicting conclusions between FFR and CFR are explained from coronary vascular resistances. As confirmed by our results, FFR and CFR are complementary; they could jointly contribute to better PCI guidance through the CFR-to-FFR ratio in patients with coronary artery disease.
“…Hyperemic microvascular resistance HMR involves the coronary microvasculature downstream from the lesion. It increases in situations such as diffuse coronary disease, acute myocardial infarction [24], cardiac hypertrophy [25] or reduced vasodilatory capacity [26]. Our mathematical model establishes that FFR increases with increasing HMR, all other parameters being equal, as reported by Meuwissen et al .…”
ObjectiveThe aim was threefold: 1) expound the independent physiological parameters that drive FFR, 2) elucidate contradictory conclusions between fractional flow reserve (FFR) and coronary flow reserve (CFR), and 3) highlight the need of both FFR and CFR in clinical decision making. Simple explicit theoretical models were supported by coronary data analyzed retrospectively.MethodologyFFR was expressed as a function of pressure loss coefficient, aortic pressure and hyperemic coronary microvascular resistance. The FFR-CFR relationship was also demonstrated mathematically and was shown to be exclusively dependent upon the coronary microvascular resistances. The equations were validated in a first series of 199 lesions whose pressures and distal velocities were monitored. A second dataset of 75 lesions with pre- and post-PCI measures of FFR and CFR was also analyzed to investigate the clinical impact of our hemodynamic reasoning.ResultsHyperemic coronary microvascular resistance and pressure loss coefficient had comparable impacts (45% and 49%) on FFR. There was a good concordance (y = 0.96 x − 0.02, r2 = 0.97) between measured CFR and CFR predicted by FFR and coronary resistances. In patients with CFR < 2 and CFR/FFR ≥ 2, post-PCI CFR was significantly >2 (p < 0.001), whereas it was not (p = 0.94) in patients with CFR < 2 and CFR/FFR < 2.ConclusionThe FFR behavior and FFR-CFR relationship are predictable from basic hemodynamics. Conflicting conclusions between FFR and CFR are explained from coronary vascular resistances. As confirmed by our results, FFR and CFR are complementary; they could jointly contribute to better PCI guidance through the CFR-to-FFR ratio in patients with coronary artery disease.
“…According to Poiseuille’s Law, the velocity of the flow along the tube depends on the area of the cross section. Thus, the velocity of the flow increases abruptly while decreasing the diameter of the blood vessel 18 , 54 . Figure 5 ( a ) A simple model scheme of a stenosis artery (A: diameter of the artery, B: diameter of the artery in the stenosis region, and L: length of the stenosis), and ( b ) sinusoidal variable velocity profile.…”
In the new generation of blood velocimeter systems, considerable attention has been paid to atomic magnetometers due to their high resolution and high sensitivity for detection of magnetic tracers. Passing the magnetic tracers adjacent to the atomic magnetometer produces a spike-like signal, the shape of which depends on the position of the tracer, as well as its velocity and orientation. The present study aimed to evaluate the effect of abrupt variations in the instantaneous velocity of the magnetic tracer on the magnetometer response compare to constant velocity. Modeling the magnetic tracer as a dipole moment indicated that the velocity dependence of the magnetic field and local magnetic field gradient associated with moving magnetic tracer cause the spike-like signal to go out of symmetry in the case of variable velocity. Based on the experimental results, any instantaneous variation in tracer velocity leads to shrinkage in the signal width. The behavior has been studied for both magnetic microwire with variable instantaneous velocity and magnetic droplets in stenosis artery phantom. In addition, the position of the tracer could be detected by following the shrinkage behavior which may occur on the peak, valley, or both. These advantageous outcomes can be applied for high sensitivity diagnosis of arterial stenosis.
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