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Estimation of coronary artery hyperemic blood flow based on arterial lumen volume using angiographic images.

Molloi S, Chalyan D, Le H, Wong JT - Int J Cardiovasc Imaging (2011)

Bottom Line: Using densitometry, the results showed that the stem hyperemic flow (Q) and the associated crown lumen volume (V) were related by Q = 159.08 V(3/4) (r = 0.98, SEE = 10.59 ml/min).The stem hyperemic flow and the associated crown length (L) using cone-beam CT were related by Q = 2.89 L (r = 0.99, SEE = 8.72 ml/min).This, in conjunction with measured hyperemic flow in the presence of a stenosis, could be used to predict fractional flow reserve based entirely on angiographic data.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiological Sciences, University of California, Medical Sciences B, B-140, Irvine, CA 92697, USA. symolloi@uci.edu

ABSTRACT
The purpose of this study is to develop a method to estimate the hyperemic blood flow in a coronary artery using the sum of the distal lumen volumes in a swine animal model. The limitations of visually assessing coronary artery disease are well known. These limitations are particularly important in intermediate coronary lesions where it is difficult to determine whether a particular lesion is the cause of ischemia. Therefore, a functional measure of stenosis severity is needed using angiographic image data. Coronary arteriography was performed in 10 swine (Yorkshire, 25-35 kg) after power injection of contrast material into the left main coronary artery. A densitometry technique was used to quantify regional flow and lumen volume in vivo after inducing hyperemia. Additionally, 3 swine hearts were casted and imaged post-mortem using cone-beam CT to obtain the lumen volume and the arterial length of corresponding coronary arteries. Using densitometry, the results showed that the stem hyperemic flow (Q) and the associated crown lumen volume (V) were related by Q = 159.08 V(3/4) (r = 0.98, SEE = 10.59 ml/min). The stem hyperemic flow and the associated crown length (L) using cone-beam CT were related by Q = 2.89 L (r = 0.99, SEE = 8.72 ml/min). These results indicate that measured arterial branch lengths or lumen volumes can potentially be used to predict the expected hyperemic flow in an arterial tree. This, in conjunction with measured hyperemic flow in the presence of a stenosis, could be used to predict fractional flow reserve based entirely on angiographic data.

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A coronary angiogram showing the definition of stems and crowns
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Fig1: A coronary angiogram showing the definition of stems and crowns

Mentions: Various possible theoretical explanations for the coronary arterial tree design include the principles of minimum work [25, 26], optimal design [27], minimum blood volume [28] and minimum total shear force on the vessel wall [29]. Irrespective of the underlying design principles, previous studies have observed relationships between coronary blood flow (Q) and oxygen consumption or metabolic need [30]; coronary blood flow and myocardial mass (M) [31]; and myocardial mass and the cumulative arterial branch lengths (L) or crown lumen volume (V) that supply it [20, 21]. In investigating the design of the coronary arterial system, the coronary arterial tree can be recursively decomposed into stem and crown subunits, where a stem is defined as any segment between two consecutive bifurcation (or trifurcation) points, and the corresponding crown is defined as a collection of all the branches distal to the stem whose terminals consist of the same diameter (see Fig. 1). Using this decomposition of the coronary arterial tree, previous reports have shown the following relationships [22, 24, 32]:1\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\text{Q}} = {\text{k}}_{\text{L}} {\text{L}} $$\end{document}2\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\text{L}} = {\text{k}}_{\text{LV}} \left( {{\frac{\text{V}}{{{\text{V}}_{\text{ref}} }}}} \right)^{3/4} $$\end{document}3\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\text{Q}} = {\text{k}}_{\text{V}} \left( {{\frac{\text{V}}{{{\text{V}}_{\text{ref}} }}}} \right)^{3/4} $$\end{document}Fig. 1


Estimation of coronary artery hyperemic blood flow based on arterial lumen volume using angiographic images.

Molloi S, Chalyan D, Le H, Wong JT - Int J Cardiovasc Imaging (2011)

A coronary angiogram showing the definition of stems and crowns
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3094746&req=5

Fig1: A coronary angiogram showing the definition of stems and crowns
Mentions: Various possible theoretical explanations for the coronary arterial tree design include the principles of minimum work [25, 26], optimal design [27], minimum blood volume [28] and minimum total shear force on the vessel wall [29]. Irrespective of the underlying design principles, previous studies have observed relationships between coronary blood flow (Q) and oxygen consumption or metabolic need [30]; coronary blood flow and myocardial mass (M) [31]; and myocardial mass and the cumulative arterial branch lengths (L) or crown lumen volume (V) that supply it [20, 21]. In investigating the design of the coronary arterial system, the coronary arterial tree can be recursively decomposed into stem and crown subunits, where a stem is defined as any segment between two consecutive bifurcation (or trifurcation) points, and the corresponding crown is defined as a collection of all the branches distal to the stem whose terminals consist of the same diameter (see Fig. 1). Using this decomposition of the coronary arterial tree, previous reports have shown the following relationships [22, 24, 32]:1\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\text{Q}} = {\text{k}}_{\text{L}} {\text{L}} $$\end{document}2\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\text{L}} = {\text{k}}_{\text{LV}} \left( {{\frac{\text{V}}{{{\text{V}}_{\text{ref}} }}}} \right)^{3/4} $$\end{document}3\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\text{Q}} = {\text{k}}_{\text{V}} \left( {{\frac{\text{V}}{{{\text{V}}_{\text{ref}} }}}} \right)^{3/4} $$\end{document}Fig. 1

Bottom Line: Using densitometry, the results showed that the stem hyperemic flow (Q) and the associated crown lumen volume (V) were related by Q = 159.08 V(3/4) (r = 0.98, SEE = 10.59 ml/min).The stem hyperemic flow and the associated crown length (L) using cone-beam CT were related by Q = 2.89 L (r = 0.99, SEE = 8.72 ml/min).This, in conjunction with measured hyperemic flow in the presence of a stenosis, could be used to predict fractional flow reserve based entirely on angiographic data.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiological Sciences, University of California, Medical Sciences B, B-140, Irvine, CA 92697, USA. symolloi@uci.edu

ABSTRACT
The purpose of this study is to develop a method to estimate the hyperemic blood flow in a coronary artery using the sum of the distal lumen volumes in a swine animal model. The limitations of visually assessing coronary artery disease are well known. These limitations are particularly important in intermediate coronary lesions where it is difficult to determine whether a particular lesion is the cause of ischemia. Therefore, a functional measure of stenosis severity is needed using angiographic image data. Coronary arteriography was performed in 10 swine (Yorkshire, 25-35 kg) after power injection of contrast material into the left main coronary artery. A densitometry technique was used to quantify regional flow and lumen volume in vivo after inducing hyperemia. Additionally, 3 swine hearts were casted and imaged post-mortem using cone-beam CT to obtain the lumen volume and the arterial length of corresponding coronary arteries. Using densitometry, the results showed that the stem hyperemic flow (Q) and the associated crown lumen volume (V) were related by Q = 159.08 V(3/4) (r = 0.98, SEE = 10.59 ml/min). The stem hyperemic flow and the associated crown length (L) using cone-beam CT were related by Q = 2.89 L (r = 0.99, SEE = 8.72 ml/min). These results indicate that measured arterial branch lengths or lumen volumes can potentially be used to predict the expected hyperemic flow in an arterial tree. This, in conjunction with measured hyperemic flow in the presence of a stenosis, could be used to predict fractional flow reserve based entirely on angiographic data.

Show MeSH
Related in: MedlinePlus