cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2021.7.n1540cardio-1540Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИRESEARCH ARTICLESОценка фракционного резерва кровотока по данным компьютерной томографии: сравнение расчетных показателей с результатами инвазивных измеренийEvaluation of the Fractional Flow Reserve by Computer Tomography Data: Comparison of the Calculated Parameters with the Results of Invasive Measurementshttps://orcid.org/0000-0001-8319-3714ВеселоваТ. Н.VeselovaT. N.

дмн, ведущий научный сотрудник отдела томографии

 

Tomograthy depertmant, Leading Researcher

tnikveselova@gmail.comhttps://orcid.org/0000-0003-4374-1063ТерновойС. К.TernovoyS. K.

академик РАН, руководитель отдела томографии «НМИЦ кардиологии», зав. кафедрой лучевой диагностики и терапии Сеченовского Университета.

 

prof_ternovoy@list.ruhttps://orcid.org/0000-0001-8959-6119ЧеповскийА. М.ChepovskiyA. M.

 профессор кафедры Информационных технологий

 

 

professor of Department of Information technology

achepovskiy@hse.ruБорисенкоВ. В.BorisenkoV. V.

к.ф.-м. н., PhD (Math.),  механико-математический факультет, ведущий научный сотрудник.

 

Leading Researcher, PhD (Math.)

vladimir_borisen@mail.ruhttps://orcid.org/0000-0002-7838-584XГавриловА. В.GavrilovA. V.

заведующий лабораторией медицинских компьютерных систем 

Head of the Laboratory of Medical Computer Systems

 

Agavrilov4@gmail.comhttps://orcid.org/0000-0002-4678-060XБлагосклоноваЕ. Р.BlagosklonovaE. R.

научный сотрудник

research scientis

evrobsp@gmail.comhttps://orcid.org/0000-0002-5538-1109ДолотоваД. Д.DolotovaD. D.

ведущий научный сотрудник

Lead researcher, PhD (Med)

 

daria_dolotov@gmail.comhttps://orcid.org/0000-0002-2323-4059МироновВ. М.MironovV. M.

отдел рентгенэндоваскулярных методов диагностики и лечения, врач по рентгенэндоваскулярным диагностике и лечению, к.м.н.

Department of X-ray endovascular diagnostic and treatment methods, doctor for X-ray endovascular diagnosis and treatment, Ph.D

mironovangio@yandex.ruhttps://orcid.org/0000-0001-8600-3189АрутюнянГ. К.ArutyunyanG. K.

мл.н.с. отдела рентгенэндоваскулярных методов диагностики и лечения

 

junior researcher Department of X-ray Endovascular Diagnostic and Treatment Methods

argoar@yandex.ruФГБУ "Национальный медицинский исследовательский центр кардиологии" Минздрава России, МоскваРоссияNational medical research Center of cardiology of the Ministry of Healthcare of Russia, MoscowRussian FederationФГБУ "Национальный медицинский исследовательский центр кардиологии" Минздрава России, Москва ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский университет), Москва, РоссияРоссияNational medical research Center of cardiology of the Ministry of Healthcare of Russia, Moscow; Sechenov First Moscow State Medical University (Sechenov University), MoscowRussian FederationФГАОУ ВО "Российский университет Дружбы Народов" (РУДН), МоскваРоссияPeoples Friendship University of Russia (RUDN University), MoscowRussian FederationФГАОУ ВО "Московский государственный университет им. М.В. Ломоносова", МоскваРоссияLomonosov Moscow State University, MoscowRussian FederationООО «Гаммамед-Софт», МоскваРоссияGammamed-Soft, Ltd, MoscowRussian FederationФГБУ "Национальный медицинский исследовательский центр кардиологии" Минздрава России, МоскваРоссияNational Medical Research Centre for Therapy and Preventive Medicine, MoscowRussian Federation2021310720216172835Copyright © Kardiomag, 20212021KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/1540

Цель    Создание трехмерной математической модели коронарного кровотока у больных ишемической болезнью сердца по данным компьютерной томографической ангиографии (КТА) с последующим расчетом фракционного резерва кровотока (ФРККТА) и сопоставление расчетного ФРККТА с референтными значениями ФРК, измеренными инвазивно во время проведения коронарной ангиографии (КАГ).

Материал и методы  В исследование включены 10 больных с «пограничными» (50–75 %) стенозами по данным КТА, выполненной на 640‑срезовом компьютерном томографе. На основании данных КТА построены трехмерные математические модели коронарных артерий для дальнейшего расчета ФРККТА. Впоследствии всем больным было выполнено инвазивное измерение ФРК (ФРКИНВ). Значение ФРК <0,8 указывало на гемодинамическую значимость стеноза.

Результаты   Значения ФРККТА и ФРКИНВ в большинстве случаев (n=9) отличались незначительно и только в одном случае превышали 5 %. Регрессионный анализ показал тесную корреляцию расчетных и инвазивно измеренных значений ФРК.

Заключение     Предварительные результаты показали хорошую сопоставимость расчетных и инвазивно измеренных значений ФРК. Поэтому дальнейшая разработка методики математического моделирования объемного кровотока по данным КТА является перспективным направлением отечественной кардиологии. Неинвазивная оценка ФРК особенно актуальна для анализа гемодинамической значимости «пограничных» (50–75 %) стенозов в коронарных артериях.

Aim      To create a three-dimensional mathematical model of coronary flow in patients with ischemic heart disease based on findings of computed tomography angiography (CTA) with subsequent calculation of the fractional flow reserve (FFRCTA) and comparison of estimated FFRCTA with FFR reference values measured by coronary angiography (CAG).Material and methods  The study included 10 patients with borderline stenosis (50–75 %) as determined by CTA performed with a 640‑slice CT-scanner. Based on CTA findings, three-dimensional mathematical models were constructed for further calculation of FFRCTA. Later, an invasive measurement of FFR (FFRINV) was performed for all patients. FFR values <0.8 indicated the hemodynamic significance of stenosis.Results FFRCTA and FFRINV values differed insignificantly in most cases (n=9) and exceeded 5% in only one case. The regression analysis showed a close correlation between estimated and invasively measured FFR values.Conclusion      Preliminary results showed a good consistency of calculated and measured FFR values. Therefore, further development of the method for mathematical modeling of three-dimensional blood flow by CTA findings is promising. Noninvasive evaluation of FFR is particularly relevant for analysis of hemodynamic significance of borderline (50–75 %) coronary stenoses. 

 

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The authors declare that there are no conflicts of interest present.