Noninvasive Assessment of Fractional Flow Reserve Using Mathematical Modeling of Coronary Flow
https://doi.org/10.18087/cardio.2018.12.10164
Abstract
Nowadays an invasive evaluation of fractional flow reserve (FFR) is one of the main methods used for detecting lesions that cause ischemia. Invasively obtained FFR <0.75 has the specificity of 100 %, and FFR >0.80 has the sensitivity >90 %. Recent achievements in computational fluid dynamics and computer simulations allow noninvasive assessment of FFR using data obtained by CT angiography performed according to standard protocol at rest without additional radiation, modification of image acquisition protocols, or added medications for vasodilatation. The present review covers the results of the DISCOVER, the NXT, the DEFACTO and the PLATFORM randomized multicenter studies as well as the prospects of using a noninvasive method for measuring FFR developed by specialists of the Institute of Numerical Mathematics in collaboration with specialists of the I. M. Sechenov First Moscow State Medical University.
About the Authors
D. G. GognievaRussian Federation
Gognieva Daria G. - post-graduate student
A. L. Syrkin
Russian Federation
Yu. V. Vassilevski
Russian Federation
Dolgoprudny, Moscow
S. S. Simakov
Russian Federation
Dolgoprudny
A. V. Melerzanov
Russian Federation
Dolgoprudny, Shanghai
Liang Fuyou
China
A. A. Lomonosova
Russian Federation
A. A. Bykova
Russian Federation
H. E. El Manaa
Russian Federation
Ph. Yu. Kopylov
Russian Federation
References
1. Mironov V. M., Merkulov E. V., Samko A. N. Assessment of fractional coronary blood flow reserve. Kardiologiia 2012; 8; 66-71. Russian
2. Kopylov F. Yu., Bykova A. A., Vasilevsky Yu. V., Simakov S. S. Role of measurement of fractional flow reserve in coronary artery atherosclerosis. Therapeutic archive 2015;87(9):106-113. Russian
3. Pijls N. H., van Schaardenburgh P., Manoharan G. et al. Percutaneous coronary intervention of functionally nonsignificant stenosis: 5-year follow-up of the DEFER Study. J Am Coll Cardiol 2007;49: 1052111. DOI: http://dx.doi.org/10.1016/j.jacc.2007.01.087.
4. Pijls N. H., Fearon W. F., Tonino P. A. et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease: 2-year followup of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) study. J Am Coll Cardiol 2010;56:177-184. DOI: http://dx.doi.org/10.1016/jjacc.2010.04.012.
5. Tonino P. A., Fearon W. F., De Bruyne B. et al. Angiographic versus functional severity of coronary artery stenoses in the FAME study fractional flow reserve versus angiography in multivessel evaluation. J Am Coll Cardiol 2010;55:2816-2821.
6. Wijns W., Kolh P., Danchin N. et al. Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2010;31:2501-2555. DOI: http://dx.doi.org/10.1016/j.repce.2011.11.010.
7. Patel M. R., Dehmer G.J., Hirshfeld J. W. et al. ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: A Report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology: Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography. Circulation 2009;119:1330-1352.
8. Griffin B. P., Topol E.J. Cardiology. Moscow: Praktika Publishing House 2004;809-852p. Russian (Гриффин Б., Тополь Э. Кардиология. Москва: Издательство «Практика» 2004;809–852с).
9. Gaur S., Bezerra H. G., Christiansen E. H. et al. Reproducibility of Invasively Measured and Non-Invasively Computed Fractional Flow Reserve. J Am Coll Cardiol 2014;63 (12):1016-1097. Russian
10. Gamilov T. M., Kopylov Ph. Yu., Pryamonosov R. A., Simakov S. S. Virtual fractional flow reserve assessment in patient-specific coronary networks by 1D hemodynamic model. Russian J Numerical Analysis and Mathematical Modelling 2015;30 (5):269-276.
11. Vassilevski Yu., Gamilov T., Kopylov Ph. Personalized computation of fractional flow reserve in case of two consecutive stenoses. In: Proceedings of VII European Congress on Computational Methods in Applied Sciences and Engineering (M. Papadrakakis, V. Papadopoulos, G. Stefanou, V. Plevris ets.) Crete Island, Greece, 5-10 June 2016.
12. Simakov S. S., Gamilov T. M., Kopylov F. Yu., Vasilevsky Yu. V. Evaluation of hemodynamic significance of stenosis in multiple involvement of the coronary vessels by mathematical simulation. Bulletin of experimental biology and medicine 2016;162(7):128-132. Russian
13. Gamilov T., Kopylov Ph., Simakov S. In: Numerical Mathematics and Advanced Applications - ENUMATH 2015 (Bulent Karasozen, Murat Manguoglu, Munevver Tezer-Sezgin, Serdar Goktepe, Omur Ugur eds.). Lecture Notes in Computational Science and Engineering, Springer, 2016.
14. Bon-Kwon Koo, Andrejs Erglis, Joon-Hyung Doh et al. Diagnosis of Ischemia-Causing Coronary Stenoses by Noninvasive Fractional Flow Reserve Computed From Coronary Computed Tomographic Angiograms. Results From the Prospective Multicenter DISCOVER-FLOW (Diagnosis of Ischemia-Causing Stenoses Obtained Via Noninvasive Fractional Flow Reserve) Study. J Am Coll Cardiol 2011;19:1889-1997.
15. Hultena E., Ahmadic A., Blankstein R. CT Assessment of Myocardial Perfusion and Fractional Flow Reserve. Elsevier Inc. Progress in cardiovascular diseases. 2015 (http://dh.doi.org/10.1016/j.pcad.2015.03.003)
16. James K. Min, Bon-Kwon Koo, Andrejs Erglis et al. Usefulness of Noninvasive Fractional Flow Reserve Computed from Coronary Computed Tomographic Angiograms for Intermediate Stenoses Confirmed by Quantitative Coronary Angiography. Elsevier Inc 2012. http://dx.doi.org/10.1016/j.amjcard.2012.05.033(971-976).
17. Grunau G. L., Min J. K., Leipsic J. Modeling of Fractional Flow Reserve Based on Coronary CT Angiography. Cur Cardiol Reports 2013. http://link.springer.com/article/10.1007%2Fs11886-012-0336-0.
18. Min J. K., Leipsic J., Pencina M.J. et al. Diagnostic Accuracy of Fractional Flow Reserve from Anatomic CT Angiography. JAMA 2012;12:1237-1245.
19. Norgaard B. L., Leipsic J., Gaur S. et al. the NXT Trial Study Group. Diagnostic Performance of Noninvasive Fractional Flow Reserve Derived From Coronary Computed Tomography Angiography in Suspected Coronary Artery Disease. The NXT Trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps. J Am Coll Cardiol 2014;12:1145-1155.
20. Douglas P. S., De Bruyne B, Pontone G. et al. 1-Year Outcomes of FFRCT-Guided Care in Patients with Suspected Coronary Disease. The PLATFORM Study. J Am Coll Сardiol 2016;5:435-445.
21. Boileau E., Nithiarasu P. One-Dimensional Modelling of the Coronary Circulation. Application to Noninvasive Quantification of Fractional Flow Reserve (FFR). Computational and Experimental Biomedical Sciences: Methods and Applications 2015; 137-155.
22. Morris P. D., van de Vosse F. N., Lawford P. V. et al. “Virtual" (imputed) fractional flow reserve. Current challenges and limitations. JACC: Cardiovascular Interventions 2015;8:1009-1017.
23. Kim H.J., Vignon-Clementel I. E., Coogan J. S. et al. Patient-Specific Modeling of Blood Flow and Pressure in Human Coronary Arteries. Ann Biomed Engineering 2010;10:3195-3209.
Review
For citations:
Gognieva D.G., Syrkin A.L., Vassilevski Yu.V., Simakov S.S., Melerzanov A.V., Fuyou L., Lomonosova A.A., Bykova A.A., El Manaa H.E., Kopylov P.Yu. Noninvasive Assessment of Fractional Flow Reserve Using Mathematical Modeling of Coronary Flow. Kardiologiia. 2018;58(12):85-92. (In Russ.) https://doi.org/10.18087/cardio.2018.12.10164