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首页> 外文期刊>Journal of Biomechanics >Guidewire flow obstruction effect on pressure drop-flow relationship in moderate coronary artery stenosis.
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Guidewire flow obstruction effect on pressure drop-flow relationship in moderate coronary artery stenosis.

机译：导线阻塞对中度冠状动脉狭窄中压降-流量关系的影响。

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摘要

To evaluate the local hemodynamic effects of coronary artery balloon angioplasty, computational fluid dynamics was applied to representative stenoses geometry post-angioplasty (minimal lesion diameter d(m) = 1.8mm which produced 64% mean area stenoses) based on a group of patients and measured values of coronary flow reserve (CFR) returning to a normal range (3.6+/-0.3). The computations were at mean flow rates (Q) of 50, 100, 150 and 170 ml/min. The study indicates changes in the hemodynamic conditions due to insertion of a guidewire, which can be used to determine the mean pressure drop (Deltap ) and fall in distal mean coronary pressure (p(r)), and thus give quantitative estimate of uncertainty expected in diagnosis of moderate lesions. The guidewire to minimal lesion diameter ratio is 0.26, causing tighter "artifactual" mean area stenoses of 65.5%. During hyperemia, p(m) dropped to 72 mmHg as compared to 75 mmHg under patho-physiological condition without guidewire. Q(h) (subscript h: hyperemia) decreased from 180 without guidewire to 170 ml/min with the guidewire present. Thus, there was a significant approximately 43% increase in Deltap(h) and a approximately 51% increase in the hyperemic flow resistance (R(h) = Deltap(h)/Q(h)) over the patho-physiological condition. This could cause an overestimation of the severity of the moderate stenoses. Transient and steady flow guidewire surface shear stress was 35-50% higher than corresponding values for arterial wall shear stress. The non-dimensional data given in tabular form may be useful in interpretation of clinical guidewire measurements for moderate lesions of similar geometry and size.
机译：为了评估冠状动脉球囊成形术的局部血流动力学影响，基于一组患者，将计算流体动力学应用于典型的狭窄血管成形术后的几何形状（最小病变直径d（m）= 1.8mm，产生64％的平均狭窄面积）。冠状动脉血流储备（CFR）的测量值恢复到正常范围（3.6 +/- 0.3）。计算是在50、100、150和170 ml / min的平均流速（Q）下进行的。研究表明，由于插入了导丝，血液动力学状况发生了变化，可用于确定平均压降（Deltap）和远端平均冠状动脉压（p（r）），从而对预期的不确定性进行定量估计诊断中度病变。导丝与最小病灶直径之比为0.26，导致“假象”平均狭窄狭窄65.5％。在充血期间，p（m）降至72 mmHg，而在没有导丝的病理生理条件下，p（m）降至75 mmHg。 Q（h）（下标h：充血）从没有导丝的180降至有导丝的170 ml / min。因此，在病理生理条件下，Deltap（h）明显增加了约43％，充血流阻（R（h）= Deltap（h）/ Q（h））则增加了约51％。这可能导致对中度狭窄的严重程度的高估。瞬态和稳定流导丝的表面剪应力比相应的动脉壁剪应力值高35-50％。以表格形式给出的无量纲数据可能有助于解释类似几何形状和大小的中度病变的临床导丝测量。

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