Background: Accurate functional diagnosis of coronary stenosis is vital for decision\nmaking in coronary revascularization. With recent advances in computational fluid\ndynamics (CFD), fractional flow reserve (FFR) can be derived non-invasively from coronary\ncomputed tomography angiography images (FFRCT) for functional measurement\nof stenosis. However, the accuracy of FFRCT is limited due to the approximate modeling\napproach of maximal hyperemia conditions. To overcome this problem, a new CFD\nbased non-invasive method is proposed.\nMethods: Instead of modeling maximal hyperemia condition, a series of boundary\nconditions are specified and those simulated results are combined to provide a\npressure-flow curve for a stenosis. Then, functional diagnosis of stenosis is assessed\nbased on parameters derived from the obtained pressure-flow curve.\nResults: The proposed method is applied to both idealized and patient-specific\nmodels, and validated with invasive FFR in six patients. Results show that additional\nhemodynamic information about the flow resistances of a stenosis is provided, which\ncannot be directly obtained from anatomy information. Parameters derived from the\nsimulated pressure-flow curve show a linear and significant correlations with invasive\nFFR (r > 0.95, P < 0.05).\nConclusion: The proposed method can assess flow resistances by the pressure-flow\ncurve derived parameters without modeling of maximal hyperemia condition, which is\na new promising approach for non-invasive functional assessment of coronary stenosis
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