北京生物醫(yī)學工程

冠狀動脈狹窄幾何特征參數(shù)影響跨狹窄壓力損失的統(tǒng)計學分析

Statistical analysis on geometric characteristic parameters of coronarystenosis affecting the cross-stenosis pressure loss

作者：邵圣達周鑫鑫丁永鑫張佳玉耿佃橋

單位：東北大學冶金學院(沈陽 110819) <p>東北大學材料電磁過程研究教育部重點實驗室(沈陽110819)<br />通信作者:耿佃橋,副教授。E-mail: [email protected]</p>

關鍵詞：冠狀動脈狹窄；血流儲備分數(shù)；數(shù)值模擬；正交試驗；方差分析

分類號：R318.01

出版年·卷·期（頁碼）：2023·42·2（158-163）

摘要：

目的分析狹窄偏移、管腔離心率、狹窄彎曲度對跨狹窄壓力損失的影響,篩選其中關鍵幾何特征參數(shù)。方法本研究采用計算流體力學方法對不同幾何特征參數(shù)下冠狀動脈狹窄段內的血液流動開展數(shù)值模擬。基于模擬所得跨狹窄壓力損失開展統(tǒng)計學分析,考察了各幾何特征參數(shù)對跨狹窄壓力損失的主效應及彼此間的交互效應。結果狹窄偏移及狹窄彎曲度對跨狹窄壓力損失影響顯著:狹窄偏移與狹窄率、狹窄彎曲度與狹窄長度、狹窄彎曲度與狹窄率交互效應顯著:管腔離心率對跨狹窄壓力損失的影響一定范圍內可忽略。結論本研究結果可為現(xiàn)有冠狀動脈計算機斷層掃描血流儲備分數(shù)經驗公式引入新的幾何特征參數(shù)提供理論基礎。

Objective This study aims to analyze the effects of stenosis offset , lumen eccentricity andstenosis curvature on the cross-stenosis pressure loss, and select the key geometric characteristic parametersMethods In this study ,the computational fluid dynamics ( CFD) method was used to simulate the blood flow inthe coronary stenosis section under different geometric characteristic parameters. Based on the simulated cross:stenosis pressure loss statistical analysis was carried out to investigate the main effect of geometric characteristi(parameters on cross-stenosis pressure loss and the interaction effect between parameters. Results The stenosis offset and stenosis curvature had a significant effect on thesignificantcross-stenosis pressureloss. Therewereinteraction effects between stenosis offset andstenoslsrate , stenosis curvature and stenosis length , and stenosisstenosis rate. The effects of lumencurvature andeccentricity on the cross-stenosis pressure lloss could be ignored within a certain range.Conclusions This work may provide a theoretical basis for introducing newgeometric characteristic parameters into the existing empirical equation of computed tomography angiography.derived fractional flow reserve ( FFR_CT).

參考文獻：

[1]Gutierrez-Barrios A, Noval-Morillas l, Camacho-Freire S, et al.Contrast FFR plus intracoronary injection of nitroglycerineaccurately predicts FFR for coronaryfunctionalstenosisassessment[ J ]. Minerva Cardioangiologica, 2020，69 ( 4 ):449-457
[2] Kim SE,Suh JW.血流儲備分數(shù)的驗證[M]// Hong MK.冠狀動脈影像與生理學.陳暉姚道闊,譯.上海:上海科學技術出版社,2020:174-180.

[3]De Bruyne B,Fearon WF,Pijls NH,et al. Fractional flow reserve-guided PCI for stable coronary artery disease [ J]. The NewEngland Journal of Medicine ,2014 ,371( 13):1208-1217.

[4]Yang DH,Kim YH,Roh JH,et al. Diagnostic performance of on-site CT-derived fractional flow reserve versus CT perfusion[ J].European Heart Journal-Cardiovascular Imaging, 2017,18 ( 4):432-440.
[ 5]Tesche C, De Cecco CN, Albrecht MH, et al. Coronary CTangiography-derived fractional flow reserve[ J]. Radiology ,2017285(1):17-33.
Choi JH,Jeon KH,Kim HY.無創(chuàng)評估心肌缺血[M]// HongMK.冠狀動脈影像與生理學.陳暉,姚道闊,譯.上海:上海科學技術出版社.2020:237-249

[7]Itu L,Rapaka S,Passerini T,et al. A machine-learning approachfor computation of fractional flow reserve from coronary computedtomography[J]. Journal of Applied Physiology , 2016 , 121 ( 1 ) :42-52.
[8]Pijls NH,van Son JA ,Kirkeeide RL,et al. Experimental basis of81determining maximum coronary , myocardial , and collateral bloodflow by pressure measurements for assessing functional stenosisseverity before and after percutaneous transluminalcoronaryangioplasty[J].Circulation,199387(4):1357-1367
[9]Pijls NH,De Bruyne B,Peels K,et al. Measurement of fractionalflow reserve to assess the functional severity of coronary-arterystenoses[J]. The New England Journal of Medicine, 1996, 334(26):1703-1708.
[10]Young DF, Cholvin NR, Kirkeeide RL, et al. Hemodynamics ofarterial stenoses at elevated flow rates[ J]. Circulation Research1977,41( 1) ;99-107.
[11]Koo BK,Lee JM侵人性冠狀動脈生理學;聚焦血流儲備分數(shù)[M]// Hong MK.冠狀動脈影像與生理學.陳暉,姚道闊,譯上海:上海科學技術出版社,2020:160-166.
[12]Kern M], Samady H. Current concepts of integrated coronaryphysiology in the catheterization laboratory [ J]. Journal of theAmerican College of Cardiology ,2010 ,55( 3) :173-185.柳景華,呂樹錚,杜杰,等.冠心病:解剖、功能及影像學[M]137北京:中國協(xié)和醫(yī)科大學出版社,2013;42-49,171.Liu JH, Lyu SZ, Du J, et al. Coronary artery disease: anatomy ,function and imaging[ M]. Beijing: Peking Union Medical CollegePress,2013:42-49,171.
[14]侯映映.冠狀動脈狹窄的血流儲備分數(shù)有限元分析研究[D]北京:北京工業(yè)大學,2015.
Hou YY. Finite element analysis of fractional flow reserve of thecoronary artery stenosis[ D ]. Beijing: Beijing University of Technology,2015
[15]初博.搭橋術治療 DeBakey 亞型主動脈夾層的流固耦合數(shù)值模擬研究[D].北京:北京工業(yè)大學,2011.
Chu B. FSI simulation of bypassed DeBakey lll aortic dissection[ D]. Beijing: Beijing University of Technology ,2011.

[16]陳曦,蔣文濤,樊瑜波,等.藥物洗脫支架連接筋對流場和濃度場影響的血流動力學數(shù)值研究[J].航天醫(yī)學與醫(yī)學工程2010,23(6):440-444.
Chen X, Jiang WT, Fan YB, et al. Numerical investigation ofeffects of drug-eluting stent link on flow field and concentrationfield of hemoynamics[ J ]. Space Medicine & MedicalEngineering,2010,23(6):440-444.
[17]Klocke FJ. Measurements of coronary blood flow and degree ofstenosis ; current clinical implications and continuing uncertainties[J]. Journal of the American College of Cardiology ,1983 , 1( 1) :31-41.
[18]郭新梅.正交試驗設計應用要點及其 DPS 實施[J]現(xiàn)代農業(yè)科技,2012(3):40-41,44.
Cuo XM. Key points on orthogonal test design and application ofDPS[J]. Modern gricultural Science and Technology, 2012(3) :40-41,44.

服務與反饋：

【文章下載】【加入收藏】

提示：您還未登錄，請登錄！點此登錄

51黑料吃瓜在线观看,51黑料官网|51黑料捷克街头搭讪_51黑料入口最新视频