Validation of Wall Shear Stress Assessment in Non-invasive Coronary CTA versus Invasive Imaging: A Patient-Specific Comp
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Annals of Biomedical Engineering ( 2020) https://doi.org/10.1007/s10439-020-02631-9
Original Article
Validation of Wall Shear Stress Assessment in Non-invasive Coronary CTA versus Invasive Imaging: A Patient-Specific Computational Study PARASTOU ESLAMI ,1 ELINE M. J. HARTMAN,2 MAZEN ALBAGHADAI,3 JULIA KARADY,1 ZEXI JIN,1 VIKAS THONDAPU,1 NICHOLAS V. CEFALO,4 MICHAEL T. LU,1 AHMET COSKUN,5 PETER H. STONE,4 ALISON MARSDEN,6 UDO HOFFMANN,1 and JOLANDA J. WENTZEL2 1
Department of Radiology, Harvard Medical School, Massachusetts General Hospital, 165 Cambridge St, Suite 400, Boston, MA 02114, USA; 2Department of Cardiology, Biomedical Engineering, Erasmus MC, Rotterdam, The Netherlands; 3 Department of Cardiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA; 4Division of Cardiovascular Medicine, Harvard Medical School, Brigham Women’s Hospital, Boston, MA, USA; 5Mechanical and Industrial Engineering, Northeastern University, Boston, MA, USA; and 6Institute of Computational and Mathematical Engineering, Departments of Bioengineering and Pediatrics, Stanford University, Stanford, CA, USA (Received 17 June 2020; accepted 18 September 2020) Associate Editor Lakshmi Prasad Dasi oversaw the review of this article.
Abstract—Endothelial shear stress (ESS) identifies coronary plaques at high risk for progression and/or rupture leading to a future acute coronary syndrome. In this study an optimized methodology was developed to derive ESS, pressure drop and oscillatory shear index using computational fluid dynamics (CFD) in 3D models of coronary arteries derived from non-invasive coronary computed tomography angiography (CTA). These CTA-based ESS calculations were compared to the ESS calculations using the gold standard with fusion of invasive imaging and CTA. In 14 patients paired patient-specific CFD models based on invasive and non-invasive imaging of the left anterior descending (LAD) coronary arteries were created. Ten patients were used to optimize the methodology, and four patients to test this methodology. Time-averaged ESS (TAESS) was calculated for both coronary models applying patient-specific physiological data available at the time of imaging. For data analysis, each 3D reconstructed coronary artery was divided into 2 mm segments and each segment was subdivided into 8 arcs (45).TAESS and other hemodynamic parameters were averaged per segment as well as per arc. Furthermore, the paired segment- and arc-averaged TAESS were categorized into patient-specific tertiles (low, medium and high). In the ten LADs, used for optimization of the methodology, we found high correlations between invasively-derived and noninvasively-derived TAESS averaged over segments (n = 263, r = 0.86) as well as arcs (n = 2104, r = 0.85, p < 0.001). The
Address correspondence to Parastou Eslami, Department of Radiology, Harvard Medical School, Massachusetts General Hospital, 165 Cambridge St, Suite 400, Boston, MA 02114, USA. Electronic mail: [email protected]
correlation was also strong in the four testing-pati
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