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- 저자 : Duc Minh Tran(쩐득민) (검색결과 3 건)
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관상동맥 협착부 형상 특성 인자와 혈류역학적 생리기능성 진단인자의 상관관계에 대한 수치 해석
쩐득민(Duc Minh Tran),웬민투안(Minh Tuan Nguyen),이상욱(Sang-Wook Lee) 대한기계학회 2017 대한기계학회 춘추학술대회 Vol.2017 No.11
The functional significance rather than conventional evaluation by geometric lumen area reduction of coronary stenosis has recently received much attention. Hemodynamics based diagnostic parameters such as fractional flow reserve (FFR) and wall shear stress (WSS) are most representative physiological indices for identifying lesion severity. Previous studies demonstrated superior performance of FFR and WSS to identify ischemia-causing coronary stenosis. These hemodynamic parameters are closely related to blood flow characteristics downstream of stenosis which is greatly affected by geometric shape of stenosis. Although the in vivo geometry of stenosis is irregular and complex, we extracted major feature geometric parameters and investigate the effect on the FFR and WSS. In this study, we carried out 3D computational fluid dynamics simulations for coronary artery models with considering various stenosis geometric parameters and performed correlation analysis.
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Computational Approach to Estimate Functional Significance of Stenotic Lesion of Coronary Artery
Duc Minh Tran(쩐득민),Minh Tuan Nguyen(웬민투안),Hyoung Gwon Choi(최형권),Hyuk-Jae Chang(장혁재),Sang-Wook Lee(이상욱) 대한기계학회 2017 대한기계학회 춘추학술대회 Vol.2017 No.11
Computed tomographic (CT) angiography often overestimates the significance of stenotic lesion of coronary and it leads to a need for functional diagnostic measurements. Currently, invasive pressure-wire-based fractional flow reserve (FFR) is becoming the standard of reference for assessing the physiological significance of coronary stenoses in clinical decisions regarding revascularization and exhibits favorable outcomes in identifying the ischemia-causing stenosis. A noninvasive approach for FFR prediction based on computational fluid dynamics with CT angiography was developed. Since the hemodynamic conditions in distal vascular beds highly affects the coronary flow structures, it is necessary to incorporate zero-dimensional (0D) lumped parameter network (LPN) model for coronary microvascular flow by coupling with 3D CFD simulation. This demonstrated high diagnostic and prognostic accuracy with a reduction of adverse events. MPI parallel algorithm based on domain decomposition method was applied for the 3D-0D coupled model of coronary flow dynamics simulations in a monolithic approach. In this paper, we introduce the development of clinically practical computational tool to estimate physiological significance of stenotic lesion of coronary with aims of accelerating clinical outcomes, basically by bench to bedside approach.
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관상동맥 협착병변 형상인자와 혈류역학 기반 진단인자의 상관관계 수치해석 연구
쩐득민(Duc Minh Tran),웬비엣카이(Viet Khai Nguyen),웬민투안(Minh Tuan Nguyen),이상욱(Sang-Wook Lee) 대한기계학회 2018 大韓機械學會論文集B Vol.42 No.7
관상동맥 협착병변 심각도에 대한 기존의 혈관 협착률 기반 진단인자의 제한된 정확도로 인하여 최근 생리기능성 진단인자의 중요성이 높아지고 있다. 가장 대표적인 혈류역학 기반 생리기능성 진단인자인 심근분획혈류예비력(FFR)과 벽전단응력(WSS)가 일반적으로 협착병변의 여러 형상 특성인자에 의해 크게 영향을 받는 것으로 잘 알려져 있다. 본 연구에서는 협착병변의 다양한 형상특성인자를 고려한 혈관 모델을 설계하고 다중스케일 CFD 시뮬레이션을 수행한 후, FFR 및 WSS값과 협착병변 형상특성인자의 상관관계를 분석하였다. 기본적으로 혈관 협착률이 FFR과 WSS값에 가장 큰 영향을 미치는 것으로 나타났으며, 협착률이 높을수록, 협착부 형상(shape)의 영향이 커짐을 확인할 수 있었다. Due to the limited diagnostic accuracy of conventional evaluation by stenosis degree for coronary stenotic lesion severity, physiology-based functional indices have recently received much attention. Fractional flow reserve (FFR) and wall shear stress (WSS) are the most representative indices. These hemodynamics-based indices are closely related to blood flow characteristics downstream of stenosis which is greatly affected by the geometric features of stenosis. In this study, we considered major geometric features of stenotic lesions and investigated the correlation between the functional indices and the lesion-specific geometrical parameters by carrying out multi-scale CFD simulations. Lumen diameter reduction rate has the largest effect on the physiological indices and the effect of lesion shape becomes greater as the stenosis degree rises.
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