Hemodynamic characteristics expose the atherosclerotic severity in coronary main arteries: One-dimensional and three-dimensional approaches

Computed tomography coronary angiography image-based noninvasive virtual fractional flow reserve (vFFR) is a promising clinical practice to determine the physiological condition of coronary lesions. vFFR is the key factor in the diagnosis of coronary plaque. The purpose of this study is to detect the coronary main arteries lesion severity by using 1D (one-dimensional) hemodynamic factors compared to 3D (three-dimensional) heart flow computational models. The results provide the hemodynamic properties of the intraluminal condition by evaluating the vFFR. The computational burden of 3D hemodynamic simulations is one of the important drawbacks in most clinical cases. At first, we have established comparative results between vFFR3D (vFFR in 3D) and published results in the maximal hyperemic flow conditions. Then, we have employed statistical analysis including Pearson correlation test, Bland–Altman test, and computation time test for vFFR3D compared with the vFFR1D (vFFR in 1D) results. We have observed that the vFFR3D and vFFR1D results do not significantly differ as a function of stenosis length, type (concentric or eccentric), or location in the coronary artery. Pearson's product moment was found as r=0.9661,p<0.0001 illustrating a strong correlation between vFFR1D and vFFR3D. In both 3D and 1D cases, the results suggest that proximal stenosis is more severe compared to a distal one, even if they provide the same reduction in lumen (80% or 90% area of stenosis). The 1D inexpensive computational results vFFR1D can be used to predict the severity of atherosclerotic plaque in clinical procedures.