Numerical Simulation of Instantaneous Wave-Free Ratio of Stenosed Coronary Artery

Instantaneous wave-free ratio (iFR), an invasive index of coronary artery tree, can evaluate the functional performance of vascular stenosis without pharmacological vasodilators. The noninvasive assessment of diameter stenosis (DS) obtained from coronary computed tomography angiography (CTA) has high false positive rate in contrast to iFR. The aim of this study was to develop a numerical simulation method that predicts the iFR and noninvasively assess the myocardial ischemia. Based on the CTA images, a patient-specific three-dimensional model of the aorta and coronary arteries were reconstructed. A stenosis was created in the left anterior descending artery (LAD) by reducing the DS of geometric model (40%, 50%, 60%, 75% and 90%). The patient-specific LPM boundary condition were set up to compute iFRct value during the wave-free period at the resting condition. The computed pressure and flow of coronary artery were realistic as compared to literature data. In contrast to invasive iFR, the iFRct can make a cost-benefit balance in terms of clinical cost and patient’s health.