3D-QCA-based CFD estimated time-averaged wall shear stress underestimated by 0.21 Pa compared to OCT in normal coronary arteries (p<0.001) but showed no significant difference in stenotic arteries (mean difference -0.39 Pa, p=0.25).
Does 3D-QCA-based CFD simulation provide comparable time-averaged wall shear stress (TAWSS) estimations to OCT-based CFD in coronary arteries of a preclinical minipig model?
3D-QCA-based TAWSS estimation is feasible, significantly faster than OCT-based methods, and provides comparable spatial distributions, supporting its potential for clinical adoption in coronary artery disease assessment.
Effect estimate: Mean difference -0.21 ± 0.64 Pa in normal arteries (95%CI -1.46 to 1.04, p<0.001); mean difference -0.39 ± 3.04 Pa in stenotic arteries (95%CI -6.35 to 5.56, p=0.25) (95% CI 95% CI -1.46 to 1.04 Pa for normal arteries; 95% CI -6.35 to 5.56 Pa for stenotic arteries)
Absolute Event Rate: 1.12% vs 1.23%
p-value: p=<0.001 for normal arteries; 0.25 for stenotic arteries
Abstract An approach to rapid simulation of time-averaged wall shear stress (TAWSS) on 3D geometries created from 3D Quantitative Coronary Angiography (3D-QCA) methodology has been developed, which enables rapid computational fluid dynamic (CFD) shear stress simulation. We compared TAWSS estimated from 3D-QCA-CFD with optical coherence tomography (OCT)-based CFD simulations in coronary arteries. 15 normal and 5 stenotic coronary arteries in instrumented minipigs were studied. 3D arterial geometries were reconstructed from 3D-QCA and OCT using common centrelines and matched axial positions. Identical boundary conditions were used for both methods through directly measured vessel-specific inlet blood velocities. TAWSS was calculated for axially matched segments (n = 80 for normal arteries; n = 160 for stenotic arteries) and in 3 mm/60° sectors. Mean TAWSS simulation times for 3D-QCA and OCT-based CFD were 17.8 min and ~ 1.5 h respectively. There were significant but numerically small differences in TAWSS for normal arteries (-0.21 ± 0.64 Pa 95%CI -1.04,1.46, p < 0.001), and no significant difference for stenotic arteries (-0.39 ± 3.04 Pa 95%CI -6.35, 5.56, p = 0.25). Axial TAWSS profiles along vessel lengths were similar between the two methods. There is a trend of underestimation by 3D-QCA at higher values of TAWSS compared with OCT, due to differences in geometry dimensions. Similar spatial distributions of TAWSS in both normal and stenotic arteries were observed from co-registered TAWSS maps. This study suggests that 3D-QCA-based TAWSS is feasible in both normal and stenotic arteries and that further clinical evaluation of rapid TAWSS from 3D-QCA is warranted, which may facilitate clinical adoption of TAWSS assessment.
Naser et al. (Fri,) conducted a other in Adult instrumented transgenic D374Y-PCSK9 hyperlipidaemic minipigs with normal or stenotic coronary arteries (n=20). 3D quantitative coronary angiography (3D-QCA) based time-averaged wall shear stress (TAWSS) estimation with computational fluid dynamics (CFD) vs. Optical coherence tomography (OCT)-based CFD TAWSS estimation was evaluated on Time-averaged wall shear stress (TAWSS) estimation comparison between 3D-QCA-CFD and OCT-CFD methods (Mean difference -0.21 ± 0.64 Pa in normal arteries (95%CI -1.46 to 1.04, p<0.001); mean difference -0.39 ± 3.04 Pa in stenotic arteries (95%CI -6.35 to 5.56, p=0.25), 95% CI 95% CI -1.46 to 1.04 Pa for normal arteries; 95% CI -6.35 to 5.56 Pa for stenotic arteries, p=<0.001 for normal arteries; 0.25 for stenotic arteries). 3D-QCA-based CFD estimated time-averaged wall shear stress underestimated by 0.21 Pa compared to OCT in normal coronary arteries (p<0.001) but showed no significant difference in stenotic arteries (mean difference -0.39 Pa, p=0.25).