NDLI: Myocardial perfusion distribution and coronary arterial pressure and flow signals: clinical relevance in relation to multiscale modeling, a review

Content Provider	Springer Nature Link
Author	lte, Froukje Hyde, Eoin R. Rolandi, Cristina Lee, Jack Horssen, Pepijn Asrress, Kal den Wijngaard, Jeroen P. H. M. Cookson, Andrew N. Hoef, Tim Chabiniok, Radomir Razavi, Reza Michler, Christian Hautvast, Gilion L. T. F. Piek, Jan J. Breeuwer, Marcel Siebes, Maria Nagel, Eike Smith, Nic P. Spaan, Jos A. E.
Copyright Year	2013
Abstract	Coronary artery disease, CAD, is associated with both narrowing of the epicardial coronary arteries and microvascular disease, thereby limiting coronary flow and myocardial perfusion. CAD accounts for almost 2 million deaths within the European Union on an annual basis. In this paper, we review the physiological and pathophysiological processes underlying clinical decision making in coronary disease as well as the models for interpretation of the underlying physiological mechanisms. Presently, clinical decision making is based on non-invasive magnetic resonance imaging, MRI, of myocardial perfusion and invasive coronary hemodynamic measurements of coronary pressure and Doppler flow velocity signals obtained during catheterization. Within the euHeart project, several innovations have been developed and applied to improve diagnosis-based understanding of the underlying biophysical processes. Specifically, MRI perfusion data interpretation has been advanced by the gradientogram, a novel graphical representation of the spatiotemporal myocardial perfusion gradient. For hemodynamic data, functional indices of coronary stenosis severity that do not depend on maximal vasodilation are proposed and the Valsalva maneuver for indicating the extravascular resistance component of the coronary circulation has been introduced. Complementary to these advances, model innovation has been directed to the porous elastic model coupled to a one-dimensional model of the epicardial arteries. The importance of model development is related to the integration of information from different modalities, which in isolation often result in conflicting treatment recommendations.
Starting Page	1271
Ending Page	1286
Page Count	16
File Format	PDF
ISSN	01400118
Journal	Medical and Biological Engineering and Computing
Volume Number	51
Issue Number	11
e-ISSN	17410444
Language	English
Publisher	Springer Berlin Heidelberg
Publisher Date	2013-07-27
Publisher Place	Berlin, Heidelberg
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Multi scale modeling Coronary disease Coronary stenosis evaluation Magnetic resonance imaging Perfusion distribution Human Physiology Biomedical Engineering Imaging Radiology Computer Applications
Content Type	Text
Resource Type	Article
Subject	Biomedical Engineering Computer Science Applications

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