Method and system for quantifying limitations in coronary artery blood flow during physical activity in patients with coronary artery disease
Embodiments include a system for determining cardiovascular information for a patient with coronary artery disease. The system may include at least one computer system configured to receive patient-specific data regarding a geometry of the patient's heart and create a model representing at least a portion of the patient's heart based on the patient-specific data. The at least one computer system may be further configured to create, for a given level of physical activity, a physics-based model of blood flow through the patient's heart simulated during a selected level of physical activity; determine and normalize one or more values of at least one blood flow characteristic within the patient's heart during the simulated level of physical activity; and compare the one or more normalized values of the at least one blood flow characteristic to a threshold to determine whether the level of physical activity exceeds an acceptable level of risk.
1. A system for quantifying limitations in coronary artery blood flow during exercise in a patient with coronary artery disease, the system comprising:
at least one processor; and
at least one memory storing instructions that, when executed by the at least one processor, perform operations comprising:
receiving patient-specific anatomical image data regarding geometry of a patient's vasculature;
creating a three-dimensional geometric model based on the received patient-specific anatomical image data representing the geometry of the patient's vasculature, the three-dimensional geometric model reflecting vascular geometry at a first intensity level of exercise;
computing, using the three-dimensional geometric model, a value of a blood flow characteristic of blood flow through the three-dimensional geometric model for the first intensity level of exercise;
determining a threshold value quantifying a limitation of exercise of the patient based on the value of the blood flow characteristic at the first intensity level of exercise, wherein the threshold value is one of a hypothetical normal state or a population norm;
determining whether the value of the blood flow characteristic is at or below the determined threshold value;
upon determining that the value of the blood flow characteristic is at or below the determined threshold value, simulating a second intensity level of exercise;
computing, using the three-dimensional geometric model, a blood flow characteristic of blood flow through the three-dimensional geometric model for the second intensity level of exercise, different from the first intensity level of exercise; and
providing a recommendation of a maximum level of exercise based on the determined threshold value, the first intensity level of exercise, and the second intensity level of exercise.
2. The system of claim 1 , wherein the at least one processor is further configured for: generating a physics-based model based on the three-dimensional geometric model; and computing the blood flow characteristic based on the physics-based model, wherein the physics-based model corresponds to the second intensity level of exercise.
3. The system of claim 1 , wherein the computed blood flow characteristic is chosen from coronary blood flow, blood pressure, plaque stress, myocardial perfusion, plaque vulnerability, and FFR.
4. The system of claim 1 , wherein the second intensity level of exercise comprises an elevated intensity level of exercise relative to the first intensity level of exercise.
5. The system of claim 1 , wherein the three-dimensional geometric model represents at least the portion of a heart of the patient that includes at least a portion of an aorta and at least a portion of a plurality of coronary arteries emanating from the portion of the aorta.
6. The system of claim 5 , wherein the at least one processor is further configured for: computing the threshold value at a plurality of locations in the plurality of coronary arteries.
7. A method for quantifying limitations in coronary artery blood flow during exercise in a patient with coronary artery disease using at least one computer system, the method comprising:
receiving patient-specific anatomical image data regarding geometry of a patient's vasculature; creating a three-dimensional geometric model based on the received patient-specific image representing the geometry of the patient's vasculature, the three-dimensional geometric model reflecting vascular geometry at a first intensity level of exercise;
computing, using the three-dimensional geometric model, a value of a blood flow characteristic of blood flow through the three-dimensional geometric model for the first intensity level of exercise;
determining a threshold value quantifying a limitation of exercise of the patient based on the value of the blood flow characteristic at the first intensity level of exercise, wherein the threshold value is one of a hypothetical normal state or a population norm;
determining whether the value of the blood flow characteristic is at or below the determined threshold value;
upon determining that the value of the blood flow characteristic is at or below the determined threshold value, simulating a second intensity level of exercise;
computing, using the three-dimensional geometric model, a blood flow characteristic of blood flow through the three-dimensional geometric model for the second intensity level of exercise, different from the first intensity level of exercise; and
providing a recommendation of a maximum level of exercise based on the determined threshold value, the first intensity level of exercise, and the second intensity level of exercise.
8. The method of claim 7 , further comprising: generating a physics-based model based on the three-dimensional geometric model; and computing the blood flow characteristic based on the physics-based model, wherein the physics-based model corresponds to the second intensity level of exercise.
9. The method of claim 7 , wherein the computed blood flow characteristic is chosen from coronary blood flow, blood pressure, plaque stress, myocardial perfusion, plaque vulnerability, and FFR.
10. The method of claim 7 , wherein the second intensity level of exercise comprises an elevated intensity level of exercise relative to the first intensity level of exercise.
11. The method of claim 7 , wherein the three-dimensional geometric model represents at least the portion of a heart of the patient that includes at least a portion of an aorta and at least a portion of a plurality of coronary arteries emanating from the portion of the aorta.
12. The method of claim 11 , further comprising:
computing the threshold value at a plurality of locations in the plurality of coronary arteries.
13. A non-transitory computer readable medium for use on at least one computer system containing computer-executable programming instructions for quantifying limitations in coronary artery blood flow during exercise in a patient with coronary artery disease, the programming instructions executing operations comprising:
receiving patient-specific anatomical image data regarding geometry of a patient's vasculature;
creating a three-dimensional geometric model based on the received patient-specific image data representing the geometry of the patient's vasculature, the three-dimensional geometric model reflecting vascular geometry at a first intensity level of exercise;
computing, using the three-dimensional geometric model, a value of a blood flow characteristic of blood flow through the three-dimensional geometric model for the first intensity level of exercise;
determining a threshold value quantifying a limitation of exercise of the patient based on the value of the blood flow characteristic at the first intensity level of exercise, wherein the threshold value is one of a hypothetical normal state or a population norm;
determining whether the value of the blood flow characteristic is at or below the determined threshold value;
upon determining that the value of the blood flow characteristic is at or below the determined threshold value, simulating a second intensity level of exercise;
computing, using the three-dimensional geometric model, a blood flow characteristic of blood flow through the three-dimensional geometric model for the second intensity level of exercise, different from the first intensity level of exercise; and
providing a recommendation of a maximum level of exercise based on the determined threshold value, the first intensity level of exercise, and the second intensity level of exercise.
14. The non-transitory computer readable medium of claim 13 , wherein the operations further comprise: generating a physics-based model based on the three-dimensional geometric model; and computing the blood flow characteristic based on the physics-based model, wherein the physics-based model corresponds to the second intensity level of exercise.
15. The non-transitory computer readable medium of claim 13 , where the computed blood flow characteristic is chosen from coronary blood flow, blood pressure, plaque stress, myocardial perfusion, plaque vulnerability, and FFR.