IMR Press / RCM / Volume 23 / Issue 11 / DOI: 10.31083/j.rcm2311377
Open Access Review
Current and Future Applications of Computational Fluid Dynamics in Coronary Artery Disease
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1 PoliToBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129 Torino, Italy
2 Department of Cardiology, Zurich University Hospital, 8091 Zurich, Switzerland
3 Department of Medical Sciences, Division of Cardiology, AOU Città Della Salute e Della Scienza, University of Turin, 10124 Turin, Italy
*Correspondence: (Claudio Chiastra)
Academic Editor: Jerome L. Fleg
Rev. Cardiovasc. Med. 2022, 23(11), 377;
Submitted: 14 May 2022 | Revised: 2 September 2022 | Accepted: 26 September 2022 | Published: 4 November 2022
(This article belongs to the Special Issue Coronary Artery Atherosclerosis: Translation from Basic to Clinic)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Hemodynamics interacts with the cellular components of human vessels, influencing function and healthy status. Locally acting hemodynamic forces have been associated—by a steadily increasing amount of scientific evidence—with nucleation and evolution of atherosclerotic plaques in several vascular regions, resulting in the formulation of the ‘hemodynamic risk hypothesis’ of the atherogenesis. At the level of coronary arteries, however, the complexity of both anatomy and physiology made the study of this vascular region particularly difficult for researchers. Developments in computational fluid dynamics (CFD) have recently allowed an accurate modelling of the intracoronary hemodynamics, thus offering physicians a unique tool for the investigation of this crucial human system by means of advanced mathematical simulations. The present review of CFD applications in coronary artery disease was set to concisely offer the medical reader the theoretical foundations of quantitative intravascular hemodynamics—reasoned schematically in the text in its basic (i.e., pressure and velocity) and derived quantities (e.g., fractional flow reserve, wall shear stress and helicity)—along with its current implications in clinical research. Moreover, attention was paid in classifying computational modelling derived from invasive and non-invasive imaging modalities with unbiased remarks on the advantages and limitations of each procedure. Finally, an extensive description—aided by explanatory figures and cross references to recent clinical findings—was presented on the role of near-wall hemodynamics, in terms of shear stress, and of intravascular flow complexity, in terms of helical flow.

coronary artery disease
computer model
computer simulation
computational hemodynamics
virtual FFR
wall shear stress
FISR2019_03221, CECOMES/Italian Ministry of Education, University and Research
Fig. 1.
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