Search arXiv⌕ Search
Home/Archive/arXiv

arXiv · 2401.17433

Coronary CTA and Quantitative Cardiac CT Perfusion (CCTP) in Coronary Artery Disease

Hao Wu·Yingnan Song·Ammar Hoori·Ananya Subramaniam·Juhwan Lee·Justin Kim·Tao Hu·Sadeer Al-Kindi·Wei-Ming Huang·Chun-Ho Yun·Chung-Lieh Hung·Sanjay Rajagopalan·David L. Wilson
View original source ↗Read source document ↗Export metadata ↓

Abstract

We assessed the benefit of combining stress cardiac CT perfusion (CCTP) myocardial blood flow (MBF) with coronary CT angiography (CCTA) using our innovative CCTP software. By combining CCTA and CCTP, one can uniquely identify a flow limiting stenosis (obstructive-lesion + low-MBF) versus MVD (no-obstructive-lesion + low-MBF. We retrospectively evaluated 104 patients with suspected CAD, including 18 with diabetes, who underwent CCTA+CCTP. Whole heart and territorial MBF was assessed using our automated pipeline for CCTP analysis that included beam hardening correction; temporal scan registration; automated segmentation; fast, accurate, robust MBF estimation; and visualization. Stenosis severity was scored using the CCTA coronary-artery-disease-reporting-and-data-system (CAD-RADS), with obstructive stenosis deemed as CAD-RADS>=3. We established a threshold MBF (MBF=199-mL/min-100g) for normal perfusion. In patients with CAD-RADS>=3, 28/37(76%) patients showed ischemia in the corresponding territory. Two patients with obstructive disease had normal perfusion, suggesting collaterals and/or a hemodynamically insignificant stenosis. Among diabetics, 10 of 18 (56%) demonstrated diffuse ischemia consistent with MVD. Among non-diabetics, only 6% had MVD. Sex-specific prevalence of MVD was 21%/24% (M/F). On a per-vessel basis (n=256), MBF showed a significant difference between territories with and without obstructive stenosis (165 +/- 61 mL/min-100g vs. 274 +/- 62 mL/min-100g, p <0.05). A significant and negative rank correlation (rho=-0.53, p<0.05) between territory MBF and CAD-RADS was seen. CCTA in conjunction with a new automated quantitative CCTP approach can augment the interpretation of CAD, enabling the distinction of ischemia due to obstructive lesions and MVD.

Explore related subjects

q-bio.TO

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Hao Wu, Yingnan Song, Ammar Hoori, Ananya Subramaniam, Juhwan Lee, Justin Kim, Tao Hu, Sadeer Al-Kindi, Wei-Ming Huang, Chun-Ho Yun, Chung-Lieh Hung, Sanjay Rajagopalan, David L. Wilson. 2024-01-30. Coronary CTA and Quantitative Cardiac CT Perfusion (CCTP) in Coronary Artery Disease. https://arxiv.org/abs/2401.17433

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

arXiv2026

A Combined ODE Model of Carbohydrate Fermentation and Colorectal Cancer

We formulate and analyze a system of non-linear ordinary differential equations that describe key metabolic and immunological interactions between butyrate produced by fiber-fermenting gut microbiota, colorectal cancer cells and host cell populations. The model is studied both independently and in conjunction with a pre-existing carbohydrate fermentation model. The parameter space is explored through sensitivity analyses. Simulation experiments are conducted to illustrate the emergence of varying dynamical behaviour driven by butyrate availability. Our model predicts that butyrate production is driven by fiber consumption and further supported by probiotics in the case of microbial dysbiosis. It also suggests that butyrate may help in suppressing tumour growth. We also show that by adding noise with sufficiently high intensity, cancer elimination occurs almost surely in infinite time and that this threshold level of noise intensity decreases with increasing butyrate concentrations.

q-bio.TO↗
arXiv2026

Intestinal villi and crypt density robustly maximizes nutrient absorption

The villi and crypts of the gastrointestinal tract increase the effective surface area of the intestinal mucosa, potentially enhancing nutrient absorption. It is commonly assumed that this is their primary function, and that a higher villi density necessarily leads to improved absorption. However, when villi are packed too closely together, diffusion can be hindered, potentially offsetting this benefit. In this work, we investigate quantitatively the relationship between the density of these structures and the overall efficiency of absorption. In three different simplified geometries, approximating leaf-like villi, finger-like villi, and colonic crypts, we calculate analytically the concentration profile and the absorption flux, assuming that there is only diffusion between these structures while the lumen is well mixed. When plotting the absorption flux per unit of gut length as a function of the structures' density, we observe that there is a density maximizing absorption. We study numerically this optimum. We find that it is robust to the nutrient absorption properties: a geometry optimal for one nutrient is close to optimum for another nutrient. Physiological data from various animal species fall within this predicted optimal range, consistent with the hypothesis that structure density is shaped by selection for efficient nutrient uptake.

q-bio.TO↗
arXiv2026

Interstitial flow in the chick yolk sac exhibits organ-scale patterns driven by segregated leakage and drainage

Interstitial flow plays a key role in drug delivery, angiogenesis, cancer, and edema. Recent studies have identified connected interstitial pathways that can transport material over long distances. However, the spatial scale of physiological interstitial flow remains unclear: despite the existence of connected pathways, flow may be dominated by nearby vascular filtration or extend over longer distances. Here, we identify organ-scale interstitial flow patterns in the chick yolk sac and elucidate the mechanisms that determine their spatial scale. The yolk sac contains an organ-scale interstitial region that enables large-scale flow patterns to be identified without truncation. Our approach combines experimental imaging with computational modeling of coupled blood and interstitial flow in the whole yolk sac. Scaling analysis identifies a hydraulic conductivity ratio that controls the transition from small-scale to organ-scale flow. In organ-scale patterns, we find interstitial flow speed to be substantially greater than the transvascular flow speed. Mechanistically, the organ-scale patterns arise from the spatial segregation of the leakage and drainage of interstitial fluid from the vessels. These findings have important implications for biological transport by interstitial flow, suggesting that flow-mediated cues may be sensed locally but generated nonlocally.

q-bio.TO↗