Improvement Assessment of Coronary Flow Dysfunction Using Fundamental Fluid Dynamics

Diagnosis of relative contributions of large artery blockages and microvascular blockages is
very much needed in the treatment of coronary artery disease. In order to achieve this, two
novel parameters, pressure drop coefficient (CDP), which combines flow and pressure readings
and Lesion flow coefficient (LFC), which combines anatomical details of the lesion with
pressure and flow readings, are being investigated. The diagnostic parameters will be
correlated with Coronary Flow Reserve (CFR)values obtained using Positron Emission Tomography
(PET) imaging. They will also be correlated with Fractional Flow Reserve (FFR).

Inclusion Criteria:

- 18 years of age or above

- Patients referred to a stress test by a Cardiologist

- Acute Chest pain, as per patient input.

- Risk Assessment with prior test results and/or previous history of known chronic
stable CAD.

- Borderline or discordant stress testing where obstructive CAD remains a concern.

- New or worsening symptoms- Abnormal coronary angiography or abnormal prior stress
imaging study.

- Coronary stenosis or anatomic abnormality of uncertain significance.

- In absence of reliable diagnostic information from another imaging modality.

Exclusion Criteria:

- Left ventricular ejection fraction less the 25% determined by gated SPECT imaging

- Non-dialysis dependent chronic kidney disease with baseline serum creatinine greater
than 2.5 gm/dL.

- History of type II heparin-induced thrombocytopenia.

- Significant co-morbid condition that is medically unstable and would make coronary
angiography prohibitive or contraindicated.

- Pregnant women.

- Incapacitated for Consent