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Arterial Stenosis

  • Nicolaas Westerhof
  • Nikolaos Stergiopulos
  • Mark I. M. Noble
  • Berend E. Westerhof
Chapter

Abstract

Aortic coarctation and arterial stenosis are a localized narrowing of the arterial lumen. The pressure-flow relation contains a linear term and a quadratic term the latter accounting for losses due to turbulence, and dominating in severe stenoses (area occlusion more than 85%) thereby limiting blood supply to the tissue. The Flow Reserve is defined as the ratio of flow during maximal dilatation and flow during control conditions, and is determined by the stenosis and also by the dilatory capacity of the periphery. Fractional Flow Reserve, FFR, is the ratio of the maximal flow with the stenosis present and maximal flow in a normal bed. During maximal dilation FFR ≈ Pdistal.minimal/Pao, with Pdistal.minimal the pressure distal of the stenosis during dilatation and Pao aortic pressure. The, nonlinear, relation between pressure drop over the stenosis and flow through it depends on the stenosis severity only.

Keywords

Stenosis severity Flow reserve Fractional flow reserve Area ratio Vasodilation 

References

  1. 1.
    Young DF, Tsai FY. Flow characteristics in models of arterial stenoses: I steady flow. J Biomech. 1973;6:395–410.CrossRefPubMedGoogle Scholar
  2. 2.
    Newman DL, Westerhof N, Sipkema P. Modelling of aortic stenosis. J Biomech. 1979;12:229–35.CrossRefPubMedGoogle Scholar
  3. 3.
    Roach MR, Stockley D. The effects of the geometry of a stenosis on poststenotic flow in models and poststenotic vibration of canine carotid arteries in vivo. J Biomech. 1980;13:623–34.CrossRefPubMedGoogle Scholar
  4. 4.
    Marques KM, Spruijt HJ, Boer C, Westerhof N, Visser CA, Visser FC. The diastolic flow-pressure gradient relation in coronary stenoses in humans. J Am Coll Cardiol. 2002;39:1630–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Pijls NHJ, De Bruyne B. Coronary pressure. Dordrecht & Boston: Kluwer Academic Publishers; 1997.CrossRefGoogle Scholar
  6. 6.
    Spaan JAE, Piek JJ, Hoffman JIE, Siebes M. Physiological basis of clinically used coronary hemodynamic indices. Circulation. 2006;113:446–55.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Nicolaas Westerhof
    • 1
  • Nikolaos Stergiopulos
    • 2
  • Mark I. M. Noble
    • 3
  • Berend E. Westerhof
    • 1
  1. 1.Department of Pulmonary Diseases, Amsterdam Cardiovascular SciencesVU University Medical CenterAmsterdamThe Netherlands
  2. 2.Laboratory of Hemodynamics and Cardiovascular TechnologyEcole Polytechnique Fédérale de Lausanne (EPFL), Institute of BioengineeringLausanneSwitzerland
  3. 3.Cardiovascular Medicine, Department of Medicine and TherapeuticsUniversity of AberdeenAberdeenUnited Kingdom

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