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Effect of porous media of the stenosed artery wall to the coronary physiological diagnostic parameter: a computational fluid dynamic analysis

Govindaraju K, Kamangar S, Badruddin IA, Viswanathan GN, Badarudin A, Salman Ahmed NJ

Atherosclerosis, 2014 Apr;233(2):630-635.
PMID: 24549189 DOI: 10.1016/j.atherosclerosis.2014.01.043

Functional assessment of a coronary artery stenosis severity is generally assessed by fractional flow reserve (FFR), which is calculated from pressure measurements across the stenosis. The purpose of this study is to investigate the effect of porous media of the stenosed arterial wall on this diagnostic parameter. To understand the role of porous media on the diagnostic parameter FFR, a 3D computational simulations of the blood flow in rigid and porous stenotic artery wall models are carried out under steady state and transient conditions for three different percentage area stenoses (AS) corresponding to 70% (moderate), 80% (intermediate), and 90% (severe). Blood was modeled as a non Newtonian fluid. The variations of pressure drop across the stenosis and diagnostic parameter were studied in both models. The FFR decreased in proportion to the increase in the severity of the stenosis. The relationship between the percentage AS and the FFR was non linear and inversely related in both the models. The cut-off value of 0.75 for FFR was observed at 81.89% AS for the rigid artery model whereas 83.61% AS for the porous artery wall model. This study demonstrates that the porous media consideration on the stenotic arterial wall plays a substantial role in defining the cut-off value of FFR. We conclude that the effect of porous media on FFR, could lead to misinterpretation of the functional severity of the stenosis in the region of 81.89 %-83.61% AS.
The influence of artery wall curvature on the anatomical assessment of stenosis severity derived from fractional flow reserve: a computational fluid dynamics study

Govindaraju K, Viswanathan GN, Badruddin IA, Kamangar S, Salman Ahmed NJ, Al-Rashed AA

Comput Methods Biomech Biomed Engin, 2016 Nov;19(14):1541-9.
PMID: 27052093 DOI: 10.1080/10255842.2016.1170119

This study aims to investigate the influence of artery wall curvature on the anatomical assessment of stenosis severity and to identify a region of misinterpretation in the assessment of per cent area stenosis (AS) for functionally significant stenosis using fractional flow reserve (FFR) as standard. Five artery models of different per cent AS severity (70, 75, 80, 85 and 90%) were considered. For each per cent AS severity, the angle of curvature of the arterial wall varied from straight to an increasingly curved model (0°, 30°, 60°, 90° and 120°). Computational fluid dynamics was performed under transient physiologic hyperemic flow conditions to investigate the influence of artery wall curvature on the pressure drop and the FFR. The findings in this study may be useful in in vitro anatomical assessment of functionally significant stenosis. The FFR decreased with increasing stenosis severity for a given curvature of the artery wall. Moreover, a significant decrease in FFR was found between straight and curved models discussed for a given severity condition. These findings indicate that the curvature effect was included in the FFR assessment in contrast to minimum lumen area (MLA) or per cent AS assessment. The MLA or per cent AS assessment may lead to underestimation of stenosis severity. From this numerical study, an uncertainty region could be evaluated using the clinical FFR cutoff value of 0.8. This value was observed at 81.98 and 79.10% AS for arteries with curvature angles of 0° and 120° respectively. In conclusion, the curvature of the artery should not be neglected in in vitro anatomical assessment.
Fulltext Noise characteristics of grass-trimming machine engines and their effect on operators

Mallick Z, Badruddin IA, Khaleed Hussain MT, Salman Ahmed NJ, Kanesan J

Noise Health, 2009 Apr-Jun;11(43):98-102.
PMID: 19414929 DOI: 10.4103/1463-1741.50694

Over the last few years, interaction of humans with noisy power-driven agricultural tools and its possible adverse after effects have been realized. Grass-trimmer engine is the primary source of noise and the use of motorized cutter, spinning at high speed, is the secondary source of noise to which operators are exposed. In the present study, investigation was carried out to determine the effect of two types of grass-trimming machine engines (SUM 328 SE and BG 328) noise on the operators in real working environment. It was found that BG-328 and SUM-328 SE produced high levels of noise, of the order of 100 and 105 dB(A), respectively, to which operators are exposed while working. It was also observed that situation aggravates when a number of operators simultaneously operate resulting in still higher levels of noise. Operators should be separated 15 meters from each other in order to avoid the combined level of noise exposure while working with these machines. It was found that SPL, of the grass-trimmer machine engines (BG-328 and SUM-328 SE), were higher than the limit of noise recommended by ISO, NIOSH, and OSHA for an 8-hour workday. Such a high level of noise exposure may cause physiological and psychological problems to the operators in long run.
Influence of stenosis on hemodynamic parameters in the realistic left coronary artery under hyperemic conditions

Kamangar S, Badruddin IA, Badarudin A, Nik-Ghazali N, Govindaraju K, Salman Ahmed NJ, et al.

Comput Methods Biomech Biomed Engin, 2017 Mar;20(4):365-372.
PMID: 27612619 DOI: 10.1080/10255842.2016.1233402

The current study investigates the hyperemic flow effects on heamodynamics parameters such as velocity, wall shear stress in 3D coronary artery models with and without stenosis. The hyperemic flow is used to evaluate the functional significance of stenosis in the current era. Patients CT scan data of having healthy and coronary artery disease was chosen for the reconstruction of 3D coronary artery models. The diseased 3D models of coronary artery shows a narrowing of >50% lumen area. Computational fluid dynamics was performed to simulate the hyperemic flow condition. The results showed that the recirculation zone was observed immediate to the stenosis and highest wall shear stress was observed across the stenosis. The decrease in pressure was found downstream to the stenosis as compared to the coronary artery without stenosis. Our analysis provides an insight into the distribution of wall shear stress and pressure drop, thus improving our understanding of hyperemic flow effect under both conditions.
Visualization of multiphase pulsatile blood over single phase blood flow in a patient specific stenosed left coronary artery using image processing technique

Athani A, Ghazali NNN, Anjum Badruddin I, Kamangar S, Salman Ahmed NJ, Honnutagi A

Biomed Mater Eng, 2023;34(1):13-35.
PMID: 36278331 DOI: 10.3233/BME-211333

BACKGROUND: Coronary arteries disease has been reported as one of the principal roots of deaths worldwide.
OBJECTIVE: The aim of this study is to analyze the multiphase pulsatile blood flow in the left coronary artery tree with stenosis.
METHODS: The 3D left coronary artery model was reconstructed using 2D computerized tomography (CT) scan images. The Red Blood Cell (RBC) and varying hemodynamic parameters for single and multiphase blood flow conditions were analyzed.
RESULTS: Results asserted that the multiphase blood flow modeling has a maximum velocity of 1.017 m/s and1.339 m/s at the stenosed region during the systolic and diastolic phases respectively. The increase in Wall Shear Stress (WSS) observed at the stenosed region during the diastole phase as compared during the systolic phase. It was also observed that the highest Oscillatory Shear Index (OSI) regions are found in the downstream area of stenosis and across the bifurcations. The increase in RBCs velocity from 0.45 m/s to 0.6 m/s across the stenosis was also noticed.
CONCLUSION: The computational multiphase blood flow analysis improves the understanding and accuracy of the complex flow conditions of blood elements (RBC and Plasma) and provides the progression of the disease development in the coronary arteries. This study helps to enhance the diagnosis of the blocked (stenosed) arteries more precisely compared to the single-phase blood flow modeling.
Patient specific 3-d modeling of blood flow in a multi-stenosed left coronary artery

Kamangar S, Badruddin IA, Ameer Ahamad N, Soudagar MEM, Govindaraju K, Nik-Ghazali N, et al.

Biomed Mater Eng, 2017;28(3):257-266.
PMID: 28527189 DOI: 10.3233/BME-171672

The current study investigates the effect of multi stenosis on the hemodynamic parameters such as wall pressure, velocity and wall shear stress in the realistic left coronary artery. Patients CT scan image data of normal and diseased left coronary artery was chosen for the reconstruction of 3D coronary artery models. The diseased 3D model of left coronary artery shows a narrowing of more than 70% and 80% of area stenosis (AS) at the left main stem (LMS) and left circumflex (LCX) respectively. The results show that the decrease in pressure was found downstream to the stenosis as compared to the coronary artery without stenosis. The maximum pressure drop was noted across the 80% AS at the left circumflex branch. The recirculation zone was also observed immediate to the stenosis and highest wall shear stress was found across the 80% area stenosis. Our analysis provides an insight into the distribution of wall shear stress and pressure drop, thus improving our understanding on the hemodynamics in realistic coronary artery.