Automatic Estimation of Coronary Blood Flow Velocity Step 1 for Developing a Tool to Diagnose Patients With Micro-Vascular Angina Pectoris
Journal article, Peer reviewed
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Original versionKhanmohammadi M, Engan K, Sæland C, Eftestøl T and Larsen AI (2019) Automatic Estimation of Coronary Blood Flow Velocity Step 1 for Developing a Tool to Diagnose Patients With Micro-Vascular Angina Pectoris. Frontiers in Cardiovascular Medicine, 6(1), doi: 10.3389/fcvm.2019.00001 https://doi.org/10.3389/fcvm.2019.00001
Aim: Our aim was to automatically estimate the blood velocity in coronary arteries using cine X-ray angiographic sequence. Estimating the coronary blood velocity is a key approach in investigating patients with angina pectoris and no signiﬁcant coronary artery disease. Blood velocity estimation is central in assessing coronary ﬂow reserve. Methods and Results: A multi-step automatic method for blood ﬂow velocity estimation based on the information extracted solely from the cine X-ray coronary angiography sequence obtained by invasive selective coronary catheterization was developed. The method includes (1) an iterative process of segmenting coronary arteries modeling and removing the heart motion using a non-rigid registration, (2) measuring the area of the segmented arteries in each frame, (3) ﬁtting the measured sequence of areas with a 7◦ polynomial to ﬁnd start and stop time of dye propagation, and (4) estimating the blood ﬂow velocity based on the time of the dye propagation and the length of the artery-tree. To evaluate the method, coronary angiography recordings from 21 patients with no obstructive coronary artery disease were used. In addition, coronary ﬂow velocity was measured in the same patients using a modiﬁed transthoracic Doppler assessment of the left anterior descending artery. We found a moderate but statistically signiﬁcant correlation between ﬂow velocity assessed by trans thoracic Doppler and the proposed method applying both Spearman and Pearson tests. Conclusion: Measures of coronary ﬂow velocity using a novel fully automatic method that utilizes the information from the X-ray coronary angiographic sequence were statistically signiﬁcantly correlated to measurements obtained with transthoracic Doppler recordings.