Method and system for quantifying limitations in coronary artery blood flow during physical activity in patients with coronary artery disease

Patent metadata

Field	Value
Publication number	US-10092247-B2
Application number	US-201414496752-A
Country	US
Kind code	B2
Filing date	Sep 25, 2014
Priority date	Sep 9, 2014
Publication date	Oct 9, 2018
Grant date	Oct 9, 2018

Abstract

Embodiments include a system for determining cardiovascular information for a patient with coronary artery disease. The system may include at least one computer system configured to receive patient-specific data regarding a geometry of the patient's heart and create a model representing at least a portion of the patient's heart based on the patient-specific data. The at least one computer system may be further configured to create, for a given level of physical activity, a physics-based model of blood flow through the patient's heart simulated during a selected level of physical activity; determine and normalize one or more values of at least one blood flow characteristic within the patient's heart during the simulated level of physical activity; and compare the one or more normalized values of the at least one blood flow characteristic to a threshold to determine whether the level of physical activity exceeds an acceptable level of risk.

First claim

What is claimed is:

1. A system for determining an activity level recommendation for a patient, the system comprising:
at least one computer system configured to:
receive data describing a geometry of at least a portion of a patient's heart;
identify a cardiac event and a blood flow characteristic threshold value associated with the cardiac event;
determine a three-dimensional model representing the geometry of at least the portion of the patient's heart based on the received data;
determine a physics-based model of blood flow through the three-dimensional model, the physics-based model including a resistance of blood flow at the patient's myocardium simulated at a selected level of physical activity of the patient;
model the flow of blood through the three-dimensional model using the physics-based model of blood flow through the three-dimensional model simulated at the selected level of physical activity;
calculate, from the modeled flow of blood through the three-dimensional model simulated at the selected level of physical activity, a value of a blood flow characteristic within the patient's heart at the selected level of physical activity;
update the physics-based model of blood flow by iteratively reducing the resistance to blood flow at the patient's myocardium and recalculating the value of the blood flow characteristic through each updated physics-based model, until the recalculated value exceeds the blood flow characteristic threshold value associated with the cardiac event;
determine, based on one or more stored patient activities classified according to intensity level, a classification of patient activity intensity level corresponding to the physics-based model at which the recalculated value exceeded the blood flow characteristic threshold value associated with the cardiac event; and
generate an activity level recommendation based on the determined classification of the patient activity intensity level.

2. The system of claim 1 , wherein the at least one computer system is further configured to:
generate the activity level recommendation based on a risk of injury to the patient, the injury including stroke or myocardial infarction, or other injury.

3. The system of claim 2 , wherein the at least one computer system is further configured to:
quantify the risk of the stroke, myocardial infarction, or other injury.

4. The system of claim 1 , wherein the activity level recommendation includes a level of physical activity of an intensity level less than the determined classification of the patient activity intensity level.

5. The system of claim 1 , wherein the blood flow characteristic is chosen from coronary blood flow, blood pressure, plaque stress, myocardial perfusion, blood flow affecting plaque vulnerability, or blood flow resulting from a location in the patient's heart comprising a territory of the patient's heart at risk of insufficient blood flow.

6. The system of claim 1 , wherein the selected level of physical activity is chosen from aerobic activity and anaerobic activity.

7. The system of claim 1 , wherein the at least one computer system is further configured to:
generate the activity level recommendation relative to a patient activity intensity level corresponding to wherein the selected level of physical activity comprises intimacy.

8. The system of claim 1 , wherein the at least one computer system is further configured to:
update the activity level recommendation based on a change in the value of the blood flow characteristic over time.

9. The system of claim 8 , wherein the blood flow characteristic threshold value is derived from a normal state value of the patient or from subjects of similar age and/or fitness level to the patient.

10. The system of claim 1 , wherein the three-dimensional model representing the geometry of at least the portion of the patient's heart based on the received data includes at least a portion of an aorta and at least a portion of a plurality of coronary arteries emanating from the portion of the aorta.

11. The system of claim 1 , wherein the at least one computer system is configured to:
determine a location of a functionally significant narrowing in a coronary artery of the patient's heart based on the recalculated value of the at least one blood flow characteristic.

12. A method for determining an activity level recommendation for a patient, the method comprising:
receiving data describing a geometry of at least a portion of a patient's heart;
identifying a cardiac event and a blood flow characteristic threshold value associated with the cardiac event;
determining a three-dimensional model representing the geometry of at least the portion of the patient's heart based on the received data;
determining, using the at least one computer system, a physics-based model of blood flow through the three-dimensional model, the physics-based model including a resistance of blood flow at the patient's myocardium; simulated at a selected level of physical activity of the patient;
modeling the flow of blood through the three-dimensional model using the physics-based model of blood flow through the three-dimensional model simulated at the selected level of physical activity;
calculating, from the modeled flow of blood through the three-dimensional model simulated at the selected level of physical activity, a value of a blood flow characteristic within the patient's heart at the selected level of physical activity;
updating the physics-based model of blood flow by iteratively reducing the resistance to blood flow at the patient's myocardium and recalculating the value of the blood flow characteristic through each updated physics-based model, until the recalculated value exceeds the blood flow characteristic threshold value associated with the cardiac event;
determining, based on one or more stored patient activities classified according to intensity level, a classification of patient activity intensity level corresponding to the physics-based model at which the recalculated value exceeded the blood flow characteristic threshold value associated with the cardiac event; and
generating an activity level recommendation based on the determined classification of the patient activity intensity level.

13. The method of claim 12 , wherein the method further comprises:
generating the activity level recommendation based on a risk of injury to the patient, the injury including stroke or myocardial infarction, or other injury.

14. The method of claim 13 , wherein the method further comprises:
quantifying the risk of the stroke, myocardial infarction, or other injury.

15. The method of claim 12 , wherein the activity level recommendation includes a level of physical activity of an intensity level less than the determined classification of the patient activity intensity level.

16. The method of claim 12 , wherein the blood flow characteristic is chosen from coronary blood flow, blood pressure, plaque stress, myocardial perfusion, blood flow affecting plaque vulnerability, or blood flow resulting from a location in the patient's heart comprising a territory of the patient's heart at risk of insufficient blood flow.

17. The method of claim 12 , wherein the selected level of physical activity is chosen from aerobic activity and anaerobic activity.

18. The method of claim 12 , wherein the method further comprises:
generating the activity level recommendation relative to a patient activity intensity level corresponding to intimacy.

19. The method of claim 12 , wherein the metho

Assignees

• Heartflow Inc

Inventors

• Taylor Charles A

Classifications

• G06F30/28

  using fluid dynamics, e.g. using Navier-Stokes equations or computational fluid dynamics [CFD] · CPC title

• G16H50/50 Primary

  for simulation or modelling of medical disorders · CPC title

• G16H50/30

  for calculating health indices; for individual health risk assessment · CPC title

• A61B5/029

  Measuring blood output from the heart, e.g. minute volume · CPC title

• Y02A90/26

  Cross-Sectional Technologies · mapped topic