Elevated Mean Translesional Pressure Gradients and Flow Limitation in Significant Human Coronary Stenoses Before Angioplasty

Blood flow was simulated in patients (Wilson et al. 1988) with physiologically significant coronary lesions (minimal lesion size d_m = 0.95 mm; 68% mean diameter stenosis; measured coronary flow reserve (CFR) of 2.3) by using computational hemodynamics. Computed mean pressure gradients $Δp˜$ were about 9 mm Hg for basal flow, and flow limiting values about ∼ 35 mm Hg. Mean hyperemic flow rates were about 115 ml/min, and distal mean coronary pressures ∼ 55 mm Hg, a level known to cause ischemia in the subendocardium (Brown et al. 1984), and consistent with the occurrence of angina in the patients.