Physics-Guided Variational Method for Fractional Flow Reserve Based on Coronary Angiography

As a leading global cause of mortality, coronary ischemia requires accurate diagnostics for effective management. The combining coronary angiography with fractional flow reserve (FFR) offers structural and functional assessment of coronary stenosis to guide revascularization. However, traditional FFR measurements are invasive, requiring pressure wire placement. Image-based FFR estimation methods integrate vascular morphology with biomechanics but face challenges in modelling the complex fluid-structure interaction (FSI) of coronary flow and vessel walls. Therefore, we propose a physics-guided variational domain progressing method (PVDPM) for non-invasive FFR estimation through FSI system. PVDPM employs the principle of virtual work to model FSI system. This approach can improve the modelling of interdependent physical processes, enabling accurate FFR estimation based on coronary angiography-derived vascular morphology. The PVDPM demonstrates 91% accuracy in clinical datasets and offers solution for diagnosing coronary ischemia based on coronary angiography.