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In this work we propose to validate the predictive capabilities ofone-dimensional (1D) blood flow models with full three-dimensional (3D) modelsin the context of patient-specific coronary hemodynamics in hyperemicconditions. Such conditions mimic the state of coronary circulation during theacquisition of the Fractional Flow Reserve (FFR) index. Demonstrating that 1Dmodels accurately reproduce FFR estimates obtained with 3D models hasimplications in the approach to computationally estimate FFR. To this end, asample of 20 patients was employed from which 29 3D geometries of arterialtrees were constructed, 9 obtained from coronary computed tomographyangiography (CCTA) and 20 from intra-vascular ultrasound (IVUS). For each 3Darterial model, a 1D counterpart was generated. The same outflow and inletpressure boundary conditions were applied to both (3D and 1D) models. In the 1Dsetting, pressure losses at stenoses and bifurcations were accounted forthrough specific lumped models. Comparisons between 1D models($\text{FFR}_{\text{1D}}$) and 3D models ($\text{FFR}_{\text{3D}}$) wereperformed in terms of predicted $\text{FFR}$ value. Compared to$\text{FFR}_{\text{3D}}$, $\text{FFR}_{\text{1D}}$ resulted with a differenceof 0.00$\pm$0.03 and overall predictive capability AUC, Acc, Spe, Sen, PPV andNPV of 0.97, 0.98, 0.90, 0.99, 0.82, and 0.99, with an FFR threshold of 0.8. Weconclude that inexpensive $\text{FFR}_{\text{1D}}$ simulations can be reliablyused as a surrogate of demanding $\text{FFR}_{\text{3D}}$ computations.

Comparison of 1D and 3D Models for the Estimation of Fractional Flow Reserve