Attention-based Multi-fidelity Machine Learning Model for Computational Fractional Flow Reserve Assessment

Coronary Artery Disease (CAD) is one of the most common forms of heart disease, which is caused by a buildup of atherosclerotic plaque (known as stenosis) in the coronary arteries, leading to insufficient supplement of blood, oxygen, and nutrients to the heart. Fractional Flow Reserve (FFR), measuring the pressure ratio between the aorta and distal coronary artery, is an invasive physiologic gold standard for assessing the severity of coronary artery stenosis. Despite its benefits, invasive FFR assessment is still underutilized due to its high cost, time-consuming, experimental variability, and increased risk to patients. In this study, an attention-based multi-fidelity machine learning model (AttMulFid) is proposed for computationally efficient and accurate FFR assessment with uncertainty measurement. Within AttMulFid, an autoencoder is utilized to intelligently select geometric features from coronary arteries, with additional attention on the key area. Results show that the geometric features are able to represent the entirety of the geometric information and intelligently allocate attention based on crucial properties of geometry. Furthermore, the AttMulFid is a feasible approach for non-invasive, rapid, and accurate FFR assessment (with 0.002s/simulation).