Explain superior model-measurement alignment under dobutamine stress

Determine the physiological mechanisms and/or modeling factors that cause fluid-structure interaction simulations calibrated using resting fractional flow reserve to align more closely with dobutamine-induced stress fractional flow reserve measurements than with adenosine-induced stress measurements in pediatric patients with anomalous aortic origin of a coronary artery.

Background

The paper found approximately a 50% reduction in error for simulations compared with dobutamine-induced stress FFR relative to adenosine-induced stress FFR, despite using the same simplified stress model for both cases.

The authors note prior evidence that the two drugs elicit different physiological responses and hypothesize this might relate to fixed and dynamic components of obstruction captured by the FSI model, but they explicitly state the reason for better alignment under dobutamine is not yet understood.