A multiscale computational modeling for cerebral blood flow with aneurysms and/or stenoses

Yu, Hongtao; Huang, Gaofeng; Yang, Zifeng; Ludwig, Bryan

doi:10.1002/cnm.3127

Cited by 15 publications

(26 citation statements)

References 42 publications

(88 reference statements)

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“…Mathematical modeling is one means to investigate integrated organ function and dysfunction and to understand the effects of interventions. Lumped parameter models have frequently been utilized to model the hemodynamic characteristics of the heart [13][14][15][16][17][18][19], computing the pressure and volume of heart chambers through a time-dependent elastance by prescribing two constants of active and passive elastance of heart chambers [13][14][15][16]. However, these models assume constant blood volume and thus ignore the role of the kidney.…”

Section: Introductionmentioning

confidence: 99%

Cardiac and renal function interactions in heart failure with reduced ejection fraction: A mathematical modeling analysis

Basu

Hallow

2020

PLoS Comput Biol

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Congestive heart failure is characterized by suppressed cardiac output and arterial filling pressure, leading to renal retention of salt and water, contributing to further volume overload. Mathematical modeling provides a means to investigate the integrated function and dysfunction of heart and kidney in heart failure. This study updates our previously reported integrated model of cardiac and renal functions to account for the fluid exchange between the blood and interstitium across the capillary membrane, allowing the simulation of edema. A state of heart failure with reduced ejection fraction (HF-rEF) was then produced by altering cardiac parameters reflecting cardiac injury and cardiovascular disease, including heart contractility, myocyte hypertrophy, arterial stiffness, and systemic resistance. After matching baseline characteristics of the SOLVD clinical study, parameters governing rates of cardiac remodeling were calibrated to describe the progression of cardiac hemodynamic variables observed over one year in the placebo arm of the SOLVD clinical study. The model was then validated by reproducing improvements in cardiac function in the enalapril arm of SOLVD. The model was then applied to prospectively predict the response to the sodium-glucose co-transporter 2 (SGLT2) inhibitor dapagliflozin, which has been shown to reduce heart failure events in HF-rEF patients in the recent DAPAHF clinical trial by incompletely understood mechanisms. The simulations predict that dapagliflozin slows cardiac remodeling by reducing preload on the heart, and relieves congestion by clearing interstitial fluid without excessively reducing blood volume. This provides a quantitative mechanistic explanation for the observed benefits of SGLT2i in HF-rEF. The model also provides a tool for further investigation of heart failure drug therapies. Recently, the DAPAHF and EMPA-REG clinical trials showed that the Sodium-Glucose Cotransporter-2 Inhibitor (SGLT2i) class of drugs are beneficial in reducing the heart failure with reduced ejection fraction (HFrEF) hospitalization and lowering the risk of PLOS COMPUTATIONAL BIOLOGY

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Section: Introductionmentioning

confidence: 99%

Cardiac and renal function interactions in heart failure with reduced ejection fraction: A mathematical modeling analysis

Basu

Hallow

2020

PLoS Comput Biol

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“…Having capacitors and inductors included for the large arteries may improve the simulations, but will inevitably increase the complexity of the model. Another development direction is to apply a coupled or hybrid electrical analog and one dimensional (0D-1D) model, which has been presented in recent multidimensional modeling works, e.g., in Baker et al (2020) and Yu et al (2018). Specifically, the CBF re-distribution in the CoW could be analyzed from a 1D flow model coupled with 0D models at vessel outlets (Yu et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Another development direction is to apply a coupled or hybrid electrical analog and one dimensional (0D–1D) model, which has been presented in recent multidimensional modeling works, e.g., in Baker et al (2020) and Yu et al (2018) . Specifically, the CBF re-distribution in the CoW could be analyzed from a 1D flow model coupled with 0D models at vessel outlets ( Yu et al, 2018 ). Prediction of blood flow through the AVM is dependent strongly on the parameter values involved in the model.…”

Section: Discussionmentioning

confidence: 99%

Patient-Specific Blood Flow Analysis for Cerebral Arteriovenous Malformation Based on Digital Subtraction Angiography Images

Zhang

Chau

2020

Front. Bioeng. Biotechnol.

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Real-time digital subtraction angiography (DSA) is capable of revealing the cerebral vascular morphology and blood flow perfusion patterns of arterial venous malformations (AVMs). In this study, we analyze the DSA images of a subject-specific left posterior AVM case and customize a generic electric analog model for cerebral circulation accordingly. The generic model consists of electronic components representing 49 major cerebral arteries and veins, and yields their blood pressure and flow rate profiles. The model was adapted by incorporating the supplying and draining patterns of the AVM to simulate some typical AVM features such as the blood "steal" syndrome, where the flow rate in the left posterior artery increases by almost three times (∼300 ml/min vs 100 ml/min) compared with the healthy case. Meanwhile, the flow rate to the right posterior artery is reduced to ∼30 ml/min from 100 ml/min despite the presence of an autoregulation mechanism in the model. In addition, the blood pressure in the draining veins is increased from 9 to 22 mmHg, and the blood pressure in the feeding arteries is reduced from 85 to 30 mmHg due to the fistula effects of the AVM. In summary, a first DSA-based AVM model has been developed. More subject-specific AVM cases are required to apply the presented in silico model, and in vivo data are used to validate the simulation results.

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“…In all CFD simulations, the maximum Reynolds number is 565 calculated from the ICA aneurysm model. Thus, all simulations assumed the flow as laminar flow throughout the calculations …”

Section: Methodsmentioning

confidence: 99%

Numerical studies of hemodynamic alterations in pre‐ and post‐stenting cerebral aneurysms using a multiscale modeling

Huang

Yang

et al. 2019

Numer Methods Biomed Eng

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The aim of this work was to use a multiscale modeling to study the influence of stent deployment, with generic stents, on flow distributions within the vascular network and the hemodynamic alterations within the cerebral aneurysms pre‐ and post‐stenting. To achieve this goal, two image‐based anatomical cerebral aneurysm models were reconstructed along with the respective aneurysms post‐stenting models after deploying a 16‐ or 24‐wire stent. The investigation results revealed that the stent may increase the local pressure resistance resulting in flow alterations. The hemodynamic parameters demonstrated stent placement can reduce the intra‐aneurysmal pressure, decrease wall shear stress (WSS) at the neck region, and increase blood turnover time for aneurysm case I (sidewall aneurysm). These findings are consistent with the trends of hemodynamic changes reported previously. However, aneurysm case II (bifurcation aneurysm) showed gradually increased intra‐aneurysmal pressure and the pressure at the neck region, decreased WSS over the sac surface, and enhanced flow vortices within the aneurysm. When simulating the hemodynamics of pre‐ and post‐stenting aneurysms for a patient using measured flow waveforms, the flow alteration induced by the stent deployment may affect the hemodynamic predictions for the post‐stenting aneurysm. Thus, the remeasurement of boundary conditions once the morphology of the aneurysm is deformed is needed in follow‐up studies with a focus on aneurysm growth and stent deployment.

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A multiscale computational modeling for cerebral blood flow with aneurysms and/or stenoses

Cited by 15 publications

References 42 publications

Cardiac and renal function interactions in heart failure with reduced ejection fraction: A mathematical modeling analysis

Cardiac and renal function interactions in heart failure with reduced ejection fraction: A mathematical modeling analysis

Patient-Specific Blood Flow Analysis for Cerebral Arteriovenous Malformation Based on Digital Subtraction Angiography Images

Numerical studies of hemodynamic alterations in pre‐ and post‐stenting cerebral aneurysms using a multiscale modeling

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