Computational modelling of multi-temporal ventricular–vascular interactions during the progression of pulmonary arterial hypertension

Abstract

A computational framework is developed to consider the concurrent growth and remodelling (G&R) processes occurring in the large pulmonary artery (PA) and right ventricle (RV), as well as ventricular–vascular interactions during the progression of pulmonary arterial hypertension (PAH). This computational framework couples the RV and the proximal PA in a closed-loop circulatory system that operates in a short timescale of a cardiac cycle, and evolves over a long timescale due to G&R processes in the PA and RV. The framework predicts changes in haemodynamics (e.g. 68.2% increase in mean PA pressure), RV geometry (e.g. 38% increase in RV end-diastolic volume) and PA tissue microstructure (e.g. 90% increase in collagen mass) that are consistent with clinical and experimental measurements of PAH. The framework also predicts that a reduction in RV contractility is associated with long-term RV chamber dilation, a common biomarker observed in the late-stage PAH. Sensitivity analyses on the G&R rate constants show that large PA stiffening (both short and long term) is affected by RV remodelling more than the reverse. This framework can serve as a foundation for the future development of a more predictive and comprehensive cardiovascular G&R model with realistic heart and vascular geometries.

A homogenized constrained mixture model of cardiac growth and remodeling: analyzing mechanobiological stability and reversal

“…Recently, Pourmodheji et al. ( 2022 ) coupled right ventricular and pulmonary arterial G&R in a multi-temporal computational model.…”

Review of cardiac–coronary interaction and insights from mathematical modeling

“…Hybrid models coupling 3D models with 1D or 0D models can offer a more comprehensive and efficient approach that leverages the strengths of each type of model while mitigating their individual limitations in modeling blood flow (Esmaily Moghadam et al, 2013; Fritz et al, 2022; Pourmodheji et al, 2022; Zambrano et al, 2022, 2022; Figure 2). Hybrid models can span multiple scales in the cardiovascular system and allow investigation of interactions between local and global flow dynamics.…”

“…To the best of our knowledge, mathematical models describing chronic cardiac–coronary interactions have not been developed yet. A somewhat related mathematical framework describing chronic ventricular–vascular coupling, however, has been developed (Pourmodheji et al, 2022). In this framework, the chronic interaction between the right ventricle and pulmonary vasculature was described using a lumped modeling approach that describes chronic changes in geometry and function of the ventricle as well as mass production and removal of tissue constituents in the pulmonary artery.…”