Medical Image-Based Hemodynamic Analyses in a Study of the Pulmonary Artery in Children With Pulmonary Hypertension Related to Congenital Heart Disease

Abstract

Objective: Pulmonary hypertension related to congenital heart disease (PH-CHD) is a devastating disease caused by hemodynamic disorders. Previous hemodynamic research in PH-CHD mainly focused on wall shear stress (WSS). However, energy loss (EL) is a vital parameter in evaluation of hemodynamic status. We investigated if EL of the pulmonary artery (PA) is a potential biomechanical marker for comprehensive assessment of PH-CHD.Materials and Methods: Ten PH-CHD patients and 10 age-matched controls were enrolled. Subject-specific 3-D PA models were reconstructed based on computed tomography. Transient flow, WSS, and EL in the PA were calculated using non-invasive computational fluid dynamics. The relationship between body surface area (BSA)-normalized EL (E.) and PA morphology and PA flow were analyzed.Results: Morphologic analysis indicated that the BSA-normalized main PA (MPA) diameter (DMPAnorm), MPA/aorta diameter ratio (DMPA/DAO), and MPA/(left PA + right PA) [DMPA/D(LPA+RPA)] diameter ratio were significantly larger in PH-CHD patients. Hemodynamic results showed that the velocity of the PA branches was higher in PH-CHD patients, in whom PA flow rate usually increased. WSS in the MPA was lower and E. was higher in PH-CHD patients. E. was positively correlated with DMPAnorm, DMPA/DAO, and DMPA/D(LPA+RPA) ratios and the flow rate in the PA. E. was a sensitive index for the diagnosis of PH-CHD.Conclusion:E. is a potential biomechanical marker for PH-CHD assessment. This hemodynamic parameter may lead to new directions for revealing the potential pathophysiologic mechanism of PH-CHD.

Subject-specific one-dimensional fluid dynamics model of chronic thromboembolic pulmonary hypertension

“…Large animal models of CTEPH have advanced our understanding of the pathophysiology of CTEPH (Mulchrone et al 2019;Stam et al 2021), but typically do not report local mechanical stimuli for disease progression such as WSS. Image-based computational uid dynamics (CFD) modeling can compute pulmonary artery blood ow with high spatial resolution (Burrowes et al 2017;Bordones et al 2018; Wang et al 2020), from which WSS can be calculated. The combination of experiments in large animal models of CTEPH with CFD analysis enables estimation of mechanobiological stimuli in sections of the pulmonary arterial network inaccessible to measurement.…”

Subject-specific one-dimensional fluid dynamics model of chronic thromboembolic pulmonary hypertension

“…Large animal models of CTEPH have advanced our understanding of the pathophysiology of CTEPH (Mulchrone et al 2019 ; Stam et al 2021 ), but typically do not report local mechanical stimuli for disease progression such as WSS. Image-based computational fluid dynamics (CFD) modeling can compute pulmonary artery blood flow with high spatial resolution (Burrowes et al 2017 ; Bordones et al 2018 ; Wang et al 2020 ), from which WSS can be calculated. The combination of experiments in large animal models of CTEPH with CFD analysis enables estimation of mechanobiological stimuli in sections of the pulmonary arterial network inaccessible to measurement.…”

Simulation of Cardiac Flow under the Septal Defect Based on Lattice Boltzmann Method

“…Congenital heart disease (CHD), having a high incidence (about 0.8–1.2% of newborns) in China and the United States, becomes one of the main diseases affecting the survival rate of newborns [ 1 , 2 ]. As one of the main causes of CHD, the septal defect can be divided into the atrial septal defect (ASD) and ventricular septal defect (VSD) according to the location of the septal defect [ 3 , 4 ].…”