Testing a Patient-Specific In-Silico Model to Noninvasively Estimate Central Blood Pressure

Gallo, Caterina; Olbers, Joakim; Ridolfi, Luca; Scarsoglio, Stefania; Witt, Nils

doi:10.1007/s13239-020-00512-9

Cited by 3 publications

(11 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Numerical simulations were carried out by means of a closed loop 1D-0D multiscale model of the entire human cardiovascular system. This computational tool is the result of several studies 19 – 21 , and, since its first introduction 19 , has been enriched and validated 21 . The present model merges the cardiovascular description as adopted in 20 , 21 with the coronary modeling presented in 22 , 23 .…”

Section: Methodsmentioning

confidence: 99%

“…This computational tool is the result of several studies 19 – 21 , and, since its first introduction 19 , has been enriched and validated 21 . The present model merges the cardiovascular description as adopted in 20 , 21 with the coronary modeling presented in 22 , 23 . A brief overview of the resulting cardiovascular-coronary framework is recalled hereunder, while more details (including full parameter settings) are offered in the Supplementary I nformation.…”

Section: Methodsmentioning

confidence: 99%

“…For symmetry reasons, lower body 1D arteries were modeled for one leg only, but their contribution was doubled to account also for the other leg. Parameter setting can be found in our previous works 20 , 21 . …”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

A computational analysis of atrial fibrillation effects on coronary perfusion across the different myocardial layers

Saglietto

Fois

Ridolfi

et al. 2022

Sci Rep

Self Cite

View full text Add to dashboard Cite

Patients with atrial fibrillation (AF) may present ischemic chest pain in the absence of classical obstructive coronary disease. Among the possible causes, the direct hemodynamic effect exerted by the irregular arrhythmia has not been studied in detail. We performed a computational fluid dynamics analysis by means of a 1D-0D multiscale model of the entire human cardiovascular system, enriched by a detailed mathematical modeling of the coronary arteries and their downstream distal microcirculatory districts (subepicardial, midwall and subendocardial layers). Three mean ventricular rates were simulated (75, 100, 125 bpm) in both sinus rhythm (SR) and atrial fibrillation, and an inter-layer and inter-frequency analysis was conducted focusing on the ratio between mean beat-to-beat blood flow in AF compared to SR. Our results show that AF exerts direct hemodynamic consequences on the coronary microcirculation, causing a reduction in microvascular coronary flow particularly at higher ventricular rates; the most prominent reduction was seen in the subendocardial layers perfused by left coronary arteries (left anterior descending and left circumflex arteries).

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

A computational analysis of atrial fibrillation effects on coronary perfusion across the different myocardial layers

Saglietto

Fois

Ridolfi

et al. 2022

Sci Rep

Self Cite

View full text Add to dashboard Cite

show abstract

“…The present model of the human CVS is an extension of the previous works by Guala et al (2015), Gallo et al (2020), andGallo et al (2021). The global layout is composed of a 1D description of the arterial tree and 0D electric analogs of the remaining systemic microvasculature (arterioles, capillaries, and venules), the venous return (veins and venae cavae), and the cardio-pulmonary circulation.…”

Section: Mathematical Modelmentioning

confidence: 99%

“…Three additional districts were included to represent superior, inferior, and abdominal venae cavae, directly connected to the cardiopulmonary circulation. The subdivision of the 0D systemic circulation into five distinct regions represents the major layout improvement with respect to the last versions of Gallo et al (2020Gallo et al ( , 2021. In this way, the gravitational effects onto different body portions can be properly studied, devoting special focus to the head and legs compartments, where the largest gravity impact occurs.…”

Section: Mathematical Modelmentioning

confidence: 99%

Cardiovascular Response to Posture Changes: Multiscale Modeling and in vivo Validation During Head-Up Tilt

et al. 2022

Self Cite

View full text Add to dashboard Cite

In spite of cardiovascular system (CVS) response to posture changes have been widely studied, a number of mechanisms and their interplay in regulating central blood pressure and organs perfusion upon orthostatic stress are not yet clear. We propose a novel multiscale 1D-0D mathematical model of the human CVS to investigate the effects of passive (i.e., through head-up tilt without muscular intervention) posture changes. The model includes the main short-term regulation mechanisms and is carefully validated against literature data and in vivo measures here carried out. The model is used to study the transient and steady-state response of the CVS to tilting, the effects of the tilting rate, and the differences between tilt-up and tilt-down. Passive upright tilt led to an increase of mean arterial pressure and heart rate, and a decrease of stroke volume and cardiac output, in agreement with literature data and present in vivo experiments. Pressure and flow rate waveform analysis along the arterial tree together with mechano-energetic and oxygen consumption parameters highlighted that the whole system approaches a less stressed condition at passive upright posture than supine, with a slight unbalance of the energy supply-demand ratio. The transient dynamics is not symmetric in tilt-up and tilt-down testing, and is non-linearly affected by the tilting rate, with stronger under- and overshoots of the hemodynamic parameters as the duration of tilt is reduced. By enriching the CVS response to posture changes, the present modeling approach shows promise in a number of applications, ranging from autonomic system disorders to spaceflight deconditioning.

show abstract

Haemodynamic effects of hypertension and type 2 diabetes: Insights from a 4D flow MRI‐based personalized cardiovascular mathematical model

Tunedal

Viola

Garcia

et al. 2023

The Journal of Physiology

View full text Add to dashboard Cite

Type 2 diabetes (T2D) and hypertension increase the risk of cardiovascular diseases mediated by whole‐body changes to metabolism, cardiovascular structure and haemodynamics. The haemodynamic changes related to hypertension and T2D are complex and subject‐specific, however, and not fully understood. We aimed to investigate the haemodynamic mechanisms in T2D and hypertension by comparing the haemodynamics between healthy controls and subjects with T2D, hypertension, or both. For all subjects, we combined 4D flow magnetic resonance imaging data, brachial blood pressure and a cardiovascular mathematical model to create a comprehensive subject‐specific analysis of central haemodynamics. When comparing the subject‐specific haemodynamic parameters between the four groups, the predominant haemodynamic difference is impaired left ventricular relaxation in subjects with both T2D and hypertension compared to subjects with only T2D, only hypertension and controls. The impaired relaxation indicates that, in this cohort, the long‐term changes in haemodynamic load of co‐existing T2D and hypertension cause diastolic dysfunction demonstrable at rest, whereas either disease on its own does not. However, through subject‐specific predictions of impaired relaxation, we show that altered relaxation alone is not enough to explain the subject‐specific and group‐related differences; instead, a combination of parameters is affected in T2D and hypertension. These results confirm previous studies that reported more adverse effects from the combination of T2D and hypertension compared to either disease on its own. Furthermore, this shows the potential of personalized cardiovascular models in providing haemodynamic mechanistic insights and subject‐specific predictions that could aid in the understanding and treatment planning of patients with T2D and hypertension. imageKey points The combination of 4D flow magnetic resonance imaging data and a cardiovascular mathematical model allows for a comprehensive analysis of subject‐specific haemodynamic parameters that otherwise cannot be derived non‐invasively. Using this combination, we show that diastolic dysfunction in subjects with both type 2 diabetes (T2D) and hypertension is the main group‐level difference between controls, subjects with T2D, subjects with hypertension, and subjects with both T2D and hypertension. These results suggest that, in this relatively healthy population, the additional load of both hypertension and T2D affects the haemodynamic function of the left ventricle, whereas each disease on its own is not enough to cause significant effects under resting conditions. Finally, using the subject‐specific model, we show that the haemodynamic effects of diastolic dysfunction alone are not sufficient to explain all the observed haemodynamic differences. Instead, additional subject‐specific variations in cardiac and vascular function combine to explain the complex haemodynamics of subjects affected by hypertension and/or T2D.

show abstract

Testing a Patient-Specific In-Silico Model to Noninvasively Estimate Central Blood Pressure

Cited by 3 publications

References 55 publications

A computational analysis of atrial fibrillation effects on coronary perfusion across the different myocardial layers

A computational analysis of atrial fibrillation effects on coronary perfusion across the different myocardial layers

Cardiovascular Response to Posture Changes: Multiscale Modeling and in vivo Validation During Head-Up Tilt

Haemodynamic effects of hypertension and type 2 diabetes: Insights from a 4D flow MRI‐based personalized cardiovascular mathematical model

Contact Info

Product

Resources

About