A Zero-Dimensional Model and Protocol for Simulating Patient-Specific Pulmonary Hemodynamics From Limited Clinical...

Area of Science:

• Cardiovascular Physiology
• Computational Modeling
• Pediatric Cardiology

Background:

• Clinical markers for pulmonary hypertension (PH) diagnosis and management are often difficult to implement.
• Research is limited by scarce retrospective data, necessitating simulations for hemodynamic extrapolation.
• Accurate modeling of the right ventricle-pulmonary artery (RV-PA) axis is crucial for understanding PH.

Purpose of the Study:

• To develop and validate a 0D computational model of the RV-PA axis.
• To create a numerical implementation protocol for the RV-PA model.
• To assess the model's ability to predict hemodynamic parameters in pediatric PH patients.

Main Methods:

• A 0D computational model representing the RV-PA circuit was developed.
• The RV was modeled using a general elastance function; the PA used a three-element Windkessel model.
• The model was validated against right heart catheterization (RHC) data from 115 pediatric PH patients.

Main Results:

• The model predicted 96-98% of pressure variability and 98-99% of volumetric (cardiac output, stroke volume) variability.
• Qualitative comparison with published clinical data was performed.
• Bland Altman analysis revealed consistent bias and considerable error for most parameters, despite high variability prediction.

Conclusions:

• The RV-PA computational model shows promising proof of concept for simulating PH hemodynamics.
• The model's ability to predict variability is strong, but bias requires further investigation.
• Future work will focus on refining the model and comparing specific waveforms for improved accuracy.