Towards a Computational Framework for Modeling the Impact of Aortic Coarctations Upon Left Ventricular Load

Area of Science:

• Biomedical Engineering
• Computational Science
• Cardiovascular Physiology

Background:

• Computational fluid dynamics (CFD) models of blood flow in the left ventricle (LV) and aorta are crucial for understanding myocardial deformation and flow dynamics.
• Current image-based kinematic CFD models have limitations in mechanistically assessing LV load and biomarkers driving cardiac remodeling.
• LV function is not mechanistically accounted for in existing models, hindering comprehensive analysis.

Purpose of the Study:

• To develop and validate a novel electro-mechano-fluidic (EMF) model for the left ventricle (LV).
• To integrate LV electromechanics (EM) with fluid dynamics for a comprehensive simulation of cardiac function.
• To assess the clinical applicability and computational feasibility of the EMF model for patient-specific cardiovascular conditions.

Main Methods:

• Developed a biophysically detailed finite element (FE) model of LV electromechanics (EM).
• Coupled the LV EM model with a FE-based CFD solver using an arbitrary Eulerian-Lagrangian (ALE) formulation for moving domains.
• Parameterized and simulated two clinical cases of aortic coarctation (CoA) under pre- and post-treatment conditions.

Main Results:

• Demonstrated numerical stability and solver performance under significant LV deformations.
• Investigated computational tractability and scalability up to 1536 compute cores.
• Showcased that the EMF model's computational cost is comparable to existing kinematic models.

Conclusions:

• The novel EMF model provides a mechanistic understanding of LV electromechanics and blood flow.
• The EMF model shows potential as a viable clinical research tool for cardiovascular analysis.
• This approach offers a pathway to better predict responses to interventions and understand cardiac remodeling processes.