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Myocardial Perfusion Simulation for Coronary Artery Disease: A Coupled Patient-Specific Multiscale Model.

Lazaros Papamanolis1, Hyun Jin Kim2, Clara Jaquet3

  • 1Inria, Paris, France.

Annals of Biomedical Engineering
|December 2, 2020
PubMed
Summary

This study introduces a patient-specific multiscale model for simulating blood flow from coronary arteries to the heart muscle. The model accurately predicts myocardial blood flow and perfusion deficits, advancing coronary artery disease diagnosis and treatment planning.

Keywords:
Coronary artery diseaseHeartHemodynamicsMBF (Myocardial blood flow)PET perfusion map

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Area of Science:

  • Cardiovascular Physiology
  • Computational Fluid Dynamics
  • Medical Imaging Analysis

Background:

  • Patient-specific models are crucial for diagnosing and planning coronary artery disease (CAD) treatment.
  • A gap exists in modeling blood flow from large coronary arteries to the myocardial microcirculation.
  • Existing models are descriptive, lack predictive power, and haven't been validated on human data.

Purpose of the Study:

  • To develop a multiscale, patient-specific computational model for simulating blood flow from epicardial coronary arteries to the myocardium.
  • To bridge the scale gap between macro- and micro-circulation in the heart.

Main Methods:

  • Coronary computed tomography angiography (CCTA) data used to segment patient vasculatures.
  • Image-based models extended to arteriole level using synthetic trees.
  • Blood flow simulated by coupling a 1D coronary artery model with a single-compartment Darcy myocardium model.

Main Results:

  • Simulations in five non-obstructive CAD patients showed good agreement with [Formula: see text]O[Formula: see text] PET data under resting and hyperemic conditions.
  • A patient with severe obstructive CAD demonstrated the model's ability to link coronary narrowing to impaired myocardial blood flow and perfusion deficits.
  • This represents the first computational model for epicardial to myocardial blood flow simulation validated on human data.

Conclusions:

  • The developed multiscale model enables patient-specific simulation of blood flow from coronary arteries to the myocardium.
  • The model accurately predicts myocardial perfusion deficits, offering potential for improved CAD diagnosis and treatment.
  • This work establishes a novel computational framework for personalized cardiovascular research and clinical application.