First Clinical Results of Novel Haemodynamic Simulation Software for Patient-Specific Qp:Qs Quantification in...

Area of Science:

• Cardiovascular Medicine
• Medical Imaging
• Computational Biology

Background:

• Accurate quantification of left-to-right shunt volume is critical for managing atrial septal defects (ASD).
• Conventional Doppler-derived Qp:Qs measurements in echocardiography have limitations including operator dependency and measurement error amplification, especially in pediatric patients.
• Simulation-based hemodynamic modeling offers a patient-specific, operator-independent alternative for shunt quantification.

Purpose of the Study:

• To evaluate the agreement between conventional Doppler-derived Qp:Qs and a novel software-based, three-dimensional hemodynamic simulation model for quantifying shunt volume in ASD patients.
• To assess the clinical feasibility and potential of simulation-based hemodynamic modeling as an alternative to standard echocardiographic methods.

Main Methods:

• Retrospective analysis of transthoracic echocardiographic datasets from 94 patients with isolated secundum ASD undergoing defect closure.
• Conventional Qp:Qs calculated using standard echocardiographic measurements of valve diameters and velocity-time integrals.
• Software-derived Qp:Qs computed using patient-specific 3D hemodynamic modeling integrating cardiac geometry and physiological parameters.

Main Results:

• No statistically significant difference was found between mean Qp:Qs values derived from echocardiography (1.83 ± 0.45) and simulation modeling (1.73 ± 0.47).
• 53.1% of examinations met the predefined ± 20% deviation threshold for clinical acceptability.
• Increased ASD diameter correlated with greater deviation between the two quantification methods.

Conclusions:

• Patient-specific 3D hemodynamic simulation is a feasible approach for quantifying shunt physiology in ASD patients using routine echocardiographic data.
• Simulation-derived Qp:Qs estimates show no systematic difference compared to conventional Doppler methods and can be integrated into clinical workflows.
• Further prospective validation against invasive hemodynamic standards is needed to confirm analytical accuracy and clinical utility.