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

• DOI: 10.1007/s10439-020-02681-z
• Publication Date: 2020-12-01T19:14:52Z
• Authors: Lazaros Papamanolis; Hyun Jin Kim; Clara Jaquet; Matthew Sinclair; Michiel Schaap; Ibrahim Danad; Pepijn van Diemen; Paul Knaapen; Laurent Najman; Hugues Talbot; Charles A. Taylor; Irene Vignon-Clem...
• Keywords: Patient-Specific Modeling; [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging; Heart Ventricles; Coronary Artery Disease; Coronary artery disease; 03 medical and health sciences; 0302 clinical medicine; [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system; [SPI.MECA.BIOM] Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph]; Coronary Circulation; Humans; [SPI.SIGNAL] Engineering Sciences [physics]/Signal and Image processing; MBF (Myocardial Blood Flow); Myocardium; PET perfusion map; Hemodynamics; [SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph]; Heart; [INFO.INFO-NA]Computer Science [cs]/Numerical Analysis [cs.NA]; Coronary Vessels; [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system; Perfusion; [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging; [INFO.INFO-NA] Computer Science [cs]/Numerical Analysis [cs.NA]; Original Article; [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing

AbstractPatient-specific models of blood flow are being used clinically to diagnose and plan treatment for coronary artery disease. A remaining challenge is bridging scales from flow in arteries to the micro-circulation supplying the myocardium. Previously proposed models are descriptive rather than predictive and have not been applied to human data. The goal here is to develop a multiscale patient-specific model enabling blood flow simulation from large coronary arteries to myocardial tissue. Patient vasculatures are segmented from coronary computed tomography angiography data and extended from the image-based model down to the arteriole level using a space-filling forest of synthetic trees. Blood flow is modeled by coupling a 1D model of the coronary arteries to a single-compartment Darcy myocardium model. Simulated results on five patients with non-obstructive coronary artery disease compare overall well to [$$^{15}$$

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O PET exam data for both resting and hyperemic conditions. Results on a patient with severe obstructive disease link coronary artery narrowing with impaired myocardial blood flow, demonstrating the model’s ability to predict myocardial regions with perfusion deficit. This is the first report of a computational model for simulating blood flow from the epicardial coronary arteries to the left ventricle myocardium applied to and validated on human data.