Department of Mechanical Engineering, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA; Department of Mechanical Engineering, Istinye University, Zeytinburnu, Istanbul 34010, Turkey.
Department of Mechanical Engineering, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA.
Med Eng Phys. 2020 Mar;77:1-9. doi: 10.1016/j.medengphy.2020.01.006. Epub 2020 Jan 29.
Pulmonary hypertension (PH) is a progressive disease affecting approximately 10-52 cases per million, with a higher incidence in women, and with a high mortality associated with right ventricle (RV) failure. In this work, we explore the relationship between hemodynamic indices, calculated from in silico models of the pulmonary circulation, and clinical attributes of RV workload and pathological traits. Thirty-four patient-specific pulmonary arterial tree geometries were reconstructed from computed tomography angiography images and used for volume meshing for subsequent computational fluid dynamics (CFD) simulations. Data obtained from the CFD simulations were post-processed resulting in hemodynamic indices representative of the blood flow dynamics. A retrospective review of medical records was performed to collect the clinical variables measured or calculated from standard hospital examinations. Statistical analyses and canonical correlation analysis (CCA) were performed for the clinical variables and hemodynamic indices. Systolic pulmonary artery pressure (sPAP), diastolic pulmonary artery pressure (dPAP), cardiac output (CO), and stroke volume (SV) were moderately correlated with spatially averaged wall shear stress (0.60 ≤ R ≤ 0.66; p < 0.05). Similarly, the CCA revealed a linear and strong relationship (ρ = 0.87; p << 0.001) between 5 clinical variables and 2 hemodynamic indices. To this end, in silico models of PH blood flow dynamics have a high potential for predicting the relevant clinical attributes of PH if analyzed in a group-wise manner using CCA.
肺动脉高压（PH）是一种影响约每百万人口 10-52 例的进行性疾病，女性发病率较高，与右心室（RV）衰竭相关的死亡率较高。在这项工作中，我们探讨了血流动力学指数与 RV 工作量和病理特征的临床属性之间的关系，这些指数是通过肺循环的计算机模型计算得出的。从计算机断层血管造影图像重建了 34 个患者特定的肺动脉树几何形状，并用于随后的计算流体动力学（CFD）模拟的体积网格划分。从 CFD 模拟中获得的数据进行了后处理，得出了代表血流动力学的血流动力学指数。对病历进行了回顾性审查，以收集从标准医院检查中测量或计算得出的临床变量。对临床变量和血流动力学指数进行了统计分析和典型相关分析（CCA）。收缩期肺动脉压（sPAP）、舒张期肺动脉压（dPAP）、心输出量（CO）和每搏输出量（SV）与空间平均壁切应力呈中度相关（0.60≤R≤0.66；p<0.05）。同样，CCA 显示 5 个临床变量和 2 个血流动力学指数之间存在线性强关系（ρ=0.87；p<<0.001）。为此，如果使用 CCA 以组为单位进行分析，PH 血流动力学的计算机模型具有预测 PH 相关临床属性的高潜力。
