Zhang Daibo, Lindsey Stephanie E
Department of Mechanical and Aerospace Engineering, University of California, San Diego, CA 92093, USA.
J Cardiovasc Dev Dis. 2023 May 30;10(6):240. doi: 10.3390/jcdd10060240.
Computational hemodynamic simulations are becoming increasingly important for cardiovascular research and clinical practice, yet incorporating numerical simulations of human fetal circulation is relatively underutilized and underdeveloped. The fetus possesses unique vascular shunts to appropriately distribute oxygen and nutrients acquired from the placenta, adding complexity and adaptability to blood flow patterns within the fetal vascular network. Perturbations to fetal circulation compromise fetal growth and trigger the abnormal cardiovascular remodeling that underlies congenital heart defects. Computational modeling can be used to elucidate complex blood flow patterns in the fetal circulatory system for normal versus abnormal development. We present an overview of fetal cardiovascular physiology and its evolution from being investigated with invasive experiments and primitive imaging techniques to advanced imaging (4D MRI and ultrasound) and computational modeling. We introduce the theoretical backgrounds of both lumped-parameter networks and three-dimensional computational fluid dynamic simulations of the cardiovascular system. We subsequently summarize existing modeling studies of human fetal circulation along with their limitations and challenges. Finally, we highlight opportunities for improved fetal circulation models.
计算血流动力学模拟在心血管研究和临床实践中变得越来越重要，但纳入人类胎儿循环的数值模拟相对未得到充分利用且发展不足。胎儿拥有独特的血管分流，以适当分配从胎盘获取的氧气和营养物质，这增加了胎儿血管网络内血流模式的复杂性和适应性。胎儿循环的扰动会损害胎儿生长，并引发作为先天性心脏缺陷基础的异常心血管重塑。计算建模可用于阐明胎儿循环系统中正常与异常发育情况下的复杂血流模式。我们概述了胎儿心血管生理学及其从通过侵入性实验和原始成像技术进行研究到先进成像（四维磁共振成像和超声）以及计算建模的演变。我们介绍了心血管系统的集总参数网络和三维计算流体动力学模拟的理论背景。随后，我们总结了现有的人类胎儿循环建模研究及其局限性和挑战。最后，我们强调了改进胎儿循环模型的机会。
