MOX, Laboratory of Modeling and Scientific Computing, Dipartimento di Matematica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milano, Italy.
ELEM Biotech S.L., Pier01, Palau de Mar, Plaça Pau Vila, 1, 08003, Barcelona, Spain.
Sci Rep. 2023 Aug 30;13(1):14220. doi: 10.1038/s41598-023-41312-0.
The aim of this paper is to introduce a new mathematical model that simulates myocardial blood perfusion that accounts for multiscale and multiphysics features. Our model incorporates cardiac electrophysiology, active and passive mechanics, hemodynamics, valve modeling, and a multicompartment Darcy model of perfusion. We consider a fully coupled electromechanical model of the left heart that provides input for a fully coupled Navier-Stokes-Darcy Model for myocardial perfusion. The fluid dynamics problem is modeled in a left heart geometry that includes large epicardial coronaries, while the multicompartment Darcy model is set in a biventricular myocardium. Using a realistic and detailed cardiac geometry, our simulations demonstrate the biophysical fidelity of our model in describing cardiac perfusion. Specifically, we successfully validate the model reliability by comparing in-silico coronary flow rates and average myocardial blood flow with clinically established values ranges reported in relevant literature. Additionally, we investigate the impact of a regurgitant aortic valve on myocardial perfusion, and our results indicate a reduction in myocardial perfusion due to blood flow taken away by the left ventricle during diastole. To the best of our knowledge, our work represents the first instance where electromechanics, hemodynamics, and perfusion are integrated into a single computational framework.
本文旨在介绍一种新的数学模型，该模型模拟心肌血液灌注，考虑到多尺度和多物理特性。我们的模型结合了心脏电生理学、主动和被动力学、血液动力学、瓣膜建模以及灌注的多腔隙达西模型。我们考虑了左心的完全耦合机电模型，该模型为心肌灌注的完全耦合纳维-斯托克斯-达西模型提供输入。在包括大心外膜冠状血管的左心几何形状中对流体动力学问题进行建模，而多腔隙达西模型则设置在双心室心肌中。使用真实和详细的心脏几何形状，我们的模拟表明我们的模型在描述心脏灌注方面具有生物物理保真度。具体来说，我们通过将模拟的冠状动脉流量和平均心肌血流量与相关文献中报告的临床确立值范围进行比较，成功验证了模型的可靠性。此外，我们研究了反流性主动脉瓣对心肌灌注的影响，我们的结果表明，由于左心室在舒张期带走血流，心肌灌注减少。据我们所知，我们的工作代表了机电、血液动力学和灌注首次集成到单个计算框架中的情况。
