Goubergrits Leonid, Yevtushenko Pavlo, Schlief Adriano, Romberg Jan, Kuehne Titus, Arndt Andreas, Bruening Jan
Institute of Computer-Assisted Cardiovascular Medicine, Deutsches Herzzentrum der Charité, Berlin, Germany.
Biotronik, Berlin, Germany.
Int J Numer Method Biomed Eng. 2025 Jun;41(6):e70050. doi: 10.1002/cnm.70050.
Implantable pulmonary artery pressure sensors (PAPS) might impose a flow-induced risk of thrombus formation in the pulmonary artery (PA). To assess this risk, an in silico study-enhanced animal study with 20 sensors implanted in 10 pigs had previously been conducted. In the in silico study, PAPS were virtually implanted mimicking real implantations, based upon data acquired by CT. This animal in silico study investigated changes in hemodynamics caused by PAPS using image-based computational fluid dynamics (CFD). However, porcine and human PA differ significantly in geometry and hemodynamics. To investigate the transferability of animal in silico study findings toward human conditions, we propose a parallel in silico human study. Based on a similarity analysis (L1 norm for 8 geometric features) human PA geometries with the least difference to 10 porcine PA were selected. PAPS were virtually implanted in human PA as close as possible, mimicking the implantation configuration of the animal study. Finally, a numerical flow analysis of the hemodynamic changes due to PAPS implantation was done. Comparing human and porcine PA, we found significantly larger left and right PA diameters in humans, whereas no differences were found for main PA diameters and bifurcation angle. Comparing hemodynamic boundary conditions, we found a significantly smaller heart rate and a significantly higher peak systolic main PA flow rate in humans, whereas no significant differences for cardiac output were found. The human in silico PAPS study found no relevant changes in hemodynamics increasing the risk of thrombus formation after sensor implantation. This is also valid for PAPS that were non-optimally implanted. Thus, despite differences between species, findings of the in silico animal study were confirmed by the human in silico study.
可植入式肺动脉压力传感器（PAPS）可能会在肺动脉（PA）中带来血流诱导的血栓形成风险。为评估此风险，之前已进行了一项计算机模拟研究增强型动物研究，将20个传感器植入10头猪体内。在计算机模拟研究中，基于CT获取的数据，虚拟植入PAPS以模拟实际植入情况。这项动物计算机模拟研究使用基于图像的计算流体动力学（CFD）研究了PAPS引起的血流动力学变化。然而，猪和人的肺动脉在几何形状和血流动力学方面存在显著差异。为研究动物计算机模拟研究结果向人类情况的可转移性，我们提出了一项平行的人类计算机模拟研究。基于相似性分析（对8个几何特征采用L1范数），选择了与10个猪肺动脉差异最小的人类肺动脉几何形状。尽可能在人类肺动脉中虚拟植入PAPS，模拟动物研究的植入配置。最后，对PAPS植入引起的血流动力学变化进行了数值流动分析。比较人类和猪的肺动脉，我们发现人类的左右肺动脉直径明显更大，而主肺动脉直径和分叉角度没有差异。比较血流动力学边界条件，我们发现人类的心率明显更小，主肺动脉收缩期峰值流速明显更高，而心输出量没有显著差异。人类计算机模拟PAPS研究发现，传感器植入后血流动力学没有相关变化增加血栓形成风险。对于植入不佳的PAPS也是如此。因此，尽管物种之间存在差异，但计算机模拟动物研究的结果得到了人类计算机模拟研究的证实。
