Subject-specific one-dimensional fluid dynamics model of chronic thromboembolic pulmonary hypertension

Biomech Model Mechanobiol. 2023 Nov 29. doi: 10.1007/s10237-023-01786-3. Online ahead of print.ABSTRACTChronic thromboembolic pulmonary hypertension (CTEPH) develops due to the accumulation of blood clots in the lung vasculature that obstructs flow and increases pressure. The mechanobiological factors that drive progression of CTEPH are not understood, in part because mechanical and hemodynamic changes in the small pulmonary arteries due to CTEPH are not easily measurable. Using previously published hemodynamic measurements and imaging from a large animal model of CTEPH, we applied a subject-specific one-dimensional (1D) computational fluid dynamic (CFD) approach to investigate the impact of CTEPH on pulmonary artery stiffening, time-averaged wall shear stress (TAWSS), and oscillatory shear index (OSI) in extralobar (main, right, and left) pulmonary arteries and intralobar (distal to the extralobar) arteries. Our results demonstrate that CTEPH increases pulmonary artery wall stiffness and decreases TAWSS in extralobar and intralobar arteries. Moreover, CTEPH increases the percentage of the intralobar arterial network with both low TAWSS and high OSI, quantified by the novel parameter [Formula: see text], which is related to thrombogenicity. Our analysis reveals a strong positive correlation between increases in mean pulmonary artery pressure (mPAP) and [Formula: see text] from baseline to CTEPH in individual subjects, which supports the suggestion that increased [Formula: see...
Source: Biomechanics and Modeling in Mechanobiology - Category: Biomedical Science Authors: Source Type: research