Medical Image-Based Hemodynamic Analyses in a Study of the Pulmonary Artery in Children With Pulmonary Hypertension Related to Congenital Heart Disease

Frontiers in Pediatrics

article

Liping Wang¹  Jinlong Liu²  Yumin Zhong⁴  Mingjie Zhang¹  Jiwen Xiong¹  Juanya Shen¹  Zhirong Tong¹  Zhuoming Xu¹ 

[1] Department of Thoracic and Cardiovascular Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine;Pediatric Translational Medicine Institute, Shanghai Jiao Tong University School of Medicine;Shanghai Engineering Research Center of Virtual Reality of Structural Heart Disease, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine;Department of Radiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine

关键词: pulmonary hypertension;    energy loss;    congenital heart disease;    computational fluid dynamics;    wall shear stress;   

DOI  :  10.3389/fped.2020.521936

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective: Pulmonary hypertension related to congenital heart disease (PH-CHD) is a devastating disease caused by hemodynamic disorders. Previous hemodynamic research in PH-CHD mainly focused on wall shear stress (WSS). However, energy loss (EL) is a vital parameter in evaluation of hemodynamic status. We investigated if EL of the pulmonary artery (PA) is a potential biomechanical marker for comprehensive assessment of PH-CHD. Materials and Methods: Ten PH-CHD patients and 10 age-matched controls were enrolled. Subject-specific 3-D PA models were reconstructed based on computed tomography. Transient flow, WSS, and EL in the PA were calculated using non-invasive computational fluid dynamics. The relationship between body surface area (BSA)-normalized EL ( E . ) and PA morphology and PA flow were analyzed. Results: Morphologic analysis indicated that the BSA-normalized main PA (MPA) diameter (D MPAnorm ), MPA/aorta diameter ratio (D MPA /D AO ), and MPA/(left PA + right PA) [D MPA /D (LPA+RPA) ] diameter ratio were significantly larger in PH-CHD patients. Hemodynamic results showed that the velocity of the PA branches was higher in PH-CHD patients, in whom PA flow rate usually increased. WSS in the MPA was lower and E . was higher in PH-CHD patients. E . was positively correlated with D MPAnorm , D MPA /D AO , and D MPA /D (LPA+RPA) ratios and the flow rate in the PA. E . was a sensitive index for the diagnosis of PH-CHD. Conclusion:E . is a potential biomechanical marker for PH-CHD assessment. This hemodynamic parameter may lead to new directions for revealing the potential pathophysiologic mechanism of PH-CHD.

【 授权许可】

CC BY