Non-invasive estimation of pressure drop across aortic coarctations: validation of 0D and 3D computational models with in vivo measurements.
Non-invasive estimation of pressure drop across aortic coarctations: validation of 0D and 3D computational models with in vivo measurements.
复制标题
主动脉缩窄压降的无创估计：通过体内测量验证 0D 和 3D 计算模型。
DOI：
10.1101/2023.09.05.23295066
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Marsden,AlisonL
中科院分区：
文献类型：
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作者：
Nair,PriyaJ;Pfaller,MartinR;Dual,SerainaA;McElhinney,DoffB;Ennis,DanielB;Marsden,AlisonL
跨主动脉缩窄（CoA）的血压梯度（）是诊断CoA严重程度和衡量治疗效果的重要指标。有创心导管插入术是目前测量血压的金标准方法。本研究的目的是评估使用患者特定的0D和3D可变形壁模拟非侵入性得出的估计值的准确性。医学成像和常规临床测量用于创建CoA患者的患者特异性模型（N= 17）。首先进行0D模拟，并用于调整边界条件和初始化3D模拟。将使用0D和3D模拟估计的CoA与基于侵入性导管的压力测量进行比较，以进行确认。与3D模拟（集群上的30小时计算时间）相比，0D模拟非常高效（15秒计算时间）。然而，与导管插入术相比，0D估计值的平均误差大于3D估计值（12.1 ± 9.9 mmHg vs 5.3 ± 5.4 mmHg），这并不奇怪。特别是，在CoA邻近分叉的情况下，0D模型性能降低。0D模型对需要干预的重度CoA（定义为20 mmHg）患者进行分类，准确率为76%，3D模拟将其提高到88%。总体而言，使用0D模型来有效调整和启动3D模型的组合方法为CoA严重程度的非侵入性分类提供了速度和准确性的最佳组合。
Blood pressure gradient () across an aortic coarctation (CoA) is an important measurement to diagnose CoA severity and gauge treatment efficacy. Invasive cardiac catheterization is currently the gold-standard method for measuring blood pressure. The objective of this study was to evaluate the accuracy ofestimates derived non-invasively using patient-specific 0D and 3D deformable wall simulations. Medical imaging and routine clinical measurements were used to create patient-specific models of patients with CoA (N= 17). 0D simulations were performed first and used to tune boundary conditions and initialize 3D simulations.across the CoA estimated using both 0D and 3D simulations were compared to invasive catheter-based pressure measurements for validation. The 0D simulations were extremely efficient (15 s computation time) compared to 3D simulations (30 h computation time on a cluster). However, the 0Destimates, unsurprisingly, had larger mean errors when compared to catheterization than 3D estimates (12.1 ± 9.9 mmHg vs 5.3 ± 5.4 mmHg). In particular, the 0D model performance degraded in cases where the CoA was adjacent to a bifurcation. The 0D model classified patients with severe CoA requiring intervention (defined as20 mmHg) with 76% accuracy and 3D simulations improved this to 88%. Overall, a combined approach, using 0D models to efficiently tune and launch 3D models, offers the best combination of speed and accuracy for non-invasive classification of CoA severity.