Patient-specific modelling of pulmonary arterial hypertension: wall shear stress correlates with disease severity
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Published version
Author(s)
Type
Journal Article
Abstract
Introduction: Pulmonary arterial hypertension (PAH) requires an invasive right heart catheter (RHC) procedure for diagnosis. Patients can present with initial symptoms and interact with healthcare institutes for up to 3 years before referral for diagnosis. Thus, there is a great need to develop non-invasive tools, to better screen patients and improve early diagnosis rates.
Methods: seven patients diagnosed and treated for PAH were included in this study. Patient-specific computational fluid dynamics (CFD) models were built for all patients, with all model parameters tuned using non-invasive imaging data, including CT, cardiac MR, echocardiogram, and 4D-flow MRI scans–crucially, a 3D inlet velocity profile was derived from 4D-flow MRI.
Results: CFD models were quantitatively and qualitatively well matched with in-vivo 4D-flow hemodynamics. A linear correlation of R2 = 0.84 was found between CFD derived time-averaged wall shear stress (TAWSS) and RHC measured mean pulmonary pressure (key diagnostic value): low TAWSS correlated with high pressure.
Conclusion: This study highlights TAWSS as a potential computational biomarker for PAH. The clinical use of TAWSS to diagnose and stratify PAH patients has the potential to greatly improve patient outcomes. Further work is ongoing to validate these findings in larger cohorts.
Methods: seven patients diagnosed and treated for PAH were included in this study. Patient-specific computational fluid dynamics (CFD) models were built for all patients, with all model parameters tuned using non-invasive imaging data, including CT, cardiac MR, echocardiogram, and 4D-flow MRI scans–crucially, a 3D inlet velocity profile was derived from 4D-flow MRI.
Results: CFD models were quantitatively and qualitatively well matched with in-vivo 4D-flow hemodynamics. A linear correlation of R2 = 0.84 was found between CFD derived time-averaged wall shear stress (TAWSS) and RHC measured mean pulmonary pressure (key diagnostic value): low TAWSS correlated with high pressure.
Conclusion: This study highlights TAWSS as a potential computational biomarker for PAH. The clinical use of TAWSS to diagnose and stratify PAH patients has the potential to greatly improve patient outcomes. Further work is ongoing to validate these findings in larger cohorts.
Date Issued
2025-06-18
Date Acceptance
2025-06-03
Citation
Frontiers in Bioengineering and Biotechnology, 2025, 13
ISSN
2296-4185
Publisher
Frontiers Media S.A.
Journal / Book Title
Frontiers in Bioengineering and Biotechnology
Volume
13
Copyright Statement
© 2025 Armour, Gopalan, Statton, O’Regan, Howard,Wilkins, XuandLawrie.Thisisanopen access article distributed under the terms of the Creative CommonsAttribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms
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Publication Status
Published
Article Number
1585345
Date Publish Online
2025-06-18