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

• Published in: Frontiers in pediatrics Vol. 8; p. 521936
• Main Authors: Wang, Liping, Liu, Jinlong, Zhong, Yumin, Zhang, Mingjie, Xiong, Jiwen, Shen, Juanya, Tong, Zhirong, Xu, Zhuoming
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 02.12.2020
• Subjects: computational fluid dynamics; congenital heart disease; energy loss; Pediatrics; pulmonary hypertension; wall shear stress; congenital heart disease; energy loss; computational fluid dynamics; pulmonary hypertension; wall shear stress
• ISSN: 2296-2360; 2296-2360
• DOI: 10.3389/fped.2020.521936

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. 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 ( ) and PA morphology and PA flow were analyzed. Morphologic analysis indicated that the BSA-normalized main PA (MPA) diameter (D ), MPA/aorta diameter ratio (D /D ), and MPA/(left PA + right PA) [D /D ] 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 was higher in PH-CHD patients. was positively correlated with D , D /D , and D /D ratios and the flow rate in the PA. was a sensitive index for the diagnosis of PH-CHD. 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.