A review of multiscale 0D-1D computational modeling of coronary circulation with applications to cardiac arrhythmias.

Luca Ridolfi,Stefania Scarsoglio

doi:10.31083/j.rcm2204150

Abstract

Computational hemodynamics is becoming an increasingly important tool in clinical applications and surgical procedures involving the cardiovascular system. Aim of this review is to provide a compact summary of state of the art 0D-1D multiscale models of the arterial coronary system, with particular attention to applications related to cardiac arrhythmias, whose effects on the coronary circulation remain so far poorly understood. The focus on 0D-1D models only is motivated by the competitive computational cost, the reliability of the outcomes for the whole cardiovascular system, and the ability to directly account for cardiac arrhythmias. The analyzed studies show that cardiac arrhythmias by their own are able to promote significant alterations of the coronary hemodynamics, with a worse scenario as the mean heart rate (HR) increases. The present review can stimulate future investigation, both in computational and clinical research, devoted to the hemodynamic effects induced by cardiac arrhythmias on the coronary circulation.

Highlights

By combining numerical techniques and mathematical modeling of different order and geometric detail, computational hemodynamics is becoming a powerful tool in translational medicine to accurately reproduce the human cardiovascular system [1,2,3,4]
Arterial walls were modeled as linear elastic, while the myocardium was modelled as porous medium. 1D model was run on these networks and wave patterns and reflection coefficients were investigated along the three main coronary arterial paths (LAD, circumflex artery (Cx), right coronary artery (RCA))
We conclude this overview by briefly mentioning few recent works, where coronary blood flow was modeled through a fully lumped parameter (0D) approach, by means of electrical counterparts adequately tuned on the basis on measured data

Summary

Introduction

By combining numerical techniques and mathematical modeling of different order and geometric detail, computational hemodynamics is becoming a powerful tool in translational medicine to accurately reproduce the human cardiovascular system [1,2,3,4]. We focus on the coronary circulation modeling in presence of cardiac arrhythmias, in particular atrial fibrillation (AF). CAD and AF frequently coexist, even if definitive clinical data regarding the hemodynamic effects of AF on coronary circulation are still missing [7, 8]. Coronary blood flow has been recently modeled ranging from fully 3D approaches coupled with electro-mechanics response to lower order multiscale models [9,10,11,12]. Aim of this review is to provide a compact summary of state of the art 0D-1D multiscale models of the arterial coronary system. 0D-1D models are well suited to study the effects of cardiac arrhythmias on the coronary circulation, which is the object of the present review

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Discussion

Conclusion