Right ventricular remodeling and its relationship with clinically relevant pulmonary hypertension metrics
Pulmonary hypertension (PH) is a disease of the pulmonary vasculature that causes changes in the right ventricle (RV) workload. Changes in the vasculature are directly related to changes in the pulmonary hemodynamics, however, the changes in the RV due to remodeling are the most important since it leads to failure and death. Metrics like the pulmonary pressure or resistance are not good surrogates to assess RV function, for that reason is necessary to find reliable hemodynamic and geometric metrics that can effectively assess RV function. The purpose of this study was to assess the accuracy of computational fluid dynamics (CFD) simulations in the evaluation of PH hemodynamics and to analyze the feasibility of the use of global curvature indices as surrogates to assess changes on the morphology of the right ventricle.
Rapid prototyping was used for the construction of the patient-specific pulmonary geometry, derived from CT images. CFD simulations were performed with the pulmonary model. C-MRI images were collected to reconstruct the endocardial wall of the RV and calculate the global curvature indices. CT and RHC data were collected to calculate biomechanical and clinical metrics indicative of PH. The results from this study will help us to evaluate the accuracy of CFD simulations and to assess the effectiveness of the use of global curvature indices as surrogates to assess changes in the shape of the RV. The potential use of these tools will equip clinicians with non-invasive tools to assess disease progression and effectiveness of therapies in patients with PH.