Patient-specific modelling of pulmonary arterial hypertension: wall shear stress correlates with disease severity

IntroductionPulmonary 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-in...

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Main Authors: C. H. Armour, D. Gopalan, B. Statton, D. P. O’Regan, L. Howard, M. R. Wilkins, X. Y. Xu, A. Lawrie
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Bioengineering and Biotechnology
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Online Access:https://www.frontiersin.org/articles/10.3389/fbioe.2025.1585345/full
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author C. H. Armour
C. H. Armour
D. Gopalan
B. Statton
D. P. O’Regan
L. Howard
M. R. Wilkins
X. Y. Xu
A. Lawrie
author_facet C. H. Armour
C. H. Armour
D. Gopalan
B. Statton
D. P. O’Regan
L. Howard
M. R. Wilkins
X. Y. Xu
A. Lawrie
author_sort C. H. Armour
collection DOAJ
description IntroductionPulmonary 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.Methodsseven 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.ResultsCFD 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.ConclusionThis 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.
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spelling doaj-art-d5484bd066e740dbb6ef3323f9dacff82025-08-20T02:35:48ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852025-06-011310.3389/fbioe.2025.15853451585345Patient-specific modelling of pulmonary arterial hypertension: wall shear stress correlates with disease severityC. H. Armour0C. H. Armour1D. Gopalan2B. Statton3D. P. O’Regan4L. Howard5M. R. Wilkins6X. Y. Xu7A. Lawrie8National Heart and Lung Institute, Imperial College London, London, United KingdomDepartment of Chemical Engineering, Imperial College London, London, United KingdomNational Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, United KingdomMedical Research Council, Laboratory of Medical Sciences, Imperial College London, London, United KingdomMedical Research Council, Laboratory of Medical Sciences, Imperial College London, London, United KingdomNational Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, United KingdomNational Heart and Lung Institute, Imperial College London, London, United KingdomDepartment of Chemical Engineering, Imperial College London, London, United KingdomNational Heart and Lung Institute, Imperial College London, London, United KingdomIntroductionPulmonary 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.Methodsseven 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.ResultsCFD 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.ConclusionThis 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.https://www.frontiersin.org/articles/10.3389/fbioe.2025.1585345/fullpulmonary arterial hypertensioncomputational fluid dynamics4D-flow MRIwall shear stressnon-invasive assessmentcomputational biomarker
spellingShingle C. H. Armour
C. H. Armour
D. Gopalan
B. Statton
D. P. O’Regan
L. Howard
M. R. Wilkins
X. Y. Xu
A. Lawrie
Patient-specific modelling of pulmonary arterial hypertension: wall shear stress correlates with disease severity
Frontiers in Bioengineering and Biotechnology
pulmonary arterial hypertension
computational fluid dynamics
4D-flow MRI
wall shear stress
non-invasive assessment
computational biomarker
title Patient-specific modelling of pulmonary arterial hypertension: wall shear stress correlates with disease severity
title_full Patient-specific modelling of pulmonary arterial hypertension: wall shear stress correlates with disease severity
title_fullStr Patient-specific modelling of pulmonary arterial hypertension: wall shear stress correlates with disease severity
title_full_unstemmed Patient-specific modelling of pulmonary arterial hypertension: wall shear stress correlates with disease severity
title_short Patient-specific modelling of pulmonary arterial hypertension: wall shear stress correlates with disease severity
title_sort patient specific modelling of pulmonary arterial hypertension wall shear stress correlates with disease severity
topic pulmonary arterial hypertension
computational fluid dynamics
4D-flow MRI
wall shear stress
non-invasive assessment
computational biomarker
url https://www.frontiersin.org/articles/10.3389/fbioe.2025.1585345/full
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