Heart blood flow simulation: a perspective review

Abstract

Cardiovascular disease (CVD), the leading cause of death today, incorporates a wide range of cardiovascular system malfunctions that affect heart functionality. It is believed that the hemodynamic loads exerted on the cardiovascular system, the left ventricle (LV) in particular, are the leading cause of CVD initiation and propagation. Moreover, it is believed that the diagnosis and prognosis of CVD at an early stage could reduce its high mortality and morbidity rate. Therefore, a set of robust clinical cardiovascular assessment tools has been introduced to compute the cardiovascular hemodynamics in order to provide useful insights to physicians to recognize indicators leading to CVD and also to aid the diagnosis of CVD. Recently, a combination of computational fluid dynamics (CFD) and different medical imaging tools, image-based CFD (IB-CFD), has been widely employed for cardiovascular functional assessment by providing reliable hemodynamic parameters. Even though the capability of CFD to provide reliable flow dynamics in general fluid mechanics problems has been widely demonstrated for many years, up to now, the clinical implications of the IB-CFD patient-specific LVs have not been applicable due to its limitations and complications. In this paper, we review investigations conducted to numerically simulate patient-specific human LV over the past 15 years using IB-CFD methods. Firstly, we divide different studies according to the different LV types (physiological and different pathological conditions) that have been chosen to reconstruct the geometry, and then discuss their contributions, methodologies, limitations, and findings. In this regard, we have studied CFD simulations of intraventricular flows and related cardiology insights, for (i) Physiological patient-specific LV models, (ii) Pathological heart patient-specific models, including myocardial infarction, dilated cardiomyopathy, hypertrophic cardiomyopathy and hypoplastic left heart syndrome. Finally, we discuss the current stage of the IB-CFD LV simulations in order to mimic realistic hemodynamics of patient-specific LVs. We can conclude that heart flow simulation is on the right track for developing into a useful clinical tool for heart function assessment, by (i) incorporating most of heart structures’ (such as heart valves) operations, and (ii) providing useful diagnostic indices based hemodynamic parameters, for routine adoption in clinical usage.

The importance of the pericardium for cardiac biomechanics: from physiology to computational modeling

“…The boundary conditions on the structure field of the myocardium are mainly governed by two physiological aspects: Blood flow within the chambers near the inside surface of the myocardium (endocardium) and the pericardial sac on the outside surface (epicardium), see figure 1a. There are many applications for simulating heart blood flow [3]. However, for many relevant questions the exact fluid dynamics of blood within the heart or a resolved fluidsolid interaction simulation are often not needed for simulating the myocardium.…”

Impact of myocardial infarction on intraventricular vortex and flow energetics assessed using computational simulations

“…The investigation of individual MI parameters in clinical studies may pose a challenge because of the high variability in patient characteristics and various confounding factors. With the technological advancements, computational models have emerged as a reliable tool not only to study LV pathophysiology, but also to investigate the impact of individual risk factors in heart disease . CFD studies have been conducted to investigate intraventricular flow patterns in MI .…”

One Mesh to Rule Them All: Registration-Based Personalized Cardiac Flow Simulations

“…Additionally, in the context of cardiac flow simulations, those pre-processing steps also involve the extraction and manipulation of the dynamics of the segmented surface in order to provide appropriate displacement boundary conditions. It has been reported in a recent review of patient-specific cardiac flow simulations that around "20-50 hours of human effort are needed for these pre-processing steps" [1] and similar claims have been made by others [13].…”