Estimation of Cardiovascular Relative Pressure Using Virtual Work-Energy

• Published in: Scientific reports 2019-02, Vol.9 (1), p.1375-16, Article 1375
• Main Authors: Marlevi, David, Ruijsink, Bram, Balmus, Maximilian, Dillon-Murphy, Desmond, Fovargue, Daniel, Pushparajah, Kuberan, Bertoglio, Cristóbal, Colarieti-Tosti, Massimiliano, Larsson, Matilda, Lamata, Pablo, Figueroa, C. Alberto, Razavi, Reza, Nordsletten, David A.
• Format: Article
• Language: English
• Subjects: 59/57; 639/166/985; 692/308/575; Accuracy; Adolescent; Aortic Coarctation - physiopathology; Aortic dissection; Aortic Dissection - physiopathology; Biomedical engineering; Blood flow; Blood Pressure - physiology; Cardiovascular disease; Cardiovascular diseases; Catheters; Computer Simulation; Congenital diseases; Coronary artery disease; Coronary vessels; Doppler effect; Energy; Estimates; Heart diseases; Hemodynamics - physiology; Humanities and Social Sciences; Humans; Image Processing, Computer-Assisted; Magnetic resonance imaging; Medicin och hälsovetenskap; Methods; Models, Cardiovascular; multidisciplinary; Pressure; Reproducibility of Results; Science; Science (multidisciplinary); Signal-To-Noise Ratio; Ultrasound; Velocity
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-018-37714-0

Many cardiovascular diseases lead to local increases in relative pressure, reflecting the higher costs of driving blood flow. The utility of this biomarker for stratifying the severity of disease has thus driven the development of methods to measure these relative pressures. While intravascular catheterisation remains the most direct measure, its invasiveness limits clinical application in many instances. Non-invasive Doppler ultrasound estimates have partially addressed this gap; however only provide relative pressure estimates for a range of constricted cardiovascular conditions. Here we introduce a non-invasive method that enables arbitrary interrogation of relative pressures throughout an imaged vascular structure, leveraging modern phase contrast magnetic resonance imaging, the virtual work-energy equations, and a virtual field to provide robust and accurate estimates. The versatility and accuracy of the method is verified in a set of complex patient-specific cardiovascular models, where relative pressures into previously inaccessible flow regions are assessed. The method is further validated within a cohort of congenital heart disease patients, providing a novel tool for probing relative pressures in-vivo .