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J Am Heart Assoc. 2019 Apr 2;8(7):e011058. doi: 10.1161/JAHA.118.011058.

Dynamic Changes in Microvascular Flow Conductivity and Perfusion After Myocardial Infarction Shown by Image-Based Modeling.

Author information

1
1 Centro Nacional de Investigaciones Cardiovasculares (CNIC) Madrid Spain.
2
2 Biomedical Image Technologies (BIT), ETSI Telecomunicación, Universidad Politécnica de Madrid Madrid Spain.
3
3 Institute of Biomedical Engineering Department of Engineering Science University of Oxford United Kingdom.
4
4 Division of Science, Mathematics, and Computing Bard College Annandale-on-Hudson NY.
5
5 Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales y Nanomedicina (CIBERBBN) Madrid Spain.
6
6 Department of Biomedical Engineering School of Medicine Johns Hopkins University Baltimore MD.
7
7 Centro de Investigaciones Biológicas (CIB-CSIC) Madrid Spain.

Abstract

Background Microcirculation is a decisive factor in tissue reperfusion inadequacy following myocardial infarction ( MI ). Nonetheless, experimental assessment of blood flow in microcirculation remains a bottleneck. We sought to model blood flow properties in coronary microcirculation at different time points after MI and to compare them with healthy conditions to obtain insights into alterations in cardiac tissue perfusion. Methods and Results We developed an image-based modeling framework that permitted feeding a continuum flow model with anatomical data previously obtained from the pig coronary microvasculature to calculate physiologically meaningful permeability tensors. The tensors encompassed the microvascular conductivity and were also used to estimate the arteriole-venule drop in pressure and myocardial blood flow. Our results indicate that the tensors increased in a bimodal pattern at infarcted areas on days 1 and 7 after MI while a nonphysiological decrease in arteriole-venule drop in pressure was observed; contrary, the tensors and the arteriole-venule drop in pressure on day 3 after MI , and in remote areas, were closer to values for healthy tissue. Myocardial blood flow calculated using the condition-dependent arteriole-venule drop in pressure decreased in infarcted areas. Last, we simulated specific modes of vascular remodeling, such as vasodilation, vasoconstriction, or pruning, and quantified their distinct impact on microvascular conductivity. Conclusions Our study unravels time- and region-dependent alterations of tissue perfusion related to the structural changes occurring in the coronary microvasculature due to MI . It also paves the way for conducting simulations in new therapeutic interventions in MI and for image-based microvascular modeling by applying continuum flow models in other biomedical scenarios.

KEYWORDS:

blood flow; confocal microscopy; coronary microcirculation; mathematical modeling; myocardial infarction

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