Parameter inference in a computational model of hemodynamics in pulmonary hypertension

TL;DR

This study uses patient-specific computational models to noninvasively infer physiological parameters in pulmonary hypertension, demonstrating improved calibration with waveform data and aligning with known clinical findings.

Contribution

It introduces a method for calibrating cardiovascular models with static and dynamic data to identify disease-related parameters in PH patients.

Findings

Waveform data improves parameter calibration accuracy.

Model outcomes reflect typical PH right heart dynamics.

Estimated parameters agree with previous clinical studies.

Abstract

Pulmonary hypertension (PH), defined by a mean pulmonary arterial pressure (mPAP) $>$ 20 mmHg, is characterized by increased pulmonary vascular resistance and decreased pulmonary arterial compliance. There are few measurable biomarkers of PH progression, but a conclusive diagnosis of the disease requires invasive right heart catheterization (RHC). Patient-specific computational models of the cardiovascular system are a potential noninvasive tool for determining additional indicators of disease severity. Using computational modeling, this study quantifies physiological parameters indicative of disease severity in nine PH patients. The model includes all four heart chambers and the pulmonary and systemic circulations. We consider two sets of calibration data: static (systolic \& diastolic values) RHC data and a combination of static and continuous, time-series waveform data. We determine a subset of identifiable parameters for model calibration using sensitivity analyses and multistart inference, and carry out uncertainty quantification post-inference. Results show that additional waveform data enables accurate calibration of the right atrial reservoir and pump function across the PH cohort. Model outcomes, including stroke work and pulmonary resistance-compliance relations, reflect typical right heart dynamics in PH phenotypes. Lastly, we show that estimated parameters agree with previous, non-modeling studies, supporting this type of analysis in translational PH research.