Parameter inference in a computational model of hemodynamics in pulmonary hypertension
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.
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