A closer look at physiological indicators of cardiovascular function post-transplantation.

Abstract

Currently, the clinical diagnosis and treatment of cardiovascular diseases rely on minimally or non-invasive measures that statistically correlate to the treatment. For example, cardiovascular function is assessed using measurements from the minimally invasive right heart catheterization (RHC) procedure after heart transplants to advise on treatment (Colunga et al. 2020). Repeated RHC measurements of ventricular and pulmonary arterial pressure are used to observe post-transplant pulmonary hypertension to identify potential further complications in post-transplant recovery. While close monitoring of these measurements is associated with better outcomes, RHC measures only depict the broader cardiovascular phenotype and do not assess the underlying physiological mechanisms, such as pressure, volume, and flow relationships in the cardiovascular system. Previous studies have suggested that a detailed assessment of the cardiovascular system may improve the diagnosis/treatment of cardiovascular dysfunction post-transplantation (Stobierska-Dzierzek et al. 2001). Similarly, other non-invasive measures are used to evaluate cardiac function post-transplantation, including echocardiography, magnetic resonance, and Doppler imaging. Clinically, these measurements are used in conjunction with RHC measurements as they may not provide enough information individually regarding a patient’s cardiovascular function. The current study uses a patient-specific computational methodology which incorporates clinical measures and is used to predict time-dependent measures of pressure, flow, and volume, as well as mechanistic measures, many of which presented are not easily measured in the clinic. This study presented mechanistic parameter predictions of an individual patient at specific cardiovascular recovery time points. Thus, this study combines the physiology of the cardiovascular system with patient-specific measurements to better describe the cardiovascular health of a specific patient. The authors aim to use measures that monitor the health and condition of heart transplant patients to provide early indications regarding the success of the heart transplant.