Key result
CFD-derived time-averaged wall shear stress strongly correlates with invasively measured mean pulmonary arterial pressure.
Why the study?
PAH requires invasive right heart catheterization for diagnosis, driving a need to develop non-invasive tools to improve screening and early diagnosis.
Does patient-specific CFD-derived time-averaged wall shear stress correlate with invasive mean pulmonary arterial pressure in patients with pulmonary arterial hypertension?
Observational (n=7)
No
Does patient-specific CFD-derived time-averaged wall shear stress correlate with invasive mean pulmonary arterial pressure in patients with pulmonary arterial hypertension?
Effect estimate: R2 = 0.84
Patient-specific computational fluid dynamics modeling demonstrates that time-averaged wall shear stress strongly correlates with invasive pulmonary arterial pressure, highlighting its potential as a non-invasive diagnostic biomarker for PAH severity.
Supports CFD-derived TAWSS as a potential non-invasive mPAP correlate; hypothesis-generating and requires prospective validation before clinical adoption.
Introduction: Pulmonary arterial hypertension (PAH) requires an invasive right heart catheter (RHC) procedure for diagnosis. Patients can present with initial symptoms and interact with healthcare institutes for up to 3 years before referral for diagnosis. Thus, there is a great need to develop non-invasive tools, to better screen patients and improve early diagnosis rates. Methods: seven patients diagnosed and treated for PAH were included in this study. Patient-specific computational fluid dynamics (CFD) models were built for all patients, with all model parameters tuned using non-invasive imaging data, including CT, cardiac MR, echocardiogram, and 4D-flow MRI scans-crucially, a 3D inlet velocity profile was derived from 4D-flow MRI. Results: = 0.84 was found between CFD derived time-averaged wall shear stress (TAWSS) and RHC measured mean pulmonary pressure (key diagnostic value): low TAWSS correlated with high pressure. Conclusion: This study highlights TAWSS as a potential computational biomarker for PAH. The clinical use of TAWSS to diagnose and stratify PAH patients has the potential to greatly improve patient outcomes. Further work is ongoing to validate these findings in larger cohorts.
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Armour et al. (2025) conducted an observational in Pulmonary arterial hypertension (n=7). Patient-specific computational fluid dynamics (CFD) models was evaluated on Correlation between CFD derived time-averaged wall shear stress (TAWSS) and right heart catheter measured mean pulmonary pressure (R2 = 0.84). Patient-specific computational fluid dynamics models demonstrated a strong linear correlation (R2 = 0.84) between time-averaged wall shear stress and invasively measured mean pulmonary arterial pressure.
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