Key result
1D cardiovascular blood flow modeling must incorporate real-life physiological conditions like exercise and patient variability.
Why the study?
Most systemic-scale blood flow modeling has focused on simple resting and supine conditions, leaving deviations seen in everyday life, patient-specific physiology, and factors like respiration and gravity cursorily addressed.
This review highlights the need and current advances in modeling patient-specific cardiovascular hemodynamics beyond simple resting states to include real-life physiological conditions.
1D models must incorporate exercise, respiration, and variability; leaves open standardized validation before clinical use.
Research in the dynamics of blood flow is essential to the understanding of one of the major driving forces of human physiology. The hemodynamic conditions experienced within the cardiovascular system generate a highly variable mechanical environment that propels its function. Modeling this system is a challenging problem that must be addressed at the systemic scale to gain insight into the interplay between the different time and spatial scales of cardiovascular physiology processes. The vast majority of scientific contributions on systemic-scale distributed parameter-based blood flow modeling have approached the topic under relatively simple scenarios, defined by the resting state, the supine position, and, in some cases, by disease. However, the physiological states experienced by the cardiovascular system considerably deviate from such conditions throughout a significant part of our life. Moreover, these deviations are, in many cases, extremely beneficial for sustaining a healthy life. On top of this, inter-individual variability carries intrinsic complexities, requiring the modeling of patient-specific physiology. The impact of modeling hypotheses such as the effect of respiration, control mechanisms, and gravity, the consideration of other-than-resting physiological conditions, such as those encountered in exercise and sleeping, and the incorporation of organ-specific physiology and disease have been cursorily addressed in the specialized literature. In turn, patient-specific characterization of cardiovascular system models is in its early stages. As for models and methods, these conditions pose challenges regarding modeling the underlying phenomena and developing methodological tools to solve the associated equations. In fact, under certain conditions, the mathematical formulation becomes more intricate, model parameters suffer greater variability, and the overall uncertainty about the system's working point increases. This paper reviews current advances and opportunities to model and simulate blood flow in the cardiovascular system at the systemic scale in both the conventional resting setting and in situations experienced in everyday life.
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Blanco et al. (2025) conducted a review in Cardiovascular hemodynamics. One-dimensional blood flow modeling was evaluated. One-dimensional blood flow modeling of the cardiovascular system requires incorporating real-life physiological conditions such as exercise, respiration, and patient-specific variability.
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