Key result
Image-based modeling of pig coronary microvasculature showed that permeability tensors increased bimodally in infarcted areas on days 1 and 7 after myocardial infarction, with decreased blood flow.
Why the study?
Microcirculation is decisive in reperfusion inadequacy after MI, but experimental assessment of microvascular blood flow remains a bottleneck.
Image-based modeling reveals time- and region-dependent alterations in coronary microvascular conductivity and perfusion following myocardial infarction.
Answers are grounded in this paper and cite their sources.
Should not yet change post-MI microvascular assessment; leaves open whether bimodal permeability shifts affect human outcomes.
Background Microcirculation is a decisive factor in tissue reperfusion inadequacy following myocardial infarction ( MI ). Nonetheless, experimental assessment of blood flow in microcirculation remains a bottleneck. We sought to model blood flow properties in coronary microcirculation at different time points after MI and to compare them with healthy conditions to obtain insights into alterations in cardiac tissue perfusion. Methods and Results We developed an image-based modeling framework that permitted feeding a continuum flow model with anatomical data previously obtained from the pig coronary microvasculature to calculate physiologically meaningful permeability tensors. The tensors encompassed the microvascular conductivity and were also used to estimate the arteriole-venule drop in pressure and myocardial blood flow. Our results indicate that the tensors increased in a bimodal pattern at infarcted areas on days 1 and 7 after MI while a nonphysiological decrease in arteriole-venule drop in pressure was observed; contrary, the tensors and the arteriole-venule drop in pressure on day 3 after MI , and in remote areas, were closer to values for healthy tissue. Myocardial blood flow calculated using the condition-dependent arteriole-venule drop in pressure decreased in infarcted areas. Last, we simulated specific modes of vascular remodeling, such as vasodilation, vasoconstriction, or pruning, and quantified their distinct impact on microvascular conductivity. Conclusions Our study unravels time- and region-dependent alterations of tissue perfusion related to the structural changes occurring in the coronary microvasculature due to MI . It also paves the way for conducting simulations in new therapeutic interventions in MI and for image-based microvascular modeling by applying continuum flow models in other biomedical scenarios.
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Gkontra et al. (2019) studied Myocardial infarction. Myocardial infarction vs. Healthy conditions was evaluated on Microvascular conductivity (permeability tensors) and arteriole-venule pressure drop. Image-based modeling of pig coronary microvasculature showed that permeability tensors increased bimodally in infarcted areas on days 1 and 7 after myocardial infarction, with decreased blood flow.
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