Key result
Simulated coronary sinus occlusion reduces mean coronary flow by ~14% and promotes myocardial swelling.
Why the study?
A computational framework coupling left ventricular poroelastic mechanics with myocardial perfusion and circulatory models is needed to simulate myocardial perfusion dynamics and effects of coronary sinus resistance.
A novel poroelastic computational framework successfully reproduced cardiac mechanics and perfusion dynamics, demonstrating that simulated coronary sinus occlusion attenuates coronary flow and promotes myocardial swelling.
Hypothesis-generating for perfusion-driven LV stiffening; requires experimental and clinical validation before informing practice.
We present a computational modeling framework coupling a poroelastic left ventricle (LV) with lumped‐parameter descriptions of the coronary and systemic circulations in a closed‐loop system. The finite element method, with P1‐P1‐P0 discretization of the displacement, Darcy flow and pore‐pressure fields, is used to solve the boundary value problem associated with the poroelastic formulation. We show that simulation of the isolated non‐contractile poroelastic LV can reproduce perfusion‐induced stiffening features found in measurements of pressure‐volume relationships with less than 1 mmHg error. Simulations coupling the poroelastic LV with systemic and coronary circulatory models also show that the framework can produce phasic changes in coronary flow rate and myocardial wall volume that agree with the experiments. Using the framework, we investigate the effects of coronary sinus (CS) resistance on myocardial perfusion. We show that increasing CS resistance attenuates coronary flow rate, increases myocardial pore pressure, and promotes myocardial swelling.
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An et al. (2026) studied Myocardial perfusion and cardiac mechanics. Simulated coronary sinus occlusion (increased coronary sinus resistance) vs. Baseline coronary sinus resistance was evaluated on Mean coronary flow rate, pore pressure, and myocardial wall volume (swelling). Simulated coronary sinus occlusion increased myocardial pore pressure, reduced mean coronary flow by 13.84%, and promoted myocardial swelling by 0.93% to 2.8%.
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