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• W2810837128 abstract "Abstract Distribution of blood flow in myocardium is a key determinant of the localization and severity of myocardial ischemia under impaired coronary perfusion conditions. Previous studies have extensively demonstrated the transmural difference of ischemic vulnerability. However, it remains incompletely understood how transmural myocardial flow is regulated under in vivo conditions. In the present study, a computational model of the coronary circulation was developed to quantitatively evaluate the sensitivity of transmural flow distribution to various cardiovascular and hemodynamic factors. The model was further incorporated with the flow autoregulatory mechanism to simulate the regulation of myocardial flow in the presence of coronary artery stenosis. Numerical tests demonstrated that heart rate ( HR ), intramyocardial tissue pressure ( P im ), and coronary perfusion pressure ( P per ) were the major determinant factors for transmural flow distribution (evaluated by the subendocardial‐to‐subepicardial (endo/epi) flow ratio) and that the flow autoregulatory mechanism played an important compensatory role in preserving subendocardial perfusion against reduced P per . Further analysis for HR variation‐induced hemodynamic changes revealed that the rise in endo/epi flow ratio accompanying HR decrease was attributable not only to the prolongation of cardiac diastole relative to systole, but more predominantly to the fall in P im . Moreover, it was found that P im and P per interfered with each other with respect to their influence on transmural flow distribution. These results demonstrate the interactive effects of various cardiovascular and hemodynamic factors on transmural myocardial flow, highlighting the importance of taking into account patient‐specific conditions in the explanation of clinical observations." @default.
• W2810837128 created "2018-07-10" @default.
• W2810837128 creator A5023597320 @default.
• W2810837128 creator A5028380691 @default.
• W2810837128 creator A5029159076 @default.
• W2810837128 creator A5040878398 @default.
• W2810837128 creator A5047130395 @default.
• W2810837128 date "2018-07-19" @default.
• W2810837128 modified "2023-10-13" @default.
• W2810837128 title "A multi‐scale model of the coronary circulation applied to investigate transmural myocardial flow" @default.
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• W2810837128 doi "https://doi.org/10.1002/cnm.3123" @default.
• W2810837128 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/29947132" @default.
• W2810837128 hasPublicationYear "2018" @default.
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