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A computational model of the fetal circulation to quantify blood redistribution in intrauterine growth restriction

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dc.contributor.author García Cañadilla, Patricia, 1985-
dc.contributor.author Rudenick, Paula A.
dc.contributor.author Crispi Brillas, Fàtima
dc.contributor.author Cruz-Lemini, Mónica
dc.contributor.author Palau, Georgina
dc.contributor.author Camara, Oscar
dc.contributor.author Gratacós Solsona, Eduard
dc.contributor.author Bijnens, Bart
dc.date.accessioned 2016-02-16T18:10:12Z
dc.date.available 2016-02-16T18:10:12Z
dc.date.issued 2014
dc.identifier.citation Garcia-Canadilla P, Rudenick PA, Crispi F, Cruz-Lemini M, Palau G, Camara O, Gratacos E, Bijens BH. A computational model of the fetal circulation to quantify blood redistribution in intrauterine growth restriction. PLoS Computational Biology. 2014;10(6):1-14. DOI: 10.1371/journal.pcbi.1003667.
dc.identifier.citation http://dx.doi.org/10.1371/journal.pcbi.1003667
dc.identifier.issn 1553-7358
dc.identifier.uri http://hdl.handle.net/10230/25844
dc.description.abstract Intrauterine growth restriction (IUGR) due to placental insufficiency is associated with blood flow redistribution in order to/nmaintain delivery of oxygenated blood to the brain. Given that, in the fetus the aortic isthmus (AoI) is a key arterial/nconnection between the cerebral and placental circulations, quantifying AoI blood flow has been proposed to assess this/nbrain sparing effect in clinical practice. While numerous clinical studies have studied this parameter, fundamental/nunderstanding of its determinant factors and its quantitative relation with other aspects of haemodynamic remodeling has/nbeen limited. Computational models of the cardiovascular circulation have been proposed for exactly this purpose since/nthey allow both for studying the contributions from isolated parameters as well as estimating properties that cannot be/ndirectly assessed from clinical measurements. Therefore, a computational model of the fetal circulation was developed,/nincluding the key elements related to fetal blood redistribution and using measured cardiac outflow profiles to allow/npersonalization. The model was first calibrated using patient-specific Doppler data from a healthy fetus. Next, in order to/nunderstand the contributions of the main parameters determining blood redistribution, AoI and middle cerebral artery/n(MCA) flow changes were studied by variation of cerebral and peripheral-placental resistances. Finally, to study how this/naffects an individual fetus, the model was fitted to three IUGR cases with different degrees of severity. In conclusion, the/nproposed computational model provides a good approximation to assess blood flow changes in the fetal circulation. The/nresults support that while MCA flow is mainly determined by a fall in brain resistance, the AoI is influenced by a balance/nbetween increased peripheral-placental and decreased cerebral resistances. Personalizing the model allows for quantifying/nthe balance between cerebral and peripheral-placental remodeling, thus providing potentially novel information to aid/nclinical follow up.
dc.description.sponsorship This study was partially supported by grants from Instituto de Salud Carlos III and Ministerio de Economia y Competitividad (ref. PI11/00051, PI11//n01709, PI12/00801 and SAF2012-37196); Fondo Europeo de Desarrollo Regional de la Unio/ń/nn Europea ‘‘Una manera de hacer Europa’’, Spain; Obra Social ‘La Caixa’,/nSpain; Cerebra Foundation for the Brain Injured Child (Carmarthen, Wales, UK); and the Seventh Framework Programme (FP7/2007-2013) under grant agr/neement/nNo. 611823. PGC was supported by the Programa de Ayudas Predoctorales de Formacio/ń/nn en investigacio/ń/nn en Salud (FI12/00362) from the Instituto Carlos III,/nSpain. MCL wishes to express her gratitude to the Mexican National Council for Science and Technology (CONACyT, Mexico City, Mexico) for supporting h/ner/npredoctoral stay at Hospital Clinic, Barcelona, Spain. The funders had no role in study design, data collection and analysis, decision to publish, or/npreparation of/nthe manuscript
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartof PLoS Computational Biology. 2014;10(6):1-14
dc.rights © 2014 Garcia-Canadilla et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title A computational model of the fetal circulation to quantify blood redistribution in intrauterine growth restriction
dc.type info:eu-repo/semantics/article
dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/611823
dc.relation.projectID info:eu-repo/grantAgreement/ES/3PN/SAF2012-37196
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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