Computational modelling of the cardiovascular system for the non-invasive diagnosis of portal hypertension

Abstract

Cirrhosis is a prevalent chronic liver disease that causes scarring of the liver, leading to altered mechanics and impaired function. One of its most severe complications is portal hypertension, characterised by an increase in portal vein pressure, associated with abnormal blood flow dynamics. Portal hypertension is usually diagnosed by measuring the hepatic venous pressure gradient (HVPG) through invasive catheterisation. Computational models can help to understand the causes of observed phenomena and assess certain variables that are challenging to measure without invasive procedures. Therefore, the aim of this study was to use a 0D model of the cardiovascular system to study portal hypertension and its haemodynamic effects in the circulation. A sensitivity analysis was conducted to assess the impact of different variables on the model. In addition, the model was personalised based on hepatic Doppler waveforms from two patients, one with elevated HVPG (and cirrhosis) and the other with normal HVPG (and hepatitis). The model-based haemodynamic parameters were compared to the invasive haemodynamic measurements. This study provides insight into how cirrhosis alters haemodynamics and demonstrates the potential of employing computational models of the cardiovascular system to understand haemodynamic changes in individual patients.