Lucas O. Müller

A global multiscale mathematical model for the human circulation with emphasis on the venous system

We present a global, closed-loop, multiscale mathematical model for the human circulation including the arterial system, the venous system, the heart, the pulmonary circulation and the microcirculation. A distinctive feature of our model is the detailed description of the venous system, particularly for intracranial and extracranial veins. Medium to large vessels are described by one-dimensional hyperbolic systems while the rest of the components are described by zero-dimensional models represented by differential-algebraic equations. Robust, high-order accurate numerical methodology is implemented for solving the hyperbolic equations, which are adopted from a recent reformulation that includes variable material properties. Because of the large intersubject variability of the venous system, we perform a patient-specific characterization of major veins of the head and neck using MRI data. Computational results are carefully validated using published data for the arterial system and most regions of the venous system. For head and neck veins, validation is carried out through a detailed comparison of simulation results against patient-specific phase-contrast MRI flow quantification data. A merit of our model is its global, closed-loop character; the imposition of highly artificial boundary conditions is avoided. Applications in mind include a vast range of medical conditions. Of particular interest is the study of some neurodegenerative diseases, whose venous haemodynamic connection has recently been identified by medical researchers.

Well-balanced high-order numerical schemes for one-dimensional blood flow in vessels with varying mechanical properties

We construct well-balanced, high-order numerical schemes for one-dimensional blood flow in elastic vessels with varying mechanical properties. We adopt the ADER (Arbitrary high-order DERivatives) finite volume framework, which is based on three building blocks: a first-order monotone numerical flux, a non-linear spatial reconstruction operator and the solution of the Generalised (or high-order) Riemann Problem. Here, we first construct a well-balanced first-order numerical flux following the Generalised Hydrostatic Reconstruction technique. Then, a conventional non-linear spatial reconstruction operator and the local solver for the Generalised Riemann Problem are modified in order to preserve well-balanced properties. A carefully chosen suit of test problems is used to systematically assess the proposed schemes and to demonstrate that well-balanced properties are mandatory for obtaining correct numerical solutions for both steady and time-dependent problems.

Well-balanced high-order solver for blood flow in networks of vessels with variable properties

We present a well-balanced, high-order non-linear numerical scheme for solving a hyperbolic system that models one-dimensional flow in blood vessels with variable mechanical and geometrical properties along their length. Using a suitable set of test problems with exact solution, we rigorously assess the performance of the scheme. In particular, we assess the well-balanced property and the effective order of accuracy through an empirical convergence rate study. Schemes of up to fifth order of accuracy in both space and time are implemented and assessed. The numerical methodology is then extended to realistic networks of elastic vessels and is validated against published state-of-the-art numerical solutions and experimental measurements. It is envisaged that the present scheme will constitute the building block for a closed, global model for the human circulation system involving arteries, veins, capillaries and cerebrospinal fluid.

A benchmark study of numerical schemes for one-dimensional arterial blood flow modelling

Haemodynamical simulations using one-dimensional (1D) computational models exhibit many of the features of the systemic circulation under normal and diseased conditions. Recent interest in verifying 1D numerical schemes has led to the development of alternative experimental setups and the use of three-dimensional numerical models to acquire data not easily measured in vivo. In most studies to date, only one particular 1D scheme is tested. In this paper, we present a systematic comparison of six commonly used numerical schemes for 1D blood flow modelling: discontinuous Galerkin, locally conservative Galerkin, Galerkin least-squares finite element method, finite volume method, finite difference MacCormack method and a simplified trapezium rule method. Comparisons are made in a series of six benchmark test cases with an increasing degree of complexity. The accuracy of the numerical schemes is assessed by comparison with theoretical results, three-dimensional numerical data in compatible domains with distensible walls or experimental data in a network of silicone tubes. Results show a good agreement among all numerical schemes and their ability to capture the main features of pressure, flow and area waveforms in large arteries. All the information used in this study, including the input data for all benchmark cases, experimental data where available and numerical solutions for each scheme, is made publicly available online, providing a comprehensive reference data set to support the development of 1D models and numerical schemes.

Hyperbolic reformulation of a 1D viscoelastic blood flow model and ADER finite volume schemes

The applicability of ADER finite volume methods to solve hyperbolic balance laws with stiff source terms in the context of well-balanced and non-conservative schemes is extended to solve a one-dimensional blood flow model for viscoelastic vessels, reformulated as a hyperbolic system, via a relaxation time. A criterion for selecting relaxation times is found and an empirical convergence rate assessment is carried out to support this result. The proposed methodology is validated by applying it to a network of viscoelastic vessels for which experimental and numerical results are available. The agreement between the results obtained in the present paper and those available in the literature is satisfactory. Key features of the present formulation and numerical methodologies, such as accuracy, efficiency and robustness, are fully discussed in the paper.

Enhanced global mathematical model for studying cerebral venous blood flow

Here we extend the global, closed-loop, mathematical model for the cardiovascular system in Müller and Toro (2014) to account for fundamental mechanisms affecting cerebral venous haemodynamics: the interaction between intracranial pressure and cerebral vasculature and the Starling-resistor like behaviour of intracranial veins. Computational results are compared with flow measurements obtained from Magnetic Resonance Imaging (MRI), showing overall satisfactory agreement. The role played by each model component in shaping cerebral venous flow waveforms is investigated. Our results are discussed in light of current physiological concepts and model-driven considerations, indicating that the Starling-resistor like behaviour of intracranial veins at the point where they join dural sinuses is the leading mechanism. Moreover, we present preliminary results on the impact of neck vein strictures on cerebral venous hemodynamics. These results show that such anomalies cause a pressure increment in intracranial cerebral veins, even if the shielding effect of the Starling-resistor like behaviour of cerebral veins is taken into account.

A high order approximation of hyperbolic conservation laws in networks

We present a methodology for the high order approximation of hyperbolic conservation laws in networks by using the Dumbser-Enaux-Toro solver and exact solvers for the classical Riemann problem at junctions. The proposed strategy can be applied to any hyperbolic system, conservative or non-conservative, and possibly with flux functions containing discontinuous parameters, as long as an exact or approximate Riemann problem solver is available. The methodology is implemented for a one-dimensional blood flow model that considers discontinuous variations of mechanical and geometrical properties of vessels. The achievement of formal order of accuracy, as well as the robustness of the resulting numerical scheme, is verified through the simulation of both, academic tests and physiological flows.

A high-order local time stepping finite volume solver for one-dimensional blood flow simulations: application to the ADAN model.

In recent years, the complexity of vessel networks for one-dimensional blood flow models has significantly increased, because of enhanced anatomical detail or automatic peripheral vasculature generation, for example. This fact, along with the application of these models in uncertainty quantification and parameter estimation poses the need for extremely efficient numerical solvers. The aim of this work is to present a finite volume solver for one-dimensional blood flow simulations in networks of elastic and viscoelastic vessels, featuring high-order space-time accuracy and local time stepping (LTS). The solver is built on (i) a high-order finite volume type numerical scheme, (ii) a high-order treatment of the numerical solution at internal vertexes of the network, often called junctions, and (iii) an accurate LTS strategy. The accuracy of the proposed methodology is verified by empirical convergence tests. Then, the resulting LTS scheme is applied to arterial networks of increasing complexity and spatial scale heterogeneity, with a number of one-dimensional segments ranging from a few tens up to several thousands and vessel lengths ranging from less than a millimeter up to tens of centimeters, in order to evaluate its computational cost efficiency. The proposed methodology can be extended to any other hyperbolic system for which network applications are relevant. Copyright

Blood pressure gradients in cerebral arteries: a clue to pathogenesis of cerebral small vessel disease

Rationale The role of hypertension in cerebral small vessel disease is poorly understood. At the base of the brain (the ‘vascular centrencephalon’), short straight arteries transmit blood pressure directly to small resistance vessels; the cerebral convexity is supplied by long arteries with many branches, resulting in a drop in blood pressure. Hypertensive small vessel disease (lipohyalinosis) causes the classically described lacunar infarctions at the base of the brain; however, periventricular white matter intensities (WMIs) seen on MRI and WMI in subcortical areas over the convexity, which are often also called ‘lacunes’, probably have different aetiologies. Objectives We studied pressure gradients from proximal to distal regions of the cerebral vasculature by mathematical modelling. Methods and results Blood flow/pressure equations were solved in an Anatomically Detailed Arterial Network (ADAN) model, considering a normotensive and a hypertensive case. Model parameters were suitably modified to account for structural changes in arterial vessels in the hypertensive scenario. Computations predict a marked drop in blood pressure from large and medium-sized cerebral vessels to cerebral peripheral beds. When blood pressure in the brachial artery is 192/113 mm Hg, the pressure in the small arterioles of the posterior parietal artery bed would be only 117/68 mm Hg. In the normotensive case, with blood pressure in the brachial artery of 117/75 mm Hg, the pressure in small parietal arterioles would be only 59/38 mm Hg. Conclusion These findings have important implications for understanding small vessel disease. The marked pressure gradient across cerebral arteries should be taken into account when evaluating the pathogenesis of small WMIs on MRI. Hypertensive small vessel disease, affecting the arterioles at the base of the brain should be distinguished from small vessel disease in subcortical regions of the convexity and venous disease in the periventricular white matter.

Computational haemodynamics in stenotic internal jugular veins

An association of stenotic internal jugular veins (IJVs) to anomalous cerebral venous hemodynamics and Multiple Sclerosis has been recently hypothesized. In this work, we set up a computational framework to assess the relevance of IJV stenoses through numerical simulation, combining medical imaging, patient-specific data and a mathematical model for venous occlusions. Coupling a three-dimensional description of blood flow in IJVs with a reduced one-dimensional model for major intracranial veins, we are able to model different anatomical configurations, an aspect of importance to understand the impact of IJV stenosis in intracranial venous haemodynamics. We investigate several stenotic configurations in a physiologic patient-specific regime, quantifying the effect of the stenosis in terms of venous pressure increase and wall shear stress patterns. Simulation results are in qualitative agreement with reported pressure anomalies in pathological cases. Moreover, they demonstrate the potential of the proposed multiscale framework for individual-based studies and computer-aided diagnosis.