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From Patient-Specific Hemodynamic Modeling to Clinical Decision-Making in Chronic Thromboembolic Pulmonary Hypertension: Opportunities and Caveats
Gianluca Pagnoni, Aurora Vicenzi, Francesca Coppi
https://doi.org/10.1002/pul2.70224
Abstract
We read with great interest the recent article on patient-specific hemodynamic modeling to estimate microvascular disease burden and predict response to pulmonary endarterectomy (PEA) in chronic thromboembolic pulmonary hypertension (CTEPH) [1]. The integration of multiscale structure-based modeling with routine clinical data addresses the key challenges of quantifying distal microvascular remodeling and anticipating heterogeneous hemodynamic responses after technically successful PEA. The strong correlation between modeled and observed changes in mean pulmonary artery pressure (mPAP), together with the use of CT pulmonary angiography–derived vascular geometry and a continuous remodeling scale, is particularly compelling. In parallel, histopathological data describing heterogeneous endothelial features and angiogenic cues along the pulmonary vascular tree in CTEPH further reinforce the biological plausibility of regionally explicit modeling strategies [2].
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