Patient-specific estimates of vascular and placental properties in growth-restricted fetuses based on a model of the fetal circulation

Introduction: Intrauterine growth restriction (IUGR) due to placental insufficiency is associated with blood-flow redistribution in order to maintain perfusion to the brain. However, some hemodynamic parameters that might be more directly related to staging of the disease cannot be measured non-inva...

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Authors: Bijnens, Bart, García Cañadilla, Patricia, 1985-, Crispi Brillas, Fàtima, Cruz-Lemini, Mónica, Triunfo, Stefania, Nadal, Alfons, Valenzuela Alcaraz, Brenda, Rudenick, Paula A., Gratacós Solsona, Eduard
Format: article
Status:Versión aceptada para publicación
Publication Date:2015
Country:España
Institution:Universitat Pompeu Fabra
Repository:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/28221
Online Access:http://hdl.handle.net/10230/28221
http://dx.doi.org/10.1016/j.placenta.2015.07.130
Access Level:Open access
Keyword:Computational model
Fetal circulation
Doppler
Placental resistance
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spelling Patient-specific estimates of vascular and placental properties in growth-restricted fetuses based on a model of the fetal circulationBijnens, BartGarcía Cañadilla, Patricia, 1985-Crispi Brillas, FàtimaCruz-Lemini, MónicaTriunfo, StefaniaNadal, AlfonsValenzuela Alcaraz, BrendaRudenick, Paula A.Gratacós Solsona, EduardComputational modelFetal circulationDopplerPlacental resistanceIntroduction: Intrauterine growth restriction (IUGR) due to placental insufficiency is associated with blood-flow redistribution in order to maintain perfusion to the brain. However, some hemodynamic parameters that might be more directly related to staging of the disease cannot be measured non-invasively in clinical practice. For this, we developed a patient-specific model of the fetal circulation to estimate vascular properties of each individual. Methods: A lumped model of the fetal circulation was developed and personalized using measured echographic data from 37 normal and IUGR fetuses to automatically estimate model-based parameters. A multivariate regression analysis was performed to evaluate the association between the Doppler pulsatility indices (PI) and the model-based parameters. The correlation between model-based parameters and the placental lesions was analyzed in a set of 13 IUGR placentas. A logistic regression analysis was done to assess the added value of the model-based parameters relative to Doppler indices, for the detection of fetuses with adverse perinatal outcome. Results: The estimated model-based placental and brain resistances were respectively increased and reduced in IUGR fetuses while placental compliance was increased in IUGR fetus. Umbilical and middle cerebral arteries PIs were most associated with both placental resistance and compliance, while uterine artery PI was more associated with the placental compliance. The logistic regression analysis showed that the model added significant information to the traditional analysis of Doppler waveforms for predicting adverse outcome in IUGR. Discussion: The proposed patient-specific computational model seems to be a good approach to assess hemodynamic parameters than cannot be measured clinically.This study was partly supported by grants from Ministerio de Economia y Competitividad (ref. SAF2012-37196); the Instituto de Salud Carlos III (ref. (PI11/01709, PI12/00801, PI14/00226) integrado en el Plan Nacional de I+D+I y cofinanciado por el ISCIII-Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER) “Otra manera de hacer Europa”; the EU FP7 for research, technological development and demonstration under grant agreement VP2HF (no 611823); The Cerebra Foundation for the Brain Injured Child (Carmarthen, Wales, UK); Obra Social “la Caixa” (Barcelona, Spain); P.G.C. was supported by the Programa de Ayudas Predoctorales de Formación en investigación en Salud (FI12/00362) from the Instituto Carlos III, Spain . M.C.L. and B.V.A. wish to express their gratitude to the Mexican National Council for Science and Technology (CONACyT, Mexico City, Mexico) for supporting their predoctoral stay at Hospital Clinic, Barcelona, Spain.Elsevier201720172015info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/28221http://dx.doi.org/10.1016/j.placenta.2015.07.130reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésPlacenta. 2015;36(9):981-89.info:eu-repo/grantAgreement/ES/3PN/SAF2012-37196info:eu-repo/grantAgreement/EC/FP7/611823© Elsevier http://dx.doi.org/10.1016/j.placenta.2015.07.130info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/282212026-06-12T07:21:37Z
dc.title.none.fl_str_mv Patient-specific estimates of vascular and placental properties in growth-restricted fetuses based on a model of the fetal circulation
title Patient-specific estimates of vascular and placental properties in growth-restricted fetuses based on a model of the fetal circulation
spellingShingle Patient-specific estimates of vascular and placental properties in growth-restricted fetuses based on a model of the fetal circulation
Bijnens, Bart
Computational model
Fetal circulation
Doppler
Placental resistance
title_short Patient-specific estimates of vascular and placental properties in growth-restricted fetuses based on a model of the fetal circulation
title_full Patient-specific estimates of vascular and placental properties in growth-restricted fetuses based on a model of the fetal circulation
title_fullStr Patient-specific estimates of vascular and placental properties in growth-restricted fetuses based on a model of the fetal circulation
title_full_unstemmed Patient-specific estimates of vascular and placental properties in growth-restricted fetuses based on a model of the fetal circulation
title_sort Patient-specific estimates of vascular and placental properties in growth-restricted fetuses based on a model of the fetal circulation
dc.creator.none.fl_str_mv Bijnens, Bart
García Cañadilla, Patricia, 1985-
Crispi Brillas, Fàtima
Cruz-Lemini, Mónica
Triunfo, Stefania
Nadal, Alfons
Valenzuela Alcaraz, Brenda
Rudenick, Paula A.
Gratacós Solsona, Eduard
author Bijnens, Bart
author_facet Bijnens, Bart
García Cañadilla, Patricia, 1985-
Crispi Brillas, Fàtima
Cruz-Lemini, Mónica
Triunfo, Stefania
Nadal, Alfons
Valenzuela Alcaraz, Brenda
Rudenick, Paula A.
Gratacós Solsona, Eduard
author_role author
author2 García Cañadilla, Patricia, 1985-
Crispi Brillas, Fàtima
Cruz-Lemini, Mónica
Triunfo, Stefania
Nadal, Alfons
Valenzuela Alcaraz, Brenda
Rudenick, Paula A.
Gratacós Solsona, Eduard
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Computational model
Fetal circulation
Doppler
Placental resistance
topic Computational model
Fetal circulation
Doppler
Placental resistance
description Introduction: Intrauterine growth restriction (IUGR) due to placental insufficiency is associated with blood-flow redistribution in order to maintain perfusion to the brain. However, some hemodynamic parameters that might be more directly related to staging of the disease cannot be measured non-invasively in clinical practice. For this, we developed a patient-specific model of the fetal circulation to estimate vascular properties of each individual. Methods: A lumped model of the fetal circulation was developed and personalized using measured echographic data from 37 normal and IUGR fetuses to automatically estimate model-based parameters. A multivariate regression analysis was performed to evaluate the association between the Doppler pulsatility indices (PI) and the model-based parameters. The correlation between model-based parameters and the placental lesions was analyzed in a set of 13 IUGR placentas. A logistic regression analysis was done to assess the added value of the model-based parameters relative to Doppler indices, for the detection of fetuses with adverse perinatal outcome. Results: The estimated model-based placental and brain resistances were respectively increased and reduced in IUGR fetuses while placental compliance was increased in IUGR fetus. Umbilical and middle cerebral arteries PIs were most associated with both placental resistance and compliance, while uterine artery PI was more associated with the placental compliance. The logistic regression analysis showed that the model added significant information to the traditional analysis of Doppler waveforms for predicting adverse outcome in IUGR. Discussion: The proposed patient-specific computational model seems to be a good approach to assess hemodynamic parameters than cannot be measured clinically.
publishDate 2015
dc.date.none.fl_str_mv 2015
2017
2017
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/28221
http://dx.doi.org/10.1016/j.placenta.2015.07.130
url http://hdl.handle.net/10230/28221
http://dx.doi.org/10.1016/j.placenta.2015.07.130
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Placenta. 2015;36(9):981-89.
info:eu-repo/grantAgreement/ES/3PN/SAF2012-37196
info:eu-repo/grantAgreement/EC/FP7/611823
dc.rights.none.fl_str_mv © Elsevier http://dx.doi.org/10.1016/j.placenta.2015.07.130
info:eu-repo/semantics/openAccess
rights_invalid_str_mv © Elsevier http://dx.doi.org/10.1016/j.placenta.2015.07.130
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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