In this work, we develop patient-specific cardiocirculatory models with the aim of building Digital Twins for hypertension. In particular, in our pathophysiology-based framework, we consider both 0D cardiocirculatory models and a 3D-0D electromechanical model. The 0D model, which consists of an RLC circuit, is studied in two variants, with and without capillaries. The 3D-0D model consists of a three-dimensional electromechanical model of the left ventricle, coupled with a 0D model for the external blood circulation: this representation enables the assessment of additional quantities related to ventricular deformation and stress, and offers a more detailed representation compared to a fully 0D model. Sensitivity analysis is performed on the 0D model, with both a mono- and a multi-parametric approach, in order to identify the parameters that most influence the model outputs and guide the calibration process. We studied three different scenarios, corresponding to systemic, pulmonary and renovascular hypertension, each in three nuances of severity. To maintain a fair comparison among the models, a parameter calibration strategy is developed; the outputs of the 0D model with capillaries are utilized to enhance the 3D-0D model. The results demonstrate that the 3D-0D model yields an accurate representation of cardiocirculatory dynamics in the presence of hypertension; this model represents a powerful step toward digital twins for real-time hypertension control, providing refined and clinically meaningful insights beyond those achievable with 0D models alone.

翻译：本研究旨在构建高血压的数字孪生体，开发了患者特异性循环系统模型。具体而言，我们基于病理生理学框架，同时考虑了0D循环系统模型和3D-0D电机械耦合模型。0D模型采用RLC电路结构，研究了包含毛细血管与不包含毛细血管的两种变体。3D-0D模型由左心室三维电机械模型与外周循环0D模型耦合构成：这种表征方式能够评估与心室形变及应力相关的附加物理量，相比纯0D模型提供了更精细的生理表征。通过对0D模型进行单参数与多参数敏感性分析，识别出对模型输出影响最显著的关键参数以指导校准流程。我们研究了三种不同病理场景（系统性高血压、肺动脉高压及肾血管性高血压），每种场景均设置三个严重程度等级。为确保模型间的公平比较，开发了参数校准策略：利用含毛细血管0D模型的输出结果来优化3D-0D模型。研究结果表明，3D-0D模型能精确表征高血压状态下的循环系统动力学特征；该模型标志着向实时高血压控制的数字孪生体迈出关键一步，其提供的精细化临床洞察超越了纯0D模型的能力范畴。