We present a novel mathematical model that simulates myocardial blood perfusion by embedding multiscale and multiphysics features. Our model incorporates cardiac electrophysiology, active and passive mechanics, hemodynamics, reduced valve modeling, and a multicompartment Darcy model of perfusion. We consider a fully coupled electromechanical model of the left heart that provides input for a fully coupled Navier-Stokes - Darcy Model for myocardial perfusion. The fluid dynamics problem is modeled in a left heart geometry that includes large epicardial coronaries, while the multicompartment Darcy model is set in a biventricular domain. Using a realistic and detailed cardiac geometry, our simulations demonstrate the accuracy of our model in describing cardiac perfusion, including myocardial blood flow maps. Additionally, we investigate the impact of a regurgitant aortic valve on myocardial perfusion, and our results indicate a reduction in myocardial perfusion due to blood flow taken away by the left ventricle during diastole. To the best of our knowledge, our work represents the first instance where electromechanics, hemodynamics, and perfusion are integrated into a single computational framework.

翻译：我们提出了一种新颖的数学模型，通过嵌入多尺度和多物理特性来模拟心肌血液灌注。该模型整合了心脏电生理学、主动与被动力学、血流动力学、简化瓣膜模型以及多室达西灌注模型。我们建立了一个完全耦合的左心电机械模型，为心肌灌注的全耦合纳维-斯托克斯-达西模型提供输入。流体动力学问题在包含心外膜大血管的左心几何结构中进行建模，而多室达西模型则设置在双心室域内。利用真实且详尽的心脏几何结构，我们的模拟展示了该模型在描述心脏灌注（包括心肌血流图）方面的准确性。此外，我们研究了主动脉瓣反流对心肌灌注的影响，结果表明舒张期左心室分流血液导致心肌灌注减少。据我们所知，本工作首次将电机械学、血流动力学和灌注整合至单一计算框架中。