A Constrained Mixture Theory Model to Study Autoregulation in the Coronary Circulation

Coronary autoregulation is a short-term response manifested by a relatively constant flow over a wide range of perfusion pressures for a given metabolic state. This phenomenon is thought to be facilitated through a combination of mechanisms, including myogenic, shear dependent, and metabolic controls. The study of coronary autoregulation is challenging due to the coupled nature of the mechanisms and their differential effects through the coronary tree. In this paper, we developed a novel framework to study coronary autoregulation based on the constrained mixture theory. This structurally-motivated autoregulation model required calibration of anatomical and structural parameters of coronary trees via a homeostatic optimization approach using extensive literature data. Autoregulation was then simulated for two different coronary trees: subepicardial and subendocardial. The structurally calibrated model reproduced available baseline hemodynamics and autoregulation data for each coronary tree. The autoregulation analysis showed that the diameter of the intermediate and small arterioles varies the most in response to changes in perfusion pressure. Finally, we demonstrated the utility of the model in two application examples: 1) response to drops in epicardial pressure, and 2) response to drug infusion in the coronary arteries. The proposed structurally-motivated model could be extended to study long-term growth and remodeling in the coronary circulation in response to hypertension, atherosclerosis, etc. Key pointsO_LICoronary autoregulation is defined as the capability of the coronary circulation to maintain the blood supply to the heart over a range of perfusion pressures. This phenomenon is facilitated through intrinsic mechanisms that control the vascular resistance by regulating the mechanical function of smooth muscle cells. Understanding the mechanisms involved in coronary autoregulation is one of the most fundamental questions in coronary physiology. C_LIO_LIThis paper presents a structurally-motivated coronary autoregulation model that uses a nonlinear continuum mechanics approach to account for the morphometry and vessel wall composition in two coronary trees in the subepicardial and subendocardial layers. C_LIO_LIThe model is calibrated against diverse experimental data from literature and is used to study heterogeneous autoregulatory response in the coronary trees. This model drastically differs from previous models, which relied on lumped parameter model formulations, and is suited to the study of long-term pathophysiological growth and remodeling phenomena in coronary vessels. C_LI