# Physics-informed self-supervised learning for predictive modeling of coronary artery digital twins

arXiv: https://arxiv.org/abs/2512.03055 · HTML: https://mlsanity.com/paper/2512.03055/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 15 of its 43 references that are in the map.
- First posted on arXiv 25 Nov 2025.

## Builds on (most cited first, 15 of 15)

- [Semi-Supervised Classification with Graph Convolutional Networks](https://mlsanity.com/paper/1609.02907/) (2016)
- [A Unified Approach to Interpreting Model Predictions](https://mlsanity.com/paper/1705.07874/) (2017)
- [Inductive Representation Learning on Large Graphs](https://mlsanity.com/paper/1706.02216/) (2017)
- [PointNet: Deep Learning on Point Sets for 3D Classification and Segmentation](https://mlsanity.com/paper/1612.00593/) (2016)
- [PointNet++: Deep Hierarchical Feature Learning on Point Sets in a Metric Space](https://mlsanity.com/paper/1706.02413/) (2017)
- [Understanding Attention and Generalization in Graph Neural Networks](https://mlsanity.com/paper/1905.02850/) (2019)
- [Towards Sparse Hierarchical Graph Classifiers](https://mlsanity.com/paper/1811.01287/) (2018)
- [Mesh Neural Networks for SE(3)-Equivariant Hemodynamics Estimation on the Artery Wall](https://mlsanity.com/paper/2212.05023/) (2022)
- [Learning Reduced-Order Models for Cardiovascular Simulations with Graph Neural Networks](https://mlsanity.com/paper/2303.07310/) (2023)
- [A personalized time-resolved 3D mesh generative model for unveiling normal heart dynamics](https://mlsanity.com/paper/2409.13825/) (2024)
- [Multi-class point cloud completion networks for 3D cardiac anatomy reconstruction from cine magnetic resonance images](https://mlsanity.com/paper/2307.08535/) (2023)
- [Modeling 3D cardiac contraction and relaxation with point cloud deformation networks](https://mlsanity.com/paper/2307.10927/) (2023)
- [On the periodicity of cardiovascular fluid dynamics simulations](https://mlsanity.com/paper/2102.00107/) (2021)
- [Personalized 3D Myocardial Infarct Geometry Reconstruction from Cine MRI with Explicit Cardiac Motion Modeling](https://mlsanity.com/paper/2507.15194/) (2025)
- [A probabilistic reduced-order modeling framework for patient-specific cardio-mechanical analysis](https://mlsanity.com/paper/2411.08822/) (2024)

## Abstract (arXiv)

Cardiovascular disease is the leading global cause of mortality, with coronary artery disease (CAD) as its most prevalent form, necessitating early risk prediction. While 3D coronary artery digital twins reconstructed from imaging offer detailed anatomy for personalized assessment, their analysis relies on computationally intensive computational fluid dynamics (CFD), limiting scalability. Data-driven approaches are hindered by scarce labeled data and lack of physiological priors. To address this, we present PINS-CAD, a physics-informed self-supervised learning framework. It pre-trains graph neural networks on 200,000 synthetic coronary digital twins to predict pressure and flow, guided by 1D Navier-Stokes equations and pressure-drop laws, eliminating the need for CFD or labeled data. When fine-tuned on clinical data from 635 patients in the multicenter FAME2 study, PINS-CAD predicts future cardiovascular events with an AUC of 0.73, outperforming clinical risk scores and data-driven baselines. This demonstrates that physics-informed pretraining boosts sample efficiency and yields physiologically meaningful representations. Furthermore, PINS-CAD generates spatially resolved pressure and fractional flow reserve curves, providing interpretable biomarkers. By embedding physical priors into geometric deep learning, PINS-CAD transforms routine angiography into a simulation-free, physiology-aware framework for scalable, preventive cardiology.