Simulation of Dilated Heart Failure with Continuous Flow Circulatory Support
Identifieur interne : 001314 ( Main/Exploration ); précédent : 001313; suivant : 001315Simulation of Dilated Heart Failure with Continuous Flow Circulatory Support
Auteurs : Yajuan Wang [États-Unis] ; Natasha Loghmanpour [États-Unis] ; Stijn Vandenberghe [Suisse] ; Antonio Ferreira [États-Unis, Brésil] ; Bradley Keller [États-Unis] ; John Gorcsan [États-Unis] ; James Antaki [États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2014.
Descripteurs français
- KwdFr :
- Cardiomyopathie dilatée (), Cardiomyopathie dilatée (imagerie diagnostique), Cardiomyopathie dilatée (physiopathologie), Circulation coronarienne (physiologie), Dispositifs d'assistance circulatoire, Débit systolique (physiologie), Défaillance cardiaque (), Défaillance cardiaque (imagerie diagnostique), Défaillance cardiaque (physiopathologie), Fonction ventriculaire gauche (physiologie), Humains, Hypertension pulmonaire (), Hypertension pulmonaire (physiopathologie), Modèles cardiovasculaires, Pression sanguine (physiologie), Simulation numérique, Systole (physiologie), Échographie, Études cas-témoins.
- MESH :
- imagerie diagnostique : Cardiomyopathie dilatée, Défaillance cardiaque.
- physiologie : Circulation coronarienne, Débit systolique, Fonction ventriculaire gauche, Pression sanguine, Systole.
- physiopathologie : Cardiomyopathie dilatée, Défaillance cardiaque, Hypertension pulmonaire.
- Cardiomyopathie dilatée, Dispositifs d'assistance circulatoire, Défaillance cardiaque, Humains, Hypertension pulmonaire, Modèles cardiovasculaires, Simulation numérique, Échographie, Études cas-témoins.
English descriptors
- KwdEn :
- Blood Pressure (physiology), Cardiomyopathy, Dilated (complications), Cardiomyopathy, Dilated (diagnostic imaging), Cardiomyopathy, Dilated (physiopathology), Case-Control Studies, Computer Simulation, Coronary Circulation (physiology), Heart Failure (complications), Heart Failure (diagnostic imaging), Heart Failure (physiopathology), Heart-Assist Devices, Humans, Hypertension, Pulmonary (complications), Hypertension, Pulmonary (physiopathology), Models, Cardiovascular, Stroke Volume (physiology), Systole (physiology), Ultrasonography, Ventricular Function, Left (physiology).
- MESH :
- complications : Cardiomyopathy, Dilated, Heart Failure, Hypertension, Pulmonary.
- diagnostic imaging : Cardiomyopathy, Dilated, Heart Failure.
- physiology : Blood Pressure, Coronary Circulation, Stroke Volume, Systole, Ventricular Function, Left.
- physiopathology : Cardiomyopathy, Dilated, Heart Failure, Hypertension, Pulmonary.
- Case-Control Studies, Computer Simulation, Heart-Assist Devices, Humans, Models, Cardiovascular, Ultrasonography.
Abstract
Lumped parameter models have been employed for decades to simulate important hemodynamic couplings between a left ventricular assist device (LVAD) and the native circulation. However, these studies seldom consider the pathological descending limb of the Frank-Starling response of the overloaded ventricle. This study introduces a dilated heart failure model featuring a unimodal end systolic pressure-volume relationship (ESPVR) to address this critical shortcoming. The resulting hemodynamic response to mechanical circulatory support are illustrated through numerical simulations of a rotodynamic, continuous flow ventricular assist device (cfVAD) coupled to systemic and pulmonary circulations with baroreflex control. The model further incorporated septal interaction to capture the influence of left ventricular (LV) unloading on right ventricular function. Four heart failure conditions were simulated (LV and bi-ventricular failure with/without pulmonary hypertension) in addition to normal baseline. Several metrics of LV function, including cardiac output and stroke work, exhibited a unimodal response whereby initial unloading improved function, and further unloading depleted preload reserve thereby reducing ventricular output. The concept of
Url:
DOI: 10.1371/journal.pone.0085234
PubMed: 24465511
PubMed Central: 3894974
Affiliations:
- Brésil, Suisse, États-Unis
- Canton de Berne, Kentucky, Maranhão, Pennsylvanie
- Berne, Pittsburgh
- Université Carnegie-Mellon, Université de Berne
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Le document en format XML
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type="state">Maranhão</region></placeName></affiliation></author><author><name sortKey="Keller, Bradley" sort="Keller, Bradley" uniqKey="Keller B" first="Bradley" last="Keller">Bradley Keller</name><affiliation wicri:level="2"><nlm:aff id="aff4"><addr-line>Cardiovascular Innovation Institute, University of Louisville, Louisville, Kentucky, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Cardiovascular Innovation Institute, University of Louisville, Louisville, Kentucky</wicri:regionArea><placeName><region type="state">Kentucky</region></placeName></affiliation></author><author><name sortKey="Gorcsan, John" sort="Gorcsan, John" uniqKey="Gorcsan J" first="John" last="Gorcsan">John Gorcsan</name><affiliation wicri:level="2"><nlm:aff id="aff5"><addr-line>Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America</addr-line></nlm:aff><country 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ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Blood Pressure (physiology)</term><term>Cardiomyopathy, Dilated (complications)</term><term>Cardiomyopathy, Dilated (diagnostic imaging)</term><term>Cardiomyopathy, Dilated (physiopathology)</term><term>Case-Control Studies</term><term>Computer Simulation</term><term>Coronary Circulation (physiology)</term><term>Heart Failure (complications)</term><term>Heart Failure (diagnostic imaging)</term><term>Heart Failure (physiopathology)</term><term>Heart-Assist Devices</term><term>Humans</term><term>Hypertension, Pulmonary (complications)</term><term>Hypertension, Pulmonary (physiopathology)</term><term>Models, Cardiovascular</term><term>Stroke Volume (physiology)</term><term>Systole (physiology)</term><term>Ultrasonography</term><term>Ventricular Function, Left (physiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Cardiomyopathie dilatée ()</term><term>Cardiomyopathie dilatée (imagerie diagnostique)</term><term>Cardiomyopathie dilatée (physiopathologie)</term><term>Circulation coronarienne (physiologie)</term><term>Dispositifs d'assistance circulatoire</term><term>Débit systolique (physiologie)</term><term>Défaillance cardiaque ()</term><term>Défaillance cardiaque (imagerie diagnostique)</term><term>Défaillance cardiaque (physiopathologie)</term><term>Fonction ventriculaire gauche (physiologie)</term><term>Humains</term><term>Hypertension pulmonaire ()</term><term>Hypertension pulmonaire (physiopathologie)</term><term>Modèles cardiovasculaires</term><term>Pression sanguine (physiologie)</term><term>Simulation numérique</term><term>Systole (physiologie)</term><term>Échographie</term><term>Études cas-témoins</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Cardiomyopathy, Dilated</term><term>Heart Failure</term><term>Hypertension, Pulmonary</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Cardiomyopathy, Dilated</term><term>Heart Failure</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Cardiomyopathie dilatée</term><term>Défaillance cardiaque</term></keywords><keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Circulation coronarienne</term><term>Débit systolique</term><term>Fonction ventriculaire gauche</term><term>Pression sanguine</term><term>Systole</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Blood Pressure</term><term>Coronary Circulation</term><term>Stroke Volume</term><term>Systole</term><term>Ventricular Function, Left</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Cardiomyopathie dilatée</term><term>Défaillance cardiaque</term><term>Hypertension pulmonaire</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Cardiomyopathy, Dilated</term><term>Heart Failure</term><term>Hypertension, Pulmonary</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Case-Control Studies</term><term>Computer Simulation</term><term>Heart-Assist Devices</term><term>Humans</term><term>Models, Cardiovascular</term><term>Ultrasonography</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Cardiomyopathie dilatée</term><term>Dispositifs d'assistance circulatoire</term><term>Défaillance cardiaque</term><term>Humains</term><term>Hypertension pulmonaire</term><term>Modèles cardiovasculaires</term><term>Simulation numérique</term><term>Échographie</term><term>Études cas-témoins</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Lumped parameter models have been employed for decades to simulate important hemodynamic couplings between a left ventricular assist device (LVAD) and the native circulation. However, these studies seldom consider the pathological descending limb of the Frank-Starling response of the overloaded ventricle. This study introduces a dilated heart failure model featuring a unimodal end systolic pressure-volume relationship (ESPVR) to address this critical shortcoming. The resulting hemodynamic response to mechanical circulatory support are illustrated through numerical simulations of a rotodynamic, continuous flow ventricular assist device (cfVAD) coupled to systemic and pulmonary circulations with baroreflex control. The model further incorporated septal interaction to capture the influence of left ventricular (LV) unloading on right ventricular function. Four heart failure conditions were simulated (LV and bi-ventricular failure with/without pulmonary hypertension) in addition to normal baseline. Several metrics of LV function, including cardiac output and stroke work, exhibited a unimodal response whereby initial unloading improved function, and further unloading depleted preload reserve thereby reducing ventricular output. The concept of <italic>extremal loading</italic> was introduced to reflect the loading condition in which the intrinsic LV stroke work is maximized. Simulation of bi-ventricular failure with pulmonary hypertension revealed inadequacy of LV support alone. These simulations motivate the implementation of an extremum tracking feedback controller to potentially optimize ventricular recovery.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Vandenberghe, S" uniqKey="Vandenberghe S">S Vandenberghe</name></author><author><name sortKey="Segers, P" uniqKey="Segers P">P Segers</name></author><author><name sortKey="Meyns, B" uniqKey="Meyns B">B Meyns</name></author><author><name sortKey="Verdonck, P" uniqKey="Verdonck P">P Verdonck</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vollkron, M" uniqKey="Vollkron M">M Vollkron</name></author><author><name sortKey="Schima, H" uniqKey="Schima H">H Schima</name></author><author><name sortKey="Huber, L" uniqKey="Huber L">L Huber</name></author><author><name sortKey="Wieselthaler, G" uniqKey="Wieselthaler G">G Wieselthaler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Morley, D" 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Dipla</name></author><author><name sortKey="Mattiello, Ja" uniqKey="Mattiello J">JA Mattiello</name></author><author><name sortKey="Houser, Sr" uniqKey="Houser S">SR Houser</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kinoshita, M" uniqKey="Kinoshita M">M Kinoshita</name></author><author><name sortKey="Takano, H" uniqKey="Takano H">H Takano</name></author><author><name sortKey="Taenaka, Y" uniqKey="Taenaka Y">Y Taenaka</name></author><author><name sortKey="Mori, H" uniqKey="Mori H">H Mori</name></author><author><name sortKey="Takaichi, S" uniqKey="Takaichi S">S Takaichi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rose, Ag" uniqKey="Rose A">AG Rose</name></author><author><name sortKey="Park, Sj" uniqKey="Park S">SJ Park</name></author><author><name sortKey="Bank, Aj" uniqKey="Bank A">AJ Bank</name></author><author><name sortKey="Miller, Lw" uniqKey="Miller L">LW Miller</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Brésil</li><li>Suisse</li><li>États-Unis</li></country><region><li>Canton de Berne</li><li>Kentucky</li><li>Maranhão</li><li>Pennsylvanie</li></region><settlement><li>Berne</li><li>Pittsburgh</li></settlement><orgName><li>Université Carnegie-Mellon</li><li>Université de Berne</li></orgName></list><tree><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Wang, Yajuan" sort="Wang, Yajuan" uniqKey="Wang Y" first="Yajuan" last="Wang">Yajuan Wang</name></region><name sortKey="Antaki, James" sort="Antaki, James" uniqKey="Antaki J" first="James" last="Antaki">James Antaki</name><name sortKey="Ferreira, Antonio" sort="Ferreira, Antonio" uniqKey="Ferreira A" first="Antonio" last="Ferreira">Antonio Ferreira</name><name sortKey="Gorcsan, John" sort="Gorcsan, John" uniqKey="Gorcsan J" first="John" last="Gorcsan">John Gorcsan</name><name sortKey="Keller, Bradley" sort="Keller, Bradley" uniqKey="Keller B" first="Bradley" last="Keller">Bradley Keller</name><name sortKey="Loghmanpour, Natasha" sort="Loghmanpour, Natasha" uniqKey="Loghmanpour N" first="Natasha" last="Loghmanpour">Natasha Loghmanpour</name></country><country name="Suisse"><region name="Canton de Berne"><name sortKey="Vandenberghe, Stijn" sort="Vandenberghe, Stijn" uniqKey="Vandenberghe S" first="Stijn" last="Vandenberghe">Stijn Vandenberghe</name></region></country><country name="Brésil"><region name="Maranhão"><name sortKey="Ferreira, Antonio" sort="Ferreira, Antonio" uniqKey="Ferreira A" first="Antonio" last="Ferreira">Antonio Ferreira</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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