Computational Modeling of Pathophysiologic Responses to Exercise in Fontan Patients
Identifieur interne : 001644 ( Pmc/Corpus ); précédent : 001643; suivant : 001645Computational Modeling of Pathophysiologic Responses to Exercise in Fontan Patients
Auteurs : Ethan Kung ; James C. Perry ; Christopher Davis ; Francesco Migliavacca ; Giancarlo Pennati ; Alessandro Giardini ; Tain-Yen Hsia ; Alison MarsdenSource :
- Annals of biomedical engineering [ 0090-6964 ] ; 2014.
Abstract
Reduced exercise capacity is nearly universal among Fontan patients. Although many factors have emerged as possible contributors, the degree to which each impacts the overall hemodynamics is largely unknown. Computational modeling provides a means to test hypotheses of causes of exercise intolerance via precisely controlled virtual experiments and measurements. We quantified the physiological impacts of commonly encountered, clinically relevant dysfunctions introduced to the exercising Fontan system via a previously developed lumped-parameter model of Fontan exercise. Elevated pulmonary arterial pressure was observed in all cases of dysfunction, correlated with lowered cardiac output, and often mediated by elevated atrial pressure. Pulmonary vascular resistance was not the most significant factor affecting exercise performance as measured by cardiac output. In the absence of other dysfunctions, atrioventricular valve insufficiency alone had significant physiological impact, especially under exercise demands. The impact of isolated dysfunctions can be linearly summed to approximate the combined impact of several dysfunctions occurring in the same system. A single dominant cause of exercise intolerance was not identified, though several hypothesized dysfunctions each led to variable decreases in performance. Computational predictions of performance improvement associated with various interventions should be weighed against procedural risks and potential complications, contributing to improvements in routine patient management protocol.
Url:
DOI: 10.1007/s10439-014-1131-4
PubMed: 25260878
PubMed Central: 4376649
Links to Exploration step
PMC:4376649***** Acces problem to record *****\Le document en format XML
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Ticri/CIDE/explor/HapticV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001644 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 001644 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Ticri/CIDE |area= HapticV1 |flux= Pmc |étape= Corpus |type= RBID |clé= PMC:4376649 |texte= Computational Modeling of Pathophysiologic Responses to Exercise in Fontan Patients }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:25260878" \ | HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \ | NlmPubMed2Wicri -a HapticV1
![]() | This area was generated with Dilib version V0.6.23. | ![]() |