Highlights
The prevalence of heart failure with preserved ejection fraction among patients who present with symptoms of heart failure is approximately 50%.
Pharmacologic therapy has not conclusively shown benefits in morbidity and mortality in clinical trials.
Although it represents an active area of research, no device-based therapy has received regulatory approval for the treatment of heart failure with preserved ejection fraction.
Approaches such as atrial shunts, left ventricular expanders, mechanical circulatory support devices, and neurostimulators are at various stages of development.
Introducing a blade curvature enhanced the hydrodynamic and hemolytic performance compared to the straight-blade configuration for the investigated centrifugal blood pump. The findings of this study provide new insights into centrifugal blood pump design by examining the influence of the blade curvature.
In this work, a lumped‐parameter Windkessel model of the cardiovascular system that simulates biomechanical parameters of the human physiology is presented. The object‐oriented platform provided by the MATLAB‐based modeling environment SIMSCAPE is employed to compute blood pressures and flows in each heart chamber and at various sites of the vascular tree. The hydraulic domain allows the determination of cardiovascular hemodynamics intuitively from geometrical and mechanical properties of the system, while custom elements model the pumping action of the heart and the effects of respiration on blood flow. The model is validated by comparing predicted hemodynamics with normal physiology during both systole and diastole, demonstrating that changes in arterial pressures with breathing are consistent with reported physiological effects of cardiorespiratory coupling. The capabilities of this platform are explored through two exemplary case studies: i) pressure‐overload heart failure due to aortic constriction, validated in vitro and via finite element analysis, and ii) single‐ventricle Fontan physiology, validated in vitro and compared with the clinical literature. This platform provides a practical tool for the calculation of cardiovascular hemodynamics from hydraulic parameters, enabling the intuitive creation of in silico representations of complex circulatory loops, the planning and optimization of medical interventions, and the prediction of clinically relevant patient‐specific hemodynamics.
Existing models of aortic stenosis (AS) are limited to inducing left ventricular pressure overload. As they have reduced control over the severity of aortic constriction, the clinical relevance of these models is largely hindered by their inability to mimic AS hemodynamics and recapitulate ow patterns associated with congenital valve defects, responsible for the accelerated onset and progression of AS. Here we report the development of a highly tunable bio-inspired soft robotic tool that enables the recapitulation of AS in a porcine model, in which customization of actuation patterns allows hemodynamic mimicry of AS and congenital aortic valve defects. In vitro and computational tools including lumped-parameter, nite element, and computational uid dynamics platforms were developed to predict the hemodynamics induced by the bio-inspired soft robotic sleeve. The controllability of our in vivo model and its ability to replicate ow patterns of AS and congenital defects were demonstrated in swine through echocardiography, left ventricular catheterization, and magnetic resonance imaging. This work supports the use of soft robotics to simulate human physiology and disease, while paving the way towards the development of patient-speci c models of AS and congenital defects that can guide clinical decisions to improve the management and treatment of these patients.
In the design of rotary blood pumps, the optimization of design parameters plays an essential role in enhancing the hydrodynamic performance and hemocompatibility. This study investigates the influence of the volute tongue angle as a volute geometric parameter on the hemodynamic characteristics of a blood pump. A numerical investigation on five different versions of volute designs is carried out by utilizing a computational fluid dynamics (CFD) software ANSYS-FLUENT. The effect of volute tongue angle is evaluated regarding the hydrodynamic performance, circumferential pressure distribution, the radial force, and the blood damage potential. A series of volute configurations are constructed with a fixed radial gap (5%), but varying tongue angles ranging from 10 to 50°. The relative hemolysis is assessed with the Eulerian based empirical power-law blood damage model. The pressure-flow rate characteristics of the volute designs at a range of rotational speeds are obtained from the experimental measurements by using the blood analog fluid. The results indicate an inverse relationship between hydraulic performance and the tongue angle; at higher tongue angles, a decrease in performance was observed. However, a higher tongue angle improves the net radial force acting on the impeller. The pump achieves the optimized performance at 20° of the tongue angle with the relatively high hydrodynamic performance and minor blood damage risk.
Existing models of aortic stenosis (AS) are limited to inducing left ventricular pressure overload. As they have reduced control over the severity of aortic constriction, the clinical relevance of these models is largely hindered by their inability to mimic AS hemodynamics and recapitulate flow patterns associated with congenital valve defects, responsible for the accelerated onset and progression of AS. Here we report the development of a highly tunable bio-inspired soft robotic tool that enables the recapitulation of AS in a porcine model, in which customization of actuation patterns allows hemodynamic mimicry of AS and congenital aortic valve defects. In vitro and computational tools including lumped-parameter, finite element, and computational fluid dynamics platforms were developed to predict the hemodynamics induced by the bio-inspired soft robotic sleeve. The controllability of our in vivo model and its ability to replicate flow patterns of AS and congenital defects were demonstrated in swine through echocardiography, left ventricular catheterization, and magnetic resonance imaging. This work supports the use of soft robotics to simulate human physiology and disease, while paving the way towards the development of patient-specific models of AS and congenital defects that can guide clinical decisions to improve the management and treatment of these patients.
Mechanical circulatory support (MCS) devices are currently under development to improve the physiology and hemodynamics of patients with heart failure with preserved ejection fraction (HFpEF). Most of these devices, however, are designed to provide continuous-flow support. While it has been shown that pulsatile support may overcome some of the complications hindering the clinical translation of these devices for other heart failure phenotypes, the effects that it may have on the HFpEF physiology are still unknown. Here, we present a multi-domain simulation study of a pulsatile pump device with left atrial cannulation for HFpEF that aims to alleviate left atrial pressure, commonly elevated in HFpEF. We leverage lumped-parameter modeling to optimize the design of the pulsatile pump, computational fluid dynamic simulations to characterize hydraulic and hemolytic performance, and finite element modeling on the Living Heart Model to evaluate effects on arterial, left atrial, and left ventricular hemodynamics and biomechanics. The findings reported in this study suggest that pulsatile-flow support can successfully reduce pressures and associated wall stresses in the left heart, while yielding more physiologic arterial hemodynamics compared to continuous-flow support. This work therefore supports further development and evaluation of pulsatile support MCS devices for HFpEF.
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