Application of a user-friendly comprehensive circulatory model for estimation of hemodynamic and ventricular variables

Ferrari, G.; Kozarski, Maciej; Gu, Yongquan; Lazzari, Claudio De; Molfetta, Arianna Di; Pałko, Krzysztof Jakub; Zieliński, Krzysztof; Górczyńska, Krystyna; Darowski, M.; Rakhorst, Gerhard

doi:10.1177/039139880803101208

Cited by 10 publications

(20 citation statements)

References 33 publications

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“…These three points are all necessary to guarantee a tailored therapy and to decrease the rate of non responders, especially in the field of electrophysiology where engineering tools could be very useful to support clinical practice and innovation [4,7,10,11,14,15,21,22].…”

Section: Discussionmentioning

confidence: 99%

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Towards a Personalized and Dynamic CRT-D

Molfetta

Santini²,

Forleo³

et al. 2012

Methods Inf Med

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SummaryBackground: In spite of cardiac resynchronization therapy (CRT) benefits, 25 -30% of patients are still non responders. One of the possible reasons could be the non optimal atrioventricular (AV) and interventricular (VV) intervals settings. Our aim was to exploit a numerical model of cardiovascular system for AV and VV intervals optimization in CRT. Methods: A numerical model of the cardiovascular system CRT-dedicated was previously developed. Echocardiographic parameters, Systemic aortic pressure and ECG were collected in 20 consecutive patients before and after CRT. Patient data were simulated by the model that was used to optimize and set into the device the intervals at the baseline and at the follow up. The optimal AV and VV intervals were chosen to optimize the simulated selected variable/s on the base of both echocardiographic and electrocardiographic parameters. Results: Intervals were different for each patient and in most cases, they changed at follow up. The model can well reproduce clinical data as verified with Bland Altman analysis and T-test (p > 0.05). Left ventricular remodeling was 38.7% and left ventricular ejection fraction increasing was 11% against the 15% and 6% reported in literature, respectively. Conclusions: The developed numerical model could reproduce patients conditions at the baseline and at the follow up including the CRT effects. The model could be used to optimize AV and VV intervals at the baseline and at the follow up realizing a personalized and dynamic CRT. A patient tailored CRT could improve patients outcome in comparison to literature data.

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Section: Discussionmentioning

confidence: 99%

“…A lumped parameter computational model of the cardiovascular system able to reproduce the main pathophysiological events in terms of pressure, volume and flow [13,14] was updated in order to develop a CRTdedicated application.…”

Section: The Numerical Model Of the Cardiovascular Systemmentioning

confidence: 99%

Towards a Personalized and Dynamic CRT-D

Molfetta

Santini²,

Forleo³

et al. 2012

Methods Inf Med

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“…Different selections are possible when starting the model: passive (simple compliance) or active (variable elastance model) atria, simple ventricles based on a single variable elastance model or more complex ventricles used for biventricular pacing simulation where two or three variable elastance models work in parallel, reproducing ventricular walls and septum. 9 Heart models include a set of heart valve models -from a simple diode to backflow models 7 to models including leaflet movements. 23 Finally, the modelling platform can be connected to physical or computational mechanical heart assist devices: they include continuous or pulsatile flow devices and intra aortic balloon pump.…”

Section: Methodsmentioning

confidence: 99%

“…This approach to modelling is based on lumped parameters models (LPM) [4][5][6][7][8] as they have the prerequisites needed for a daily clinical application: fast response, simplicity of use, reliability and easiness to be modified or re-adapted. Last but not least, thanks to their intrinsic simplicity, it is possible to tune LPMs using routinely acquired clinical data.…”

Section: Overviewmentioning

confidence: 99%

Circulatory Modelling as a Clinical Decision Support and an Educational Tool

Ferrari¹,

Molfetta²,

Zieliński³

et al. 2015

BMDJ

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“…The lumped parameter circulatory model and its structure The modular circulatory model is an evolution of a previous one [10] and is characterized by a high degree of flexibility and a polymorphic structure, easy adaptation to the model for different experimental needs, including the presence of ventricular assist devices (VADs). In this way the modeling system opens a window on the physical environment when and if necessary.…”

Section: Methodsmentioning

confidence: 99%

A modular computational circulatory model applicable to VAD testing and training

et al. 2011

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Aim of this work was to develop a modular computational model able to interact with ventricular assist devices (VAD) for research and educational applications. The lumped parameter model consists of five functional modules (left and right ventricles, systemic, pulmonary, and coronary circulation) that are easily replaceable if necessary. The possibility of interacting with VADs is achieved via interfaces acting as impedance transformers. This last feature was tested using an electrical VAD model. Tests were aimed at demonstrating the possibilities and verifying the behavior of interfaces when testing VADs connected in different ways to the circulatory system. For these reasons, experiments were performed in a purely numerical mode, simulating a caval occlusion, and with the model interfaced to an external left-VAD (LVAD) in two different ways: with atrioaortic and ventriculoaortic connection. The caval occlusion caused the leftward shift of the LV p-v loop, along with the drop in arterial and ventricular pressures. A narrower LV p-v loop and cardiac output and aortic pressure rise were the main effects of atrioaortic assistance. A wider LV p-v loop and a ventricular average volume drop were the main effects of ventricular-aortic assistance. Results coincided with clinical and experimental data attainable in the literature. The model will be a component of a hydronumerical model designed to be connected to different types of VADs. It will be completed with autonomic features, including the baroreflex and a more detailed coronary circulation model.

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Application of a user-friendly comprehensive circulatory model for estimation of hemodynamic and ventricular variables

Cited by 10 publications

References 33 publications

Towards a Personalized and Dynamic CRT-D

Towards a Personalized and Dynamic CRT-D

Circulatory Modelling as a Clinical Decision Support and an Educational Tool

A modular computational circulatory model applicable to VAD testing and training

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