Multimodal cardiovascular model for hemodynamic analysis: Simulation study on mitral valve disorders

Abstract

Valvular heart diseases are a prevalent cause of cardiovascular morbidity and mortality worldwide, affecting a wide spectrum of the population. In-silico modeling of the cardiovascular system has recently gained recognition as a useful tool in cardiovascular research and clinical applications. Here, we present an in-silico cardiac computational model to analyze the effect and severity of valvular disease on general hemodynamic parameters. We propose a multimodal and multiscale cardiovascular model to simulate and understand the progression of valvular disease associated with the mitral valve. The developed model integrates cardiac electrophysiology with hemodynamic modeling, thus giving a broader and holistic understanding of the effect of disease progression on various parameters like ejection fraction, cardiac output, blood pressure, etc., to assess the severity of mitral valve disorders, naming Mitral Stenosis and Mitral Regurgitation. The model mimics an adult cardiovascular system, comprising a four-chambered heart with systemic, pulmonic circulation. The simulation of the model output comprises regulated pressure, volume, and flow for each heart chamber, valve dynamics, and Photoplethysmogram signal for normal physiological as well as pathological conditions due to mitral valve disorders. The generated physiological parameters are in agreement with published data. Additionally, we have related the simulated left atrium and ventricle dimensions, with the enlargement and hypertrophy in the cardiac chambers of patients with mitral valve disorders, using their Electrocardiogram available in Physionet PTBI dataset. The model also helps to create ‘what if’ scenarios and relevant analysis to study the effect in different hemodynamic parameters for stress or exercise like conditions.

An Investigation of Left Ventricular Valve Disorders and the Mechano-Electric Feedback Using a Synergistic Lumped Parameter Cardiovascular Numerical Model

“…Numerical investigations of the heart valves likewise vary in complexity. 0D and 1D models involving the heart valves frequently use a ‘diode’ approach in which the dynamics of the valve are ignored and the direction of flow imposed similar to an electrical diode [ 16 , 17 ], while fully 3D examples most frequently use stiff geometry and studies using dynamic values [ 18 ] are rare. The 3D structural models provide flow field information and include interaction between the tissue structure and flow [ 18 , 19 , 20 ].…”

The New HEMS Modelling of Human Heart

“…The new version of the hydro-electro-mechanical system is modelled through 14 series of electrical circuits in which the integrated forms of all subsystems that make up the whole heart are produced by creating unique equivalent electrical circuits. By comparing our model with available hemodynamic models [17,18], our proposed model is a more comprehensive model than other minimal models that can be used to evaluate the real time implementations. Time-dependent average pressure measurement is a key tool to diagnose various heart diseases, which is one of the main reasons that this paper focused on the mathematical description of the average pressure of each segment of the whole the cardiovascular system (CVS) resulting in 28 equations (Eq.…”

“…The difficulty of cardiovascular system modelling arises from its multifunctionality and compartmentalized nonlinear structure. In order to overcome this issue, due to the difficulties encountered in integrating modelling of the whole system, instead of modelling all the subsystems of the real system, it is preferred to model some parts of it independently [6], in order to reduce the problem complexity, and developing cardiovascular system new models can produce healthy hemodynamic data that mimic diseases to certain extent [7]. The hemodynamic measurements of a healthy person with a modified Windkessel model were used to analyze the hemodynamic data of congenital heart diseases, such as hypoplastic left heart syndrome (HLHS) [8].…”

Computational Model for Therapy Optimization of Wearable Cardioverter Defibrillator: Shockable Rhythm Detection and Optimal Electrotherapy

“…Heart valves are modeled to replicate the functionality of each cardiac phase, capturing the pressure difference across the cardiac chambers to ensure unidirectional blood flow through the heart and maintain the pressure-volume dynamics. The model is also coupled with central nervous system modulation in terms of a baroreflex control, which regulates pressure autonomously through sympathetic and parasympathetic interaction of heart rate, contractility, and systemic vascular resistance, explained in detail in our prior works (Mazumder et al, 2019;Roy et al, 2021).…”

“…(Figure 4A). These electrical instances are encoded to modulate compliance function and timing information to control the synchronized operation of four heart chambers (Roy et al, 2021). Compliance function of the left ventricle can be modeled as follows:…”