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See detailMathematical multi-scale model of the cardiovascular system including mitral valve dynamics. Application to ischemic mitral insufficiency
Paeme, Sabine ULg; Moorhead, Katherine; Chase, J. Geoffrey et al

in BioMedical Engineering OnLine (2011), 10(1), 86

Valve dysfunction is a common cardiovascular pathology. Despite significant clinical research, there is little formal study of how valve dysfunction affects overall circulatory dynamics. Validated models ... [more ▼]

Valve dysfunction is a common cardiovascular pathology. Despite significant clinical research, there is little formal study of how valve dysfunction affects overall circulatory dynamics. Validated models would offer the ability to better understand these dynamics and thus optimize diagnosis, as well as surgical and other interventions. A cardiovascular and circulatory system (CVS) model has already been validated in silico, and in several animal model studies. It accounts for valve dynamics using Heaviside functions to simulate a physiologically accurate “open on pressure, close on flow” law. However, it does not consider real-time valve opening dynamics and therefore does not fully capture valve dysfunction, particularly where the dysfunction involves partial closure. This research describes an updated version of this previous closed-loop CVS model that includes the progressive opening of the mitral valve, and is defined over the full cardiac cycle. Simulations of the cardiovascular system with healthy mitral valve are performed, and, the global hemodynamic behaviour is studied compared with previously validated results. The error between resulting pressure-volume (PV) loops of already validated CVS model and the new CVS model that includes the progressive opening of the mitral valve is assessed and remains within typical measurement error and variability. Simulations of ischemic mitral insufficiency are also performed. Pressure-Volume loops, transmitral flow evolution and mitral valve aperture area evolution follow reported measurements in shape, amplitude and trends. The resulting cardiovascular system model including mitral valve dynamics provides a foundation for clinical validation and the study of valvular dysfunction in vivo. The overall models and results could readily be generalised to other cardiac valves. [less ▲]

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See detailInfluence of thermoelectric coupling on pacemaker activity generated by mechano-electric feedback in a one-dimensional ring-shaped model of cardiac fiber
Collet, Arnaud ULg; Desaive, Thomas ULg; Pierard, Luc ULg et al

in XXIIIrd congress of the International Society of Biomechanics, July 3-7, 2011 (2011, July 05)

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See detailInfluence of thermoelectric coupling on pacemaker activity generated by mechano-electric feedback in a one-dimensional ring-shaped model of cardiac fiber
Collet, Arnaud ULg; Desaive, Thomas ULg; Pierard, Luc ULg et al

Poster (2011, July 05)

Recently, the influence of thermal processes on electrophysiology has clearly been underlined, using a FitzHugh–Nagumo-type (FHN-type) model. When the temperature is raised, the action potential duration ... [more ▼]

Recently, the influence of thermal processes on electrophysiology has clearly been underlined, using a FitzHugh–Nagumo-type (FHN-type) model. When the temperature is raised, the action potential duration (APD) has been shown to shorten, while the action potential (AP) amplitude decreases, and the conduction velocity increases. In the present study, we investigate the effects of thermoelectric coupling on mechano-electric feedback (MEF), and more specifically, on pacemaker activity generated by MEF. To investigate these effects, thermoelectric coupling is introduced in a one-dimensional ring-shaped electromechanical model of cardiac fiber, which takes into account excitation-contraction coupling (ECC), as well as MEF. [less ▲]

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See detailMinimal cardiovascular system model including a physiological description of progressive mitral valve orifice dynamics for studying valve dysfunction
Paeme, Sabine ULg; Moorhead, Katerine; Chase, J. Geoffrey et al

in XXIIIrd congress of the International Society of Biomechanics, July 3-7, 2011 (2011, July)

This research presents a new closed-loop cardiovascular system model including a description of the progressive opening and closing dynamic of the mitral valve. Furthermore, this model includes a ... [more ▼]

This research presents a new closed-loop cardiovascular system model including a description of the progressive opening and closing dynamic of the mitral valve. Furthermore, this model includes a mathematical description of the left atrium. This new CVS model enables the study of valve dysfunction in the appropriate clinical context of the overall cardiac and circulatory hemodynamics. [less ▲]

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See detailInfluence of thermoelectric coupling on pacemaker activity generated by mechano-electric feedback in a one-dimensional ring-shaped model of cardiac fiber
Collet, Arnaud ULg; Desaive, Thomas ULg; Pierard, Luc ULg et al

Poster (2011, June 01)

The mechano-electric feedback (MEF) in the heart consists in the influence of the tissue deformations on the cardiac electrical activity. Under certain conditions, tissue deformations can generate ... [more ▼]

The mechano-electric feedback (MEF) in the heart consists in the influence of the tissue deformations on the cardiac electrical activity. Under certain conditions, tissue deformations can generate electrical perturbations via stretch-activated channels, such that the membrane potential can exceed the threshold value needed in order to trigger cardiac action potentials (APs). In the present study, we have developed a one-dimensional ring-shaped model of cardiac fiber taking into account three different couplings: the excitation-contraction coupling (ECC), the MEF and the thermoelectric coupling (TEC). The main goal of this work is to examine the effects of the TEC on the different properties of the pacemaker activity generated by the MEF. [less ▲]

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See detailThe Parametrized Diastolic Filling Formalism: Application in the Asklepios Population
Claessens, Tom; Muhammad Waheed, Raja; Pironet, Antoine ULg et al

in Conference Program ASME 2011 Summer Bioengineering Conference (2011, June)

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See detailEnhanced insulin sensitivity variability in the first 3 days of ICU stay: Implications for TGC
Chase, J. Geoffrey; Le Compte, Aaron; Penning, Sophie ULg et al

in Critical Care (2011, March)

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See detailValidation of a virtual patient and virtual trials method for accurate prediction of TGC protocol performance
Suhaimi, Fatanah; Le Compte, Aaron; Penning, Sophie ULg et al

in Critical Care (2011, March)

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See detailValidation of a Virtual Patient and Virtual Trials Method for Accurate Prediction of TGC Protocol Performance
Suhaimi, Fatanah; Le Compte, Aaron; Penning, Sophie ULg et al

Poster (2011, March)

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See detailEnhanced insulin sensitivity variability in the first 3 days of ICU stay: Implications for TGC
Chase, Geoffrey; Le Compte, Aaron; Penning, Sophie ULg et al

Poster (2011, March)

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See detailRespiratory variability in mechanically ventilated patients
Desaive, Thomas ULg; Piquilloud, L.; Moorhead, KT et al

in Critical Care (2011), 15 (Suppl 1)

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See detailPulmonary embolism diagnostics from the driver function
Stevenson, DJ; Revie; Chase, JG et al

in Critical Care (2011), 15 (Suppl 1)

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See detailModel-based cardiovascular monitoring of acute pulmonary embolism in porcine trials
Revie, JA; Stevenson, DJ; Chase, JG et al

in Critical Care (2011), 15 (Suppl 1)

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See detailModel-based cardiovascular monitoring of large pore hemofiltration during endotoxic shock in pigs
Revie, JA; Stevenson, DJ; Chase, JG et al

in Critical Care (2011), 15 (Suppl 1)

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See detailPatient specific identification of the cardiac driver function in a cardiovascular system model.
Hann, C. E.; Revie, J.; Stevenson, D. et al

in Computer Methods & Programs in Biomedicine (2011)

The cardiac muscle activation or driver function, is a major determinant of cardiovascular dynamics, and is often approximated by the ratio of the left ventricle pressure to the left ventricle volume. In ... [more ▼]

The cardiac muscle activation or driver function, is a major determinant of cardiovascular dynamics, and is often approximated by the ratio of the left ventricle pressure to the left ventricle volume. In an intensive care unit, the left ventricle pressure is usually never measured, and the left ventricle volume is only measured occasionally by echocardiography, so is not available real-time. This paper develops a method for identifying the driver function based on correlates with geometrical features in the aortic pressure waveform. The method is included in an overall cardiovascular modelling approach, and is clinically validated on a porcine model of pulmonary embolism. For validation a comparison is done between the optimized parameters for a baseline model, which uses the direct measurements of the left ventricle pressure and volume, and the optimized parameters from the approximated driver function. The parameters do not significantly change between the two approaches thus showing that the patient specific approach to identifying the driver function is valid, and has potential clinically. [less ▲]

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See detailTight glycemic control in critical care - The leading role of insulin sensitivity and patient variability: A review and model-based analysis.
Chase, J. G.; Le Compte, A. J.; Suhaimi, F. et al

in Computer Methods & Programs in Biomedicine (2011)

Tight glycemic control (TGC) has emerged as a major research focus in critical care due to its potential to simultaneously reduce both mortality and costs. However, repeating initial successful TGC trials ... [more ▼]

Tight glycemic control (TGC) has emerged as a major research focus in critical care due to its potential to simultaneously reduce both mortality and costs. However, repeating initial successful TGC trials that reduced mortality and other outcomes has proven difficult with more failures than successes. Hence, there has been growing debate over the necessity of TGC, its goals, the risk of severe hypoglycemia, and target cohorts. This paper provides a review of TGC via new analyses of data from several clinical trials, including SPRINT, Glucontrol and a recent NICU study. It thus provides both a review of the problem and major background factors driving it, as well as a novel model-based analysis designed to examine these dynamics from a new perspective. Using these clinical results and analysis, the goal is to develop new insights that shed greater light on the leading factors that make TGC difficult and inconsistent, as well as the requirements they thus impose on the design and implementation of TGC protocols. A model-based analysis of insulin sensitivity using data from three different critical care units, comprising over 75,000h of clinical data, is used to analyse variability in metabolic dynamics using a clinically validated model-based insulin sensitivity metric (S(I)). Variation in S(I) provides a new interpretation and explanation for the variable results seen (across cohorts and studies) in applying TGC. In particular, significant intra- and inter-patient variability in insulin resistance (1/S(I)) is seen be a major confounder that makes TGC difficult over diverse cohorts, yielding variable results over many published studies and protocols. Further factors that exacerbate this variability in glycemic outcome are found to include measurement frequency and whether a protocol is blind to carbohydrate administration. [less ▲]

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See detailPorcine trial validation of model-based cardiovascular monitoring of acute pulmonary embolism
Revie, JA; Stevenson, DJ; Shaw, GM et al

in Proceedings of ANZICS 2011 (2011)

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See detailDiagnosing pulmonary embolism from a model-based cardiac driver function
Stevenson, D; Revie, JA; Chase, JG et al

in Proceedings of ANZICS 2011 (2011)

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See detailProcessing aortic and pulmonary artery waveforms to derive the ventricle time-varying elastance
Stevenson, D; Chase, JG; Hann, CE et al

in Proceedings of the 18th IFAC World Congress, 2011 (2011)

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