Simulation of Left Atrial Function Using a Multi-Scale Model of the Cardiovascular SystemPironet, Antoine ; Dauby, Pierre ; Paeme, Sabine et alin PLoS ONE (2013), 8(6), 65146 During a full cardiac cycle, the left atrium successively behaves as a reservoir, a conduit and a pump. This complex behavior makes it unrealistic to apply the time-varying elastance theory to ... [more ▼] During a full cardiac cycle, the left atrium successively behaves as a reservoir, a conduit and a pump. This complex behavior makes it unrealistic to apply the time-varying elastance theory to characterize the left atrium, first, because this theory has known limitations, and second, because it is still uncertain whether the load independence hypothesis holds. In this study, we aim to bypass this uncertainty by relying on another kind of mathematical model of the cardiac chambers. In the present work, we describe both the left atrium and the left ventricle with a multi-scale model. The multi-scale property of this model comes from the fact that pressure inside a cardiac chamber is derived from a model of the sarcomere behavior. Macroscopic model parameters are identified from reference dog hemodynamic data. The multi-scale model of the cardiovascular system including the left atrium is then simulated to show that the physiological roles of the left atrium are correctly reproduced. This include a biphasic pressure wave and an eight-shaped pressure-volume loop. We also test the validity of our model in non basal conditions by reproducing a preload reduction experiment by inferior vena cava occlusion with the model. We compute the variation of eight indices before and after this experiment and obtain the same variation as experimentally observed for seven out of the eight indices. In summary, the multi-scale mathematical model presented in this work is able to correctly account for the three roles of the left atrium and also exhibits a realistic left atrial pressure-volume loop. Furthermore, the model has been previously presented and validated for the left ventricle. This makes it a proper alternative to the time-varying elastance theory if the focus is set on precisely representing the left atrial and left ventricular behaviors. [less ▲] Detailed reference viewed: 5 (4 ULg) A Multi‐Scale Computer Model of the Cardiovascular System Can Account for the Three Roles of the Left AtriumPironet, Antoine ; Dauby, Pierre ; Kosta, Sarah et alin Abstract Book GIGA-Day (2013, January 28) Detailed reference viewed: 38 (9 ULg) A Multi‐Scale Computer Model of the Cardiovascular System Can Account for the Three Roles of the Left AtriumPironet, Antoine ; Dauby, Pierre ; Kosta, Sarah et alPoster (2013, January 28) Detailed reference viewed: 22 (11 ULg) A multi-scale cardiovascular system model can account for the load-dependence of the end-systolic pressure-volume relationship.Pironet, Antoine ; Desaive, Thomas ; Kosta, Sarah et alin BioMedical Engineering OnLine (2013), 12(1), 8 ABSTRACT: BACKGROUND: The end-systolic pressure-volume relationship is often considered as a load-independent property of the heart and, for this reason, is widely used as an index of ventricular ... [more ▼] ABSTRACT: BACKGROUND: The end-systolic pressure-volume relationship is often considered as a load-independent property of the heart and, for this reason, is widely used as an index of ventricular contractility. However, many criticisms have been expressed against this index and the underlying time-varying elastance theory: first, it does not consider the phenomena underlying contraction and second, the end-systolic pressure volume relationship has been experimentally shown to be load-dependent. METHODS: In place of the time-varying elastance theory, a microscopic model of sarcomere contraction is used to infer the pressure generated by the contraction of the left ventricle, considered as a spherical assembling of sarcomere units. The left ventricle model is inserted into a closed-loop model of the cardiovascular system. Finally, parameters of the modified cardiovascular system model are identified to reproduce the hemodynamics of a normal dog. RESULTS: Experiments that have proven the limitations of the time-varying elastance theory are reproduced with our model: (1) preload reductions, (2) afterload increases, (3) the same experiments with increased ventricular contractility, (4) isovolumic contractions and (5) flow-clamps. All experiments simulated with the model generate different end-systolic pressure-volume relationships, showing that this relationship is actually load-dependent. Furthermore, we show that the results of our simulations are in good agreement with experiments. CONCLUSIONS: We implemented a multi-scale model of the cardiovascular system, in which ventricular contraction is described by a detailed sarcomere model. Using this model, we successfully reproduced a number of experiments that have shown the failing points of the time-varying elastance theory. In particular, the developed multi-scale model of the cardiovascular system can capture the load-dependence of the end-systolic pressure-volume relationship. [less ▲] Detailed reference viewed: 41 (29 ULg) non invasive estimation of left atrial pressure and mitral valve area waveforms during an entire cardiac cyclePaeme, Sabine ; Pironet, Antoine ; Lancellotti, Patrizio et alPoster (2012, December 07) Detailed reference viewed: 12 (3 ULg) non invasive estimation of left atrial pressure and mitral valve area waveforms during an entire cardiac cyclePaeme, Sabine ; Pironet, Antoine ; LANCELLOTTI, Patrizio et alin proceeding of 11th national day of the National Committee on Biomedical Engineering (2012, December 07) Detailed reference viewed: 16 (2 ULg) structural model of the mitral valve included in a cardiovascular closed loop model. Static and dynamic validationPaeme, Sabine ; Pironet, Antoine ; et alConference (2012, August 31) Detailed reference viewed: 7 (3 ULg) Development and Identification of a Closed-Loop Model of the Cardiovascular System Including the AtriaPironet, Antoine ; ; Paeme, Sabine et alConference (2012, August 31) Detailed reference viewed: 33 (1 ULg) Structural model of the mitral valve included in a cardiovascular closed loop model. Static and dynamic validationPaeme, Sabine ; Pironet, Antoine ; et alin proceedings of 8th IFAC Symposium on Biological and Medical Systems, Budapest 29-31 août 2012 (2012, August 31) Detailed reference viewed: 20 (3 ULg) Development and Identification of a Closed-Loop Model of the Cardiovascular System Including the AtriaPironet, Antoine ; ; Paeme, Sabine et alin Proceedings of the 8th IFAC Symposium on Biological and Medical Systems (2012, August) Detailed reference viewed: 20 (4 ULg) Parameter Identification in a Model of the Cardiovascular System Including the AtriaPironet, Antoine ; ; Paeme, Sabine et alin 10th Belgian Day on Biomedical Engineering (2011, December 02) Detailed reference viewed: 13 (4 ULg) Parameter Identification in a Model of the Cardiovascular System Including the AtriaPironet, Antoine ; ; Paeme, Sabine et alPoster (2011, December 02) Detailed reference viewed: 39 (29 ULg) Structural model of the mitral valve included in a cardiovascular closed loop modelPaeme, Sabine ; ; et alPoster (2011, December) A minimal cardiovascular system (CVS) model including mitral valve dynamics has been previously validated in silico. However parameters of this model are difficult to link with structural and anatomical ... [more ▼] A minimal cardiovascular system (CVS) model including mitral valve dynamics has been previously validated in silico. However parameters of this model are difficult to link with structural and anatomical components of the valve. This research describes the integration of a structural model of the mitral valve in an existing closed-loop cardiovascular system (CVS) model [less ▲] Detailed reference viewed: 9 (0 ULg) Mathematical multi-scale model of the cardiovascular system including mitral valve dynamics. Application to ischemic mitral insufficiencyPaeme, Sabine ; ; et alin 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 ▲] Detailed reference viewed: 47 (22 ULg) Minimal cardiovascular system model including a physiological description of progressive mitral valve orifice dynamics for studying valve dysfunctionPaeme, Sabine ; ; et alin 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 ▲] Detailed reference viewed: 45 (9 ULg) A simplified model for mitral valve dynamics.; Paeme, Sabine ; et alin Computer Methods & Programs in Biomedicine (2011) Located between the left atrium and the left ventricle, the mitral valve controls flow between these two cardiac chambers. Mitral valve dysfunction is a major cause of cardiac dysfunction and its dynamics ... [more ▼] Located between the left atrium and the left ventricle, the mitral valve controls flow between these two cardiac chambers. Mitral valve dysfunction is a major cause of cardiac dysfunction and its dynamics are little known. A simple non-linear rotational spring model is developed and implemented to capture the dynamics of the mitral valve. A measured pressure difference curve was used as the input into the model, which represents an applied torque to the anatomical valve chords. A range of mechanical model hysteresis states were investigated to find a model that best matches reported animal data of chord movement during a heartbeat. The study is limited by the use of one dataset found in the literature due to the highly invasive nature of getting this data. However, results clearly highlight fundamental physiological issues, such as the damping and chord stiffness changing within one cardiac cycle, that would be directly represented in any mitral valve model and affect behaviour in dysfunction. Very good correlation was achieved between modeled and experimental valve angle with 1-10% absolute error in the best case, indicating good promise for future simulation of cardiac valvular dysfunction, such as mitral regurgitation or stenosis. In particular, the model provides a pathway to capturing these dysfunctions in terms of modeled stiffness or elastance that can be directly related to anatomical, structural defects and dysfunction. [less ▲] Detailed reference viewed: 24 (9 ULg) minimal cardiovascular system model including physiological mitral valve openingPaeme, Sabine ; Moorhead, Katherine ; et alin 9th Belgian National Day on Biomedical Engineering, Bruxelles, 26th november (2010, November 26) A minimal cardiovascular system (CVS) model has been previously validated in silico, and in several animal model studies. It accounts for valve dynamics by means of a Heaviside function to simulate the ... [more ▼] A minimal cardiovascular system (CVS) model has been previously validated in silico, and in several animal model studies. It accounts for valve dynamics by means of a Heaviside function to simulate the “open on pressure, close on flow” law. However, this model does not describe the progressive valve opening and therefore, it is not suitable for studying valve dysfunctions. [less ▲] Detailed reference viewed: 16 (5 ULg) Minimal cardiovascular system model including physiological mitral valve openingPaeme, Sabine ; Moorhead, Katherine ; et alPoster (2010, November 26) This research describes a new closed-loop cardiovascular system (CVS) model including a model of the left atrium and a model describing the progressive aperture of the mitral valve Detailed reference viewed: 23 (9 ULg) A Simplified Rotational Spring Model for Mitral Valve Dynamics; ; et al in Proceedings of control 2010 (2010, September 07) A simple non-linear rotational spring model has been implemented to model the motion of mitral valve, located between the left atrium and ventricle. A measured pressure difference curve was used as the ... [more ▼] A simple non-linear rotational spring model has been implemented to model the motion of mitral valve, located between the left atrium and ventricle. A measured pressure difference curve was used as the input into the model, which represents an applied torque to the valve chords. Various damping and hysteresis states were investigated to find a model that best matches reported animal data of chord movement during a heartbeat. The study is limited by the use of one dataset from the literature, however results clearly highlight some physiological issues such as the damping and chord stiffness changing within one cardiac cycle. Very good correlation was achieved between modeled and experimental valve angle, indicating good promise for future simulation of cardiac dysfunction, such as mitral regurgitation or stenosis. [less ▲] Detailed reference viewed: 23 (6 ULg) Mathematical model of the mitral valve and the cardiovascular system, application for studying, monitoring and in the diagnosis of valvular pathologiesPaeme, Sabine ; Moorhead, Katherine ; et alin UKACC international Conference on Control 2010 : Coventry, 7-10 september 2010 (2010, September 07) A cardiovascular and circulatory system (CVS) model has been validated in silico, and in several animal model studies. It accounts for valve dynamics using Heaviside functions to simulate a physiological ... [more ▼] A cardiovascular and circulatory system (CVS) model has been validated in silico, and in several animal model studies. It accounts for valve dynamics using Heaviside functions to simulate a physiological accurate “open on pressure, close on flow” law. Thus, it does not consider the real time scale of the valve aperture dynamics and thus doesn’t fully capture valve dysfunction particularly where the dysfunction involves partial closure. This research describes a new closed-loop CVS model including a model describing the progressive aperture of the mitral valve and valid over the full cardiac cycle. This new model is solved for a healthy and diseased mitral valve. [less ▲] Detailed reference viewed: 84 (15 ULg) |
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