A female-specific cardiovascular lumped-parameter model

Comunale, Giulia; Susin, Francesca Maria; Mynard, Jonathan P.

doi:10.1109/embc44109.2020.9175427

Cited by 4 publications

(9 citation statements)

References 15 publications

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“…(iv) Further insights are also expected from taking into account fluid-structure interactions e.g., the remodelling of cardiac chambers as a compensation of impaired ventricular function. (v) Last but not least, further development can arise from taking into account sex differences in model parameter values and/or cardiovascular functional response i.e., differences that has been recognised as pivotal in both healthy and pathological hemodynamics 18,[56][57][58] .…”

Section: Discussionmentioning

confidence: 99%

“…Parameters' values. The methodology proposed in Comunale et al 18 , which is based on literature data and relationships representing physiological conditions, was adopted to properly calibrate the model according to physiological hemodynamics. For the systemic circulation, systemic vascular resistance (SVR) was computed as SVR = P perf /CO , where P perf is perfusion pressure i.e., the mean pressure that perfuses the systemic organs.…”

Section: Methodsmentioning

confidence: 99%

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Understanding and recognition of the right ventricular function and dysfunction via a numerical study

Comunale

Peruzzo

Castaldi

et al. 2021

Sci Rep

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The role played by the right ventricular (RV) dysfunction has long been underestimated in clinical practice. Recent findings are progressively confirming that when the RV efficiency deteriorates both the right and the left circulation is (significantly) affected, but studies dedicated to a detailed description of RV hemodynamic role still lack. In response to such a gap in knowledge, this work proposes a numerical model that for the first time evaluates the effect of isolated RV dysfunction on the whole circulation. Lumped parameter modelling was applied to represent the physio-pathological hemodynamics. Different grades of impairment were simulated for three dysfunctions i.e., systolic, diastolic, and combined systolic and diastolic. Hemodynamic alterations (i.e., of blood pressure, flow, global hemodynamic parameters), arising from the dysfunctions, are calculated and analysed. Results well accord with clinical observations, showing that RV dysfunction significantly affects both the pulmonary and systemic hemodynamics. Successful verification against in vivo data proved the clinical potentiality of the model i.e., the capability of identifying the degree of RV impairment for given hemodynamic conditions. This study aims at contributing to the improvement of RV dysfunction recognition and treatment, and to the development of tools for the clinical management of pathologies involving the right heart.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Understanding and recognition of the right ventricular function and dysfunction via a numerical study

Comunale

Peruzzo

Castaldi

et al. 2021

Sci Rep

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“…A free /A and the ejected flow rate Q. However, it is worth stressing that the presence of the obstruction in the R/LVOT may induce progressive ventricular dysfunction due to prolonged increased afterload, and ultimately reduce ventricular stroke volume and hence the flow rate Q and the cardiac output, CO. For that reason, and in order to compute not only Δp obs but also Q and CO as a function of A free /A, Eqs (1) and ( 2) are coupled to a previously developed lumped parameter model (0D) of the complete cardiovascular circulation [17]. The 0D model reduces the cardiovascular system to the sum of multiple functional compartments (e.g., atria and ventricles, large vessels, microvasculature), and describes the hydrodynamic functionality of each compartment by suitably relating the local instantaneous pressure and blood flow rate/volume.…”

Section: Plos Onementioning

confidence: 99%

“…Finally, it is worth noting that the model has been here applied to a reference paediatric case, but it can be adopted also to reproduce different populations/subgroups/specific patients by properly calibrating hemodynamic parameters. Similarly, by considering sex-specific parameters, sex-related characteristics can be accounted for [17]. For what subgroups examination is concerned, the model can help in investigating the effects of the wide inter-subject variability of the anatomy and pathophysiology.…”

Section: Plos Onementioning

confidence: 99%

Ventricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients

et al. 2021

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Background Right (R) or left (L) ventricular outflow tract (VOT) obstruction can be either a dynamic phenomenon or a congenital anatomic lesion, which requires a prompt and optimal timing of treatment to avoid a pathological ventricular remodelling. Objective To develop a simple and reliable numerical tool able to relate the R/L obstruction size with the pressure gradient and the cardiac output. To provide indication of the obstruction severity and be of help in the clinical management of patients and designing the surgical treatment for obstruction mitigation. Methods Blood flow across the obstruction is described according to the classical theory of one-dimensional flow, with the obstruction uniquely characterized by its size. Hemodynamics of complete circulation is simulated according to the lumped parameter approach. The case of a 2 years-old baby is reproduced, with the occlusion placed in either the R/ or the L/VOT. Conditions from wide open to almost complete obstruction are reproduced. Results Both R/LVOT obstruction in the in-silico model resulted in an increased pressure gradient and a decreased cardiac output, proportional to the severity of the VOT obstruction and dependent on the R/L location of the obstruction itself, as it is clinically observed. Conclusion The in-silico model of ventricular obstruction which simulates pressure gradient and/or cardiac output agrees with clinical data, and is a first step towards the creation of a tool that can support the clinical management of patients from diagnosis to surgical treatments.

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“…To properly calibrate the model, the methodology proposed in Comunale et al 17 16,22 were used. Notice that for the healthy simulation adjustment of the unstressed volume ( =0 ) of Eq.…”

Section: ) Parameters' Valuesmentioning

confidence: 99%

Understanding and Recognition of the Right Ventricular Function and Dysfunction: A Numerical Study

Comunale

Peruzzo

Castaldi

et al. 2020

Preprint

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The role played by the right ventricular (RV) dysfunction has long been underestimated in clinical practice. Recent findings are progressively confirming that when the RV efficiency deteriorates both the right and the left circulation is (significantly) affected, but studies dedicated to a detailed description of RV hemodynamic role still lack. In response to such a gap in knowledge, this work proposes a numerical model that for the first time evaluates the effect of isolated RV dysfunction on the whole circulation. Lumped parameter modelling was applied to represent the physio-pathological hemodynamics. Different grades of impairment were simulated for three dysfunctions i.e., systolic, diastolic, and combined systolic and diastolic. Hemodynamic alterations (i.e., of blood pressure, flow, global hemodynamic parameters), arising from the dysfunctions, are calculated and analysed. Results well accord with clinical observations, showing that RV dysfunction significantly affects both the pulmonary and systemic hemodynamics. Successful validation against in vivo data proved the clinical potentiality of the model i.e., the capability of identifying the degree of RV impairment for given hemodynamic conditions. This study aims at contributing to the improvement of RV dysfunction recognition and treatment, and to the development of tools for the clinical management of pathologies involving the right heart.

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A female-specific cardiovascular lumped-parameter model

Cited by 4 publications

References 15 publications

Understanding and recognition of the right ventricular function and dysfunction via a numerical study

Understanding and recognition of the right ventricular function and dysfunction via a numerical study

Ventricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients

Understanding and Recognition of the Right Ventricular Function and Dysfunction: A Numerical Study

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