How can LVAD support influence ventricular energetics parameters in advanced heart failure patients? A retrospective study

Abstract

Background and Objective:Here we present a retrospective analysis of six heart failure patients previously discussed at a multidisciplinary team meeting. Only three out of six patients underwent LVAD insertion as the most appropriate management option. Methods:We sought to reproduce the baseline conditions of these patients on hospital admission using our cardiovascular software simulator (CARDIOSIM © ). Subsequently, we simulated the effects of LVAD support and drug administration on left and right ventricular energetics parameters. LVAD assistance was delivered by CARDIOSIM © based on the module reproducing the behavior of the Berlin Heart INCOR pump. Results:The results of our simulations were in agreement with the multidisciplinary team meeting outcome. The analysis of ventricular energetics parameters based on external work and pressure volume area confirmed LVAD support as a beneficial therapeutic option for the three patients considered eligible for this type of treatment.The effects induced by LVAD support and drugs administration showed specific patterns between the two groups of patients. Conclusion:A quantitative approach with the ability to predict outcome during patient's assessment may well be an aid and not a substitute for clinical decision-making.

In silico study of airway/lung mechanics in normal human breathing

“…Further studies are being considered to address other aspects of the respiratory system including other breathing patterns and gas exchanges. The features of our respiratory model may well be suitable to interact with our numerical virtual patient simulator CARDIOSIM c ⃝ [9,10,12]. The novelty is a 0-D model of the respiratory system with the ability to interact with a software like CARDIOSIM c ⃝, which has already shown its potential for clinical application [7,9] and teaching purposes [10,11].…”

“…The features of our respiratory model may well be suitable to interact with our numerical virtual patient simulator CARDIOSIM c ⃝ [9,10,12]. The novelty is a 0-D model of the respiratory system with the ability to interact with a software like CARDIOSIM c ⃝, which has already shown its potential for clinical application [7,9] and teaching purposes [10,11]. The implementation of this respiratory model in CARDIOSIM c ⃝ may be useful to study the interaction between the cardiovascular and respiratory system during cardiac assistance [9].…”

“…The novelty is a 0-D model of the respiratory system with the ability to interact with a software like CARDIOSIM c ⃝, which has already shown its potential for clinical application [7,9] and teaching purposes [10,11]. The implementation of this respiratory model in CARDIOSIM c ⃝ may be useful to study the interaction between the cardiovascular and respiratory system during cardiac assistance [9]. Once the model presented in this work is completed and inserted into CARDIOSIM c ⃝, it can be used in clinical environment to evaluate the effects induced by mechanical ventilatory assistance on the hemodynamic and energetic variables of the cardiovascular system.…”

CARDIOSIM©: The First Italian Software Platform for Simulation of the Cardiovascular System and Mechanical Circulatory and Ventilatory Support

“…Since the first version of CARDIOSIM © , the numerical simulator has been used to carry out studies both on animal models [ 64 ] and in a clinical setting [ 11 , 17 , 43 , 52 , 65 , 66 ]. Figure 5 shows a screen output from one of the latest versions of the software platform obtained during the analysis of hemodynamic parameters measured in a clinical setting.…”

CARDIOSIM©: The First Italian Software Platform for Simulation of the Cardiovascular System and Mechanical Circulatory and Ventilatory Support

“…Since the first version of CARDIOSIM © , the numerical simulator has been used to carry out studies both on animal models [64] and in a clinical setting [11,17,43,52,65,66]. Figure 5 shows a screen output from one of the latest versions of the software platform obtained during the analysis of hemodynamic parameters measured in a clinical setting.…”