Multiscale mathematical modeling vs. the generalized transfer function approach for aortic pressure estimation: a comparison with invasive data

Guala, Andrea; Tosello, F.; Leone, Dario; Sabia, Luca; D’Ascenzo, Fabrizio; Moretti, Claudio; Bollati, Martina; Veglio, Franco; Ridolfi, Luca; Milan, Alberto

doi:10.1038/s41440-018-0159-5

Cited by 25 publications

(12 citation statements)

References 31 publications

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“…It should be also noted that given identification (sex and age) and anthropometric parameters (such as weight and height), together with basic cardiovascular information (such as brachial cuff pressure), the model can be made patient-specific. That would provide good estimates of cardiovascular fitness related to the heterogeneity of the crew, similar to what was already done in 1G physiological and pathological conditions 32,34,58 . Cardiovascular deconditioning without ad hoc countermeasures, as modeled here, is of fundamental importance to have a clear and valid baseline for testing against the cardiovascular response with specific countermeasures.…”

Section: Discussionsupporting

confidence: 61%

Cardiovascular deconditioning during long-term spaceflight through multiscale modeling

2020

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Human spaceflight has been fascinating man for centuries, representing the intangible need to explore the unknown, challenge new frontiers, advance technology, and push scientific boundaries further. A key area of importance is cardiovascular deconditioning, that is, the collection of hemodynamic changes—from blood volume shift and reduction to altered cardiac function—induced by sustained presence in microgravity. A thorough grasp of the 0G adjustment point per se is important from a physiological viewpoint and fundamental for astronauts’ safety and physical capability on long spaceflights. However, hemodynamic details of cardiovascular deconditioning are incomplete, inconsistent, and poorly measured to date; thus a computational approach can be quite valuable. We present a validated 1D–0D multiscale model to study the cardiovascular response to long-term 0G spaceflight in comparison to the 1G supine reference condition. Cardiac work, oxygen consumption, and contractility indexes, as well as central mean and pulse pressures were reduced, augmenting the cardiac deconditioning scenario. Exercise tolerance of a spaceflight traveler was found to be comparable to an untrained person with a sedentary lifestyle. At the capillary–venous level significant waveform alterations were observed which can modify the regular perfusion and average nutrient supply at the cellular level. The present study suggests special attention should be paid to future long spaceflights which demand prompt physical capacity at the time of restoration of partial gravity (e.g., Moon/Mars landing). Since spaceflight deconditioning has features similar to accelerated aging understanding deconditioning mechanisms in microgravity are also relevant to the understanding of aging physiology on the Earth.

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Section: Discussionsupporting

confidence: 61%

Cardiovascular deconditioning during long-term spaceflight through multiscale modeling

2020

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“…Therefore, this simplifies the measurement process and potentially decreases the total cost of monitoring. Recently, Guala et al published a validation of the same multiscale model using invasive catheter data [67]. Their model provided an underestimation of both central systolic and diastolic pressure values; the difference between the invasive aortic pressure and the model-derived estimates was 4.30±16.70 mmHg for central systolic pressure and 3.80±10.40 mmHg for central diastolic pressure.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive Cardiac Output and Central Systolic Pressure From Cuff-Pressure and Pulse Wave Velocity

Bikia

Pagoulatou

Trachet

et al. 2020

IEEE J. Biomed. Health Inform.

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Goal: We introduce a novel approach to estimate cardiac output (CO) and central systolic blood pressure (cSBP) from noninvasive measurements of peripheral cuff-pressure and carotid-to-femoral pulse wave velocity (cf-PWV). Methods: The adjustment of a previously validated one-dimensional arterial tree model is achieved via an optimization process. In the optimization loop, compliance and resistance of the generic arterial tree model as well as aortic flow are adjusted so that simulated brachial systolic and diastolic pressures and cf-PWV converge towards the measured brachial systolic and diastolic pressures and cf-PWV. The process is repeated until full convergence in terms of both brachial pressures and cf-PWV is reached. To assess the accuracy of the proposed framework, we implemented the algorithm on in vivo anonymized data from 20 subjects and compared the methodderived estimates of CO and cSBP to patient-specific measurements obtained with Mobil-O-Graph apparatus (central pressure) and two-dimensional transthoracic echocardiography (aortic blood flow). Results: Both CO and cSBP estimates were found to be in good agreement with the reference values achieving an RMSE of 0.36 L/min and 2.46 mmHg, respectively. Low biases were reported, namely-0.04±0.36 L/min for CO predictions and-0.27±2.51 mmHg for cSBP predictions. Significance: Our onedimensional model can be successfully "tuned" to partially patient-specific standards by using noninvasive, easily obtained peripheral measurement data. The in vivo evaluation demonstrated that this method can potentially be used to obtain central aortic hemodynamic parameters in a noninvasive and accurate way.

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“…Although this approach added 19 more vessel segments to the topology of the coronary circulation model, it was considered preferable for modelling purposes, compared to using generalised transfer functions to represent the LIMA, RIMA, and grafts attached to the ascending aorta. Guala et al ( 30 ) found a 1D-0D lumped parameter model to be more accurate in estimating aortic pressures than generalised transfer functions ( 30 ). Therefore, the patient-specific disease-free coronary circulation was nested within a generic systemic aortic circulation.…”

Section: Methodsmentioning

confidence: 99%

A predictive patient-specific computational model of coronary artery bypass grafts for potential use by cardiac surgeons to guide selection of graft configurations

Chaudhuri

Pletzer²,

Smith³

2022

Front. Cardiovasc. Med.

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Cardiac surgeons face a significant degree of uncertainty when deciding upon coronary artery bypass graft configurations for patients with coronary artery disease. This leads to significant variation in preferred configuration between different surgeons for a particular patient. Additionally, for the majority of cases, there is no consensus regarding the optimal grafting strategy. This situation results in the tendency for individual surgeons to opt for a “one size fits all” approach and use the same grafting configuration for the majority of their patients neglecting the patient-specific nature of the diseased coronary circulation. Quantitative metrics to assess the adequacy of coronary bypass graft flows have recently been advocated for routine intraoperative use by cardiac surgeons. In this work, a novel patient-specific 1D-0D computational model called “COMCAB” is developed to provide the predictive haemodynamic parameters of functional graft performance that can aid surgeons to avoid configurations with grafts that have poor flow and thus poor patency. This model has significant potential for future expanded applications.

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Multiscale mathematical modeling vs. the generalized transfer function approach for aortic pressure estimation: a comparison with invasive data

Cited by 25 publications

References 31 publications

Cardiovascular deconditioning during long-term spaceflight through multiscale modeling

Cardiovascular deconditioning during long-term spaceflight through multiscale modeling

Noninvasive Cardiac Output and Central Systolic Pressure From Cuff-Pressure and Pulse Wave Velocity

A predictive patient-specific computational model of coronary artery bypass grafts for potential use by cardiac surgeons to guide selection of graft configurations

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