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A Comprehensive Physiological Model of Circulation Enables Automatic Piloting of Hemodynamics in Patients with Acute Heart Failure

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9 Author(s)
Sugimachi, M. ; Department of Cardiovascular Dynamics, National Cardiovascular Center Research Institute, Osaka, Japan ; Uemura, K. ; Kawada, T. ; Inagaki, M.
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A comprehensive physiological model of the whole circulation is mandatory to quantitatively diagnose pathophysiology and to guide an appropriate treatment. Such a model would enable automatic piloting of hemodynamics in patients with acute heart failure. By extending Guyton's model, so as to deal with heart failure predominantly affecting left heart and to quantify left atrial pressure, we constructed such a model consisting of a venous return (VR) surface and a cardiac output (CO) curve. VR surface, the integrated property of systemic and pulmonary vascular beds, relates VR and left and right atrial pressures (PLA, PRA) linearly as VR = V/W - GRPRA- GLPLA, given total blood volume (V). CO curve, the pumping ability of hearts, relates CO and either PLAor PRAapproximately by logarithmic functions, respectively, as CO = SL[ln (PLA- BL) + CL] = SR[ln (PRA- BR) + CR]. The slopes (SRand SL) of CO curve mainly describes the pump performance. W, GR, GL, BR, BL, CRand CLare parameters. We validate the model with animal experiments. Parameters W, G's, B's and C's were relatively constant in 19 dogs. In other 8 dogs, with or without acute left heart failure, we determined V and S's from a single set of CO, PRA, PLAand standard parameter values. We then predicted hemodynamics (CO, PRA, PLA) for altered V from –8 to +8 ml/kg. We identified standard values of parameters as W (0.13 min), GR(19.6 ml/min/kg/mmHg), GL(3.5 ml/min/kg/mmHg). BL(2.1 mmHg), CL

Published in:

Engineering in Medicine and Biology Society, 2004. IEMBS '04. 26th Annual International Conference of the IEEE  (Volume:2 )

Date of Conference:

1-5 Sept. 2004