Prediction of haemodynamics after interatrial shunt for heart failure using the generalized circulatory equilibrium
Autor: | Keimei Yoshida, Kenji Sunagawa, Takuya Nishikawa, Kazunori Uemura, Genya Sunagawa, Takeshi Tohyama, Keita Saku, Takuya Kishi, Kiyoshi Uike, Hiroyuki Tsutsui |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Cardiac function curve
Cardiac output medicine.medical_specialty Hemodynamics Blood volume Heart failure 030204 cardiovascular system & hematology 03 medical and health sciences Atrial Pressure Dogs 0302 clinical medicine Internal medicine medicine Animals Humans Diseases of the circulatory (Cardiovascular) system Heart Atria 030212 general & internal medicine Cardiac Output Haemodynamics business.industry Interatrial shunting Circulatory equilibrium Central venous pressure medicine.disease RC666-701 Cardiology Cardiology and Cardiovascular Medicine business Heart failure with preserved ejection fraction Venous return curve |
Zdroj: | ESC Heart Failure, Vol 7, Iss 5, Pp 3075-3085 (2020) |
ISSN: | 2055-5822 |
Popis: | Aims Interatrial shunting (IAS) reduces left atrial pressure in patients with heart failure. Several clinical trials reported that IAS improved the New York Heart Association score and exercise capacity. However, its effects on haemodynamics vary depending on shunt size, cardiovascular properties, and stressed blood volume. To maximize the benefit of IAS, quantitative prediction of haemodynamics under IAS in individual patients is essential. The generalized circulatory equilibrium framework determines circulatory equilibrium as the intersection of the cardiac output curve and the venous return surface. By incorporating IAS into the framework, we predict the impact of IAS on haemodynamics. Methods and results In seven mongrel dogs, we ligated the left anterior descending artery and created impaired cardiac function with elevated left atrial pressure (baseline: 7.8 ± 1.0 vs. impaired: 11.9 ± 3.2 mmHg). We established extracorporeal left‐to‐right atrial shunting with a centrifugal pump. After recording pre‐IAS haemodynamics, we changed IAS flow stepwise to various levels and measured haemodynamics under IAS. To predict the impact of IAS on haemodynamics, we modelled the fluid mechanics of IAS by Newton's second law and incorporated IAS into the generalized circulatory equilibrium framework. Using pre‐IAS haemodynamic data obtained from the dogs, we predicted the impact of IAS flow on haemodynamics under IAS condition using a set of equations. We compared the predicted haemodynamic data with those measured. The predicted pulmonary flow [r2 = 0.88, root mean squared error (RMSE) 11.4 mL/min/kg, P |
Databáze: | OpenAIRE |
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