1. Proceedings
  2. I3M
  3. 2019
  4. EMSS
  5. 10.46354/i3m.2019.emss.004

A 0-D model to predict the relationship between resistance and compliance in pulmonary arterial hypertension

  • a Claudio De Lazzari  ,
  • b Silvia Marconi  ,
  • c Massimo Capoccia  ,
  •  d Silvia Papa  ,
  • e Roberto Badagliacca  ,
  •  f Carmine Dario Vizza  
  • a,b National Research Council, Institute of Clinical Physiology (IFC-CNR), Rome, Italy
  • a National Institute for Cardiovascular Research (I.N.R.C.), Bologna, Italy
  • c Royal Brompton Hospital, Royal Brompton & Harefield NHS Foundation Trust, London, UK
  • d,e,f Department of Cardiovascular Respiratory Nephrologic and Geriatric Sciences, Sapienza University of Rome, Italy
Cite as
De Lazzari C., Marconi S., Capoccia M., Papa S., Badagliacca R., Vizza C.D. (2019). A 0-D model to predict the relationship between resistance and compliance in pulmonary arterial hypertension. Proceedings of the 31st European Modeling & Simulation Symposium (EMSS 2019), pp. 23-28. DOI: https://doi.org/10.46354/i3m.2019.emss.004.

Abstract

The inverse relationship between pulmonary vascular resistance and arterial compliance plays a significant role for the treatment of pulmonary arterial hypertension. The hyperbolic relationship between pulmonary vascular resistance and arterial compliance enables to evaluate the percentage of resistance reduction, which ultimately leads to an improvement in compliance. The numerical representation of the pulmonary circulation can help clinicians evaluate these key parameters in relation to therapeutic intervention. In this paper, we present a 0-D numerical model of the pulmonary circulation. The right ventricular pressure is reproduced using a modified time-varying elastance and the pulmonary bed is modelled with RLC elements. Preliminary results obtained from clinical parameters measured in patients with pulmonary arterial hypertension are discussed in this context. The simulations performed using the 0-D model have been applied to a clinical setting to evaluate the percentage change induced on compliance by a reduction in resistance in fixed circulatory conditions.

References

  1. Barst R.J., McGoon M., et al. 2004. Diagnosis and differential assessment of pulmonary arterial hypertension. J. Am. Coll. Cardiol., 43, S40-S47.
  2. Guarracino F., Baldassarri R., et al. 2013. Ventriculoarterial decoupling in acutely hemodynamic states. Crit. Care, 17, 213.
  3. Kuehne T., Yilmaz S., Steendijk P., et al. 2004. Magnetic Resonance Imaging Analysis of Right Ventricular Pressure-Volume Loops. In Vivo Validation and Clinical Application in Patients With Pulmonary Hypertension. Circulation, 110, 2010-2016.
  4. Tello K., Dalmer A., Axmann J., et al. 2019. Reserve of Right Ventricular-Arterial Coupling in the Setting of Chronic Overload. Circulation: Heart Failure, 12(1), e005512.
  5. Lankhaar J.W., Westerof N., Faes T.J.C., et al. 2006. Quantification of right ventricular afterload in patients with and without pulmonary hypertension. Am. J. Phsyol. Heart Circ. Physiol., 291, H1731-H1737.
  6. De Lazzari C., Darowski M., et al. 1998. The influence of left ventricle assist device and ventilatory support on energy-related cardiovascular variables. Med. Engi. & Phys., 20(2), 83-91.
  7. De Lazzari C. Stalteri D. 2011. CARDIOSIM© cardiovascular software simulator. Italy: C.N.R. National Research Council, https://cardiosim.dsb.cnr.it/.
  8. De Lazzari C., Neglia D., et al. 2009. Computer simulation of coronary flow waveforms during caval occlusion. Meth. Infor. Med., 48(2), 113-122.
  9. De Lazzari C., D’Ambrosi A., Tufano F., et al. 2010. Cardiac resynchronization therapy: could a numerical simulator be a useful tool in order to predict the response of the biventricular pacemaker synchronization. Eur. Rev. Med. Pharmacol. Sci., 14(11), 969-978.
  10. De Lazzari C., Capoccia M., Marconi S. 2019. How can LVAD support influence ventricular energetics parameters in advanced heart failure patients? A retrospective study. Computer Methods and Programs in Biomedicine, 172, 117-126.
  11. De Lazzari C., Darowski M., Ferrari G., Pisanelli D.M., Tosti G 2006. Modelling in the study of interaction of Hemopump device and artificial ventilation. Computers in Biology and Medicine, 36 (11), 235-1251.
  12. Fresiello L., Gu Y.J., et al. 2011. PUCA pump and IABP comparison: analysis of hemodynamic and energetic effects using a digital computer model of the circulation. Int. J. Artif. Organs, 34 (5), 442-455.
  13. De Lazzari C., Darowski M., Ferrari G., et al. 2001. Ventricular energetics during mechanical ventilation and intraaortic balloon pumping – Computer simulation. Journal of Medical Engineering & Technology, 25 (3), 103-111.
  14. Marconi S., Cappelli C., Capoccia M., et al. 2018. A New Numerical Model of the Intra-aortic Balloon Pump as a Tool for Clinical Simulation and Outcome Prediction. World Congress on Medical Physics and Biomedical Engineering 2018. IFMBE proceedings, Springer, 795-799.
  15. Capoccia M., Marconi S., Singh A.A., et al. 2018. Simulation as a preoperative planning approach in advanced heart failure patients. A retrospective clinical analysis. BioMedical Engineering OnLine, 17:52.
  16. De Lazzari C., Del Prete E., Genuini I., Fedele F. 2013. In silico study of the haemodynamic effects induced by mechanical ventilation and biventricular pacemaker. Computer Methods and Programs in Biomedicine, 110 (3), 519-527.
  17. De Lazzari C., Genuini I., Quatember B., Fedele F. 2014. Mechanical ventilation and thoracic artificial lung assistance during mechanical circulatory support with PUCA pump: In silico study. Computer Methods and Programs in Biomedicine, 113 (2), 642-654.
  18. De Lazzari C., Pirckhalava M. 2017. Cardiovascular and pulmonary artificial organs: educational training simulators. Rome: Consiglio Nazionale delle Ricerche (CNR) Press.
  19. De Lazzari C., Darowski M., Wolski P. 2005. In vivo and simulation study of artificial ventilation effects on energetic variables in cardiosurgical patients. Meth. Infor. Med., 44(1), 98-105.
  20. Sagawa K., Maughan L., Suga H. and Sunagawa K. 1988. Cardiac Contraction and the Pressure-Volume Relationships. Oxford University Press, New York.
  21. Sunagawa K., Maughan W.L., Sagawa K. 1985. Optimal arterial resistance for the maximal stroke work studied in isolated canine left ventricle. Circ. Res. 56, 586-95.
  22. Vonk Noordegraaf A., Haddad F., Chin K.M., et al. 2013. Right heart adaptation to pulmonary arterial hypertension: physiology and pathobiology. J. Am. Coll. Cardiol. 62: Suppl., D22-D33.
  23. Vonk Noordegraaf A., Westerhof B.E., Westerhof N. 2017. The relationship between the right ventricle and its load in pulmonary hypertension. J. Am. Coll. Cardiol. 69, 236-243.