Simulation of cardiovascular system diseases by including the autonomic nervous system into a minimal model

Diagnosing cardiovascular system (CVS) diseases from clinically measured data is difficult, due to the complexity of the hemodynamic and autonomic nervous system (ANS) interactions. Physiological models could describe these interactions to enable simulation of a variety of diseases, and could be combined with parameter estimation algorithms to help clinicians diagnose CVS dysfunctions. This paper presents modifications to an existing CVS model to include a minimal physiological model of ANS activation. A minimal model is used so as to minimise the number of parameters required to specify ANS activation, enabling the effects of each parameter on hemodynamics to be easily understood. The combined CVS and ANS model is verified by simulating a variety of CVS diseases, and comparing simulation results with common physiological understanding of ANS function and the characteristic hemodynamics seen in these diseases. The model of ANS activation is required to simulate hemodynamic effects such as increased cardiac output in septic shock, elevated pulmonary artery pressure in left ventricular infarction, and elevated filling pressures in pericardial tamponade. This is the first known example of a minimal CVS model that includes a generic model of ANS activation and is shown to simulate diseases from throughout the CVS.