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Interaction between the septum and the left (right) ventricular free wall in order to evaluate the effects on
1C.N.R., Institute of Clinical Physiology, U.O.S. of Rome, Italy. claudio.delazzari@ifc.cnr.it
Insights
Mathematical modeling of the cardiovascular system (CVS) simulates how ECG delays affect heart function. This study evaluated impacts on coronary blood flow and aortic pressure, offering insights into cardiac resynchronisation therapy (CRT).
Area of Science:
- Cardiovascular Physiology
- Computational Biology
- Biomedical Engineering
Background:
- Mathematical modeling of the cardiovascular system (CVS) is crucial for understanding complex interactions within the heart, including ventricular and septal dynamics.
- Dyssynchronous interactions between the septum and ventricular walls underlie various pathologies like heart failure and dilated cardiomyopathy.
- Cardiac resynchronisation therapy (CRT) aims to correct ECG QRS duration abnormalities, potentially improving patient outcomes.
Purpose of the Study:
- To evaluate the effects of different electrocardiogram (ECG) timings, intra-ventricular, and inter-ventricular delays on coronary blood flow (CBF) and aortic pressure using a numerical CVS simulator.
- To assess the impact of simulating baseline circulatory conditions and CRT scenarios in seven patients from existing literature.
- To analyze how variations in ECG parameters influence hemodynamic parameters and patient status.
Main Methods:
- Utilized a numerical simulator of the cardiovascular system (CVS) based on variable elastance models for ventricles, atria, and septum.
- Related mechanical heart properties to the electrocardiogram (ECG) signal to analyze delay effects.
- Simulated baseline and cardiac resynchronisation therapy (CRT) conditions for seven patients, comparing results with literature data.
Main Results:
- Simulated hemodynamic outcomes, including aortic pressure, aligned with established literature data.
- Investigated the influence of varying ECG delays and intra/inter-ventricular timings on cardiovascular parameters.
- Observed simulated coronary blood flow (CBF) responses during CRT, consistent with controversial findings in existing literature.
Conclusions:
- The numerical simulator accurately reproduces patient-specific cardiovascular conditions and the effects of CRT.
- Findings support the use of mathematical modeling to understand ECG delay impacts on hemodynamics and CBF.
- The study provides valuable insights into the complex interplay between electrical signaling and mechanical function in the cardiovascular system, particularly in the context of CRT.
Abstract:
Mathematical modelling of the cardiovascular system (CVS) can help in understanding the complex interactions between both the ventricles and the septum. By describing the behaviour of the left (right) ventricular free wall, atria and septum using the variable elastance models, it is possible to reproduce their interactions. By relating the mechanical properties of both atria and both ventricles to the electrocardiogram (ECG) signal, it is possible to analyse the effects produced by different ECG delay on haemodynamic parameters. In the cardiovascular field, the incorrect interactions between septum and both ventricular free walls are based on many pathological conditions, i.e. symptomatic heart failure resulting from systolic dysfunction, ischemic dilated cardiomyopathy, and so on. The possible corrections that can be induced on the QRS complex duration in the ECG signal (i.e. cardiac resynchronisation therapy, CRT) can produce benefits improving the clinical status of the patient. The aim of this work was to evaluate, using our numerical simulator of the CVS, the effects induced on coronary blood flow (CBF) and aortic pressure using different ECG times, intra-ventricular and inter-ventricular delays. The results were obtained by reproducing the circulatory baseline and CRT conditions of seven patients described in literature. Haemodynamic simulated results are in accordance with literature data. Also the controversial results on CBF, in presence of CRT, are consistent with those described in the literature.
