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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
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Comparison of device-based therapy options for heart failure with preserved ejection fraction: a simulation study
Marcus Granegger1, Christoph Gross2, David Siemer3
1Department of Cardiac Surgery, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria. marcus.granegger@meduniwien.ac.at.
Scientific Reports
|April 7, 2022
Summary
Device-based therapies for heart failure with preserved ejection fraction (HFpEF) show promise. Numerical modeling suggests personalized treatment based on patient hemodynamics, optimizing outcomes for HFpEF management.
Area of Science:
- Cardiovascular medicine
- Biomedical engineering
- Computational physiology
Background:
- Heart failure with preserved ejection fraction (HFpEF) lacks effective therapies.
- Device-based treatments are emerging for HFpEF management.
Purpose of the Study:
- To assess the hemodynamic effects of four device-based therapies for HFpEF using a numerical model.
- To evaluate the suitability of different devices for distinct HFpEF patient subgroups.
Main Methods:
- Development of a lumped parameter model of the cardiovascular system.
- Simulation of interatrial shunt devices (IASD), left ventricle assist devices (LV-VAD), left atrium assist devices (LA-VAD), and CoPulse device.
- Analysis of hemodynamic parameters during rest and exercise in two HFpEF subgroups.
Main Results:
- All four therapies reduced left atrial pressure by over 20% in both HFpEF subgroups during rest and exercise.
- IASDs reduced cardiac output (CO) and increased pulmonary circulation load.
- Mechanical assist devices (LV-VAD, LA-VAD, CoPulse) increased CO and reduced sympathetic activity.
- LV-VADs showed a risk of suction events due to reduced end-systolic volume.
Conclusions:
- HFpEF patient heterogeneity necessitates individualized therapy selection.
- Patients with preserved CO may benefit from IASDs.
- HFpEF patients with reduced CO could be candidates for mechanical assist devices.
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