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Updated: Jul 31, 2026
Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
An Investigation of Left Ventricular Valve Disorders and the Mechano-Electric Feedback Using a Synergistic Lumped
Nicholas Pearce1, Eun-Jin Kim1
1Center for Fluids and Complex Systems (FSC), Faculty of Engineering, Environment and Computing, Coventry University, Coventry CV1 5FB, UK.
Insights
Cardiac valve disorders, particularly regurgitation, worsen arrhythmias when mechano-electric feedback is impaired. This study models heart function to understand these critical relationships.
Area of Science:
- Cardiovascular Physiology
- Computational Biology
- Biomedical Engineering
Background:
- Cardiac diseases are a leading cause of mortality, with left ventricular valve disorders like stenosis and regurgitation significantly impacting quality of life.
- Mitral valve prolapse is known to increase susceptibility to cardiac arrhythmia.
- Existing models, like the time-varying elastance (TVE) method, may not fully capture complex feedback mechanisms in the heart.
Purpose of the Study:
- To investigate the effects of mitral and aortic valve stenosis and regurgitation on mechano-electric feedback (MEF) and arrhythmia generation.
- To utilize a synergistic low-order numerical model incorporating mechanical, chemical, and electrical elements as an alternative to the TVE method.
- To analyze how valve disorders interact with MEF to influence cardiac electrical activity and arrhythmia development.
Main Methods:
- Development and application of a synergistic low-order numerical model for simulating left ventricular function.
- Integration of mechanical, chemical, and electrical components within the model to capture heart dynamics.
- Investigation of mechano-electric feedback (MEF) alterations due to mitral and aortic valve stenosis and regurgitation.
Main Results:
- Mitral valve stenosis increases sensitivity to systolic stretch and decreases sensitivity to diastolic stretch related to arrhythmia.
- Aortic valve stenosis does not alter sensitivity to arrhythmia-stimulating stretch, while regurgitation reduces it.
- Valve regurgitation, especially with diastolic stretch and impaired MEF, significantly increases ectopic beat frequency, exacerbating arrhythmia severity.
Conclusions:
- Synergistic modeling provides a framework to study heart valve disorders and their impact on MEF.
- Valve regurgitation is identified as a critical factor that amplifies arrhythmia severity in the presence of MEF dysfunction.
- Understanding these interactions is crucial for developing targeted therapies for cardiac arrhythmias associated with valve disease.
Abstract:
Cardiac diseases and failure make up one of largest contributions to global mortality and significantly detriment the quality of life for millions of others. Disorders in the valves of the left ventricle are a prominent example of heart disease, with prolapse, regurgitation, and stenoses-the three main valve disorders. It is widely known that mitral valve prolapse increases the susceptibility to cardiac arrhythmia. Here, we investigate stenoses and regurgitation of the mitral and aortic valves in the left ventricle using a synergistic low-order numerical model. The model synergy derives from the incorporation of the mechanical, chemical, and electrical elements. As an alternative framework to the time-varying elastance (TVE) method, it allows feedback mechanisms at work in the heart to be considered. The TVE model imposes the ventricular pressure-volume relationship using a periodic function rather than calculating it consistently. Using our synergistic approach, the effects of valve disorders on the mechano-electric-feedback (MEF) are investigated. The MEF is the influence of cellular mechanics on the electrical activity, and significantly contributes to the generation of arrhythmia. We further investigate stenoses and regurgitation of the mitral and aortic valves and their relationship with the MEF and generation of arrhythmia. Mitral valve stenosis is found to increase the sensitivity to arrhythmia-stimulating systolic stretch, and reduces the sensitivity to diastolic stretch. Aortic valve stenosis does not change the sensitivity to arrhythmia-stimulating stretch, and regurgitation reduces it. A key result is found when valve regurgitation is accompanied by diastolic stretch. In the presence of MEF disorder, ectopic beats become far more frequent when accompanied by valve regurgitation. Therefore, arrhythmia resulting from a disorder in the MEF will be more severe when valve regurgitation is present.
