腹腔 - 腹腔相互作用的计算建模表明,在涉及心力衰竭的临床条件中发挥了作用
Salla M Kim1, E Benjamin Randall2, Filip Jezek2,3
1Department of Biomedical Engineering, Edwards Lifesciences Foundation Cardiovascular Innovation and Research Center, University of California Irvine, Irvine, CA, United States.
Frontiers in physiology
|September 25, 2023
概括
心室相互依赖表明,左心室功能障碍可以导致右心室 (RV) 补偿,而RV功能障碍会损害左心室 (LV) 填充,这表明RV衰竭可能是心力衰竭的一些情况下的基础.
科学领域:
- 心血管生理学心血管生理学
- 计算生物学 计算生物学
- 医疗成像医学成像
背景情况:
- 心室相互依赖描述了左心室 (LV) 和右心室 (RV) 之间的生物学,血液动力学和机械联系.
- 虽然 LV 功能的对 RV 功能的影响已经确立,但相反的情况正在获得临床认可.
- 室腔相互依赖的临床研究受到侵入性方法和混患者因素的阻碍.
研究的目的:
- 通过计算来研究心室的相互依赖性,将机械和血液动力学相互作用与临床混因素分开.
- 探索 LV 和 RV 缩和腹功能障碍对在补偿体积负荷下心室相互作用的影响.
- 利用计算建模来识别诸如心力衰竭与保留射出分数 (HFpEF) 等疾病潜在的潜在机制.
主要方法:
- 采用了三段双心室心脏模型与简单的循环系统相结合.
- 模拟评估了在孤立或联合LV和RV缩和扩张功能障碍的条件下心室相互依赖.
- 关键指标包括终端透气压和体积关系,终端静脉压和体积关系,弗兰克·斯塔林曲线和心脏功率输出.
主要成果:
- 静脉缩和静脉缩功能障碍诱导了RV补偿,由RV输出功率的增加证明.
- 静脉回收系统和静脉缩功能障碍导致 LV 填充受损,模仿 LV 硬,特别是在体积负荷下.
- 计算发现表明,在某些高高压pEF情况下,RV功能障碍是潜在的主要问题.
结论:
- 计算建模为剖析心室相互依赖而没有临床混提供了有价值的工具.
- 具有保留LV射出分数的HFpEF患者的一个子集可能出现一次性RV衰竭.
- 将这种计算方法进一步应用于临床数据可以完善心力衰竭的诊断和治疗,改善患者的治疗结果.
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