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Modelling the heart with the atrioventricular plane as a piston unit
KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.ORCID iD: 0000-0002-9654-447X
KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging. Karolinska Institute, Sweden .
KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging. Karolinska Institute, Sweden .ORCID iD: 0000-0002-8987-9909
2015 (English)In: Medical Engineering and Physics, ISSN 1350-4533, E-ISSN 1873-4030, Vol. 37, no 1, 87-92 p.Article in journal (Refereed) Published
Abstract [en]

Medical imaging and clinical studies have proven that the heart pumps by means of minor outer volume changes and back-and-forth longitudinal movements in the atrioventricular (AV) region. The magnitude of AV-plane displacement has also shown to be a reliable index for diagnosis of heart failure. Despite this, AV-plane displacement is usually omitted from cardiovascular modelling. We present a lumped-parameter cardiac model in which the heart is described as a displacement pump with the AV plane functioning as a piston unit (AV piston). This unit is constructed of different upper and lower areas analogous with the difference in the atrial and ventricular cross-sections. The model output reproduces normal physiology, with a left ventricular pressure in the range of 8-130 mmHg, an atrial pressure of approximatly 9 mmHg, and an arterial pressure change between 75 mmHg and 130 mmHg. In addition, the model reproduces the direction of the main systolic and diastolic movements of the AV piston with realistic velocity magnitude (similar to 10 cm/s). Moreover, changes in the simulated systolic ventricular-contraction force influence diastolic filling, emphasizing the coupling between cardiac systolic and diastolic functions. The agreement between the simulation and normal physiology highlights the importance of myocardial longitudinal movements and of atrioventricular interactions in cardiac pumping.

Place, publisher, year, edition, pages
2015. Vol. 37, no 1, 87-92 p.
Keyword [en]
Atrioventricular interaction, Cardiac function, Cardiac pumping, Longitudinal function, Cardiac model, Bond graphs
National Category
Biomedical Laboratory Science/Technology
Identifiers
URN: urn:nbn:se:kth:diva-161634DOI: 10.1016/j.medengphy.2014.11.002ISI: 000349585100011PubMedID: 25466260Scopus ID: 2-s2.0-84920913473OAI: oai:DiVA.org:kth-161634DiVA: diva2:797615
Note

QC 20150324

Available from: 2015-03-24 Created: 2015-03-13 Last updated: 2017-12-04Bibliographically approved
In thesis
1. Imaging and modeling the cardiovascular system
Open this publication in new window or tab >>Imaging and modeling the cardiovascular system
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Understanding cardiac pumping function is crucial to guiding diagnosis, predicting outcomes of interventions, and designing medical devices that interact with the cardiovascular system.  Computer simulations of hemodynamics can show how the complex cardiovascular system is influenced by changes in single or multiple parameters and can be used to test clinical hypotheses. In addition, methods for the quantification of important markers such as elevated arterial stiffness would help reduce the morbidity and mortality related to cardiovascular disease.

The general aim of this thesis work was to improve understanding of cardiovascular physiology and develop new methods for assisting clinicians during diagnosis and follow-up of treatment in cardiovascular disease. Both computer simulations and medical imaging were used to reach this goal.

In the first study, a cardiac model based on piston-like motions of the atrioventricular plane was developed. In the second study, the presence of the anatomical basis needed to generate hydraulic forces during diastole was assessed in heathy volunteers. In the third study, a previously validated lumped-parameter model was used to quantify the contribution of arterial and cardiac changes to blood pressure during aging. In the fourth study, in-house software that measures arterial stiffness by ultrasound shear wave elastography (SWE) was developed and validated against mechanical testing.

The studies showed that longitudinal movements of the atrioventricular plane can well explain cardiac pumping and that the macroscopic geometry of the heart enables the generation of hydraulic forces that aid ventricular filling. Additionally, simulations showed that structural changes in both the heart and the arterial system contribute to the progression of blood pressure with age. Finally, the SWE technique was validated to accurately measure stiffness in arterial phantoms.

Place, publisher, year, edition, pages
KTH Royal Institute of Technology, 2016. 96 p.
Series
TRITA-STH, 2016:9
Keyword
Cardiac pumping, diastolic function, hemodynamics, modeling, simulation, arterial stiffness, ultrasound, shear wave elastography.
National Category
Other Medical Engineering
Research subject
Medical Technology
Identifiers
urn:nbn:se:kth:diva-196538 (URN)978-91-7729-192-3 (ISBN)
Public defence
2016-12-09, T2, Hälsovägen 11C, Huddinge, 10:00 (English)
Opponent
Supervisors
Funder
Swedish Research Council, 2012-2800, 2012-2795VINNOVA, 2011-01365
Note

QC 20161115

Available from: 2016-11-15 Created: 2016-11-15 Last updated: 2016-11-15Bibliographically approved

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Maksuti, EliraBroomé, Michael

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