使用人体心肺模型来研究和预测正常和病变心室力学、间隔相互作用和房室血流模式。

C Luo, D L Ware, J B Zwischenberger, J W Clark
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引用次数: 36

摘要

我们用额外的数据升级了人类心肺(CP)模型,使其能够更准确地模拟正常生理。然后,我们通过改变降低心室顺应性的两个参数值来测试其解释人类疾病的能力,并发现它可以预测左心室舒张功能障碍(LVDD)患者的许多血液动力学、气体交换和自主神经异常。新纳入的信息包括在心导管实验室中同时记录的正常人左室和左室的高保真压力描记,多普勒超声心动图入口血流速度模式,左右心室阻抗测量和心房容积。修订后的心血管切面详细描述了正常受试者的血流动力学,现在可以解释室间隔顺应性对心室相互作用的影响,左右心室压力发展的差异,以及右心房静脉血气混合。该模型可以分离出正常和异常生理高度相关的特征,并同时以一种非常困难或不可能使用完整生物体的方式展示它们的相互作用。因此,它可以帮助医生和科学家理解、诊断和改善他们对复杂心血管和肺部疾病的治疗。它还可以模拟心室和肺辅助装置的血流动力学和呼吸效应,从而有助于它们的发展。
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Using a human cardiopulmonary model to study and predict normal and diseased ventricular mechanics, septal interaction, and atrio-ventricular blood flow patterns.

We upgraded our human cardiopulmonary (CP) model with additional data that enables it to more accurately simulate normal physiology. We then tested its ability to explain human disease by changing two parameter values that decrease ventricular compliance, and found that it could predict many of the hemodynamic, gas exchange, and autonomic abnormalities found in patients with left ventricular diastolic dysfunction (LVDD). The newly incorporated information includes high-fidelity pressure tracings simultaneously recorded from the RV and LV of a normal human in a cardiac catheterization laboratory, Doppler echocardiographic inlet flow velocity patterns, measures of right and left ventricular impedance, and atrial volumes. The revised cardiovascular section details the hemodynamics of a normal subject to the extent that it can now explain the effects of septal compliance on ventricular interaction, the differences in left and right ventricular pressure development, and venous blood gas mixing in the right atrium. The model can isolate the highly interrelated features of normal and abnormal physiology, and simultaneously demonstrate their interaction in a manner that would be very difficult or impossible using an intact organism. It may therefore help physicians and scientists understand, diagnose, and improve their treatment of complicated cardiovascular and pulmonary diseases. It could also simulate the hemodynamic and respiratory effects of ventricular and pulmonary assist devices, and thus help with their development.

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