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N N, Chakraborty S. Geometry adaptive waveformer for cardio-vascular modeling. Comput Biol Med 2025; 190:110069. [PMID: 40187180 DOI: 10.1016/j.compbiomed.2025.110069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2024] [Revised: 03/04/2025] [Accepted: 03/21/2025] [Indexed: 04/07/2025]
Abstract
Modeling cardiovascular anatomies poses a significant challenge due to their complex, irregular structures and inherent pathological conditions. Numerical simulations, while accurate, are often computationally expensive, limiting their practicality in clinical settings. Traditional machine learning methods, on the other hand, often struggle with some major hurdles, including high dimensionality of the inputs, inability to effectively work with irregular grids, and preserving the time dependencies of responses in dynamic problems. In response to these challenges, this paper proposes geometry adaptive waveformer, a novel neural operator to predict blood flow dynamics in the cardiovascular system. The framework is primarily composed of three components: a geometry encoder, a geometry decoder, and a waveformer. The encoder transforms input defined on the irregular domain to a regular domain using a graph operator-based network and signed distance functions. The waveformer operates on the transformed field on the irregular grid. Finally, the decoder reverses this process, transforming the output from the regular grid back to the physical space. We evaluate the efficacy of the approach on different sets of cardiovascular data. The results obtained illustrate the effectiveness of the proposed model in accurately predicting blood flow dynamics in the cardiovascular system, establishing the proposed approach as a computationally efficient and clinically feasible alternative to traditional methods.
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Affiliation(s)
- Navaneeth N
- Department of Applied Mechanics, Indian Institute of Technology Delhi, Hauz Khas, 110016, India.
| | - Souvik Chakraborty
- Department of Applied Mechanics, Indian Institute of Technology Delhi, Hauz Khas, 110016, India; Yardi School of Artificial Intelligence, Indian Institute of Technology Delhi, Hauz Khas, 110016, India; University of Illinois Urbana-Champaign (UIUC), Urbana, Il-61801, USA.
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2
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Thiel JN, Costa AM, Wiegmann B, Arens J, Steinseifer U, Neidlin M. Quantifying the influence of combined lung and kidney support using a cardiovascular model and sensitivity analysis-informed parameter identification. Comput Biol Med 2025; 186:109668. [PMID: 39826300 DOI: 10.1016/j.compbiomed.2025.109668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 12/11/2024] [Accepted: 01/07/2025] [Indexed: 01/22/2025]
Abstract
The combination of extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) pose complex hemodynamic challenges in intensive care. In this study, a comprehensive lumped parameter model (LPM) is developed to simulate the cardiovascular system, incorporating ECMO and CRRT circuit dynamics. A parameter identification framework based on global sensitivity analysis (GSA) and multi-start gradient-based optimization was developed and tested on 30 clinical data points from eight veno-arterial ECMO patients. To demonstrate feasibility, the model is used to analyze nine CRRT-ECMO connection schemes under varying flow conditions for a single patient. Our results indicate that CRRT has a notable impact on the cardiovascular system, with changes in pulmonary artery pressure of up to 203 %, highly dependent on ECMO flow. The GSA enabled the systematic and agnostic identification of a subset of model parameters used in the calibration process. The established parameter estimation framework is fast and robust, as no manual tuning of algorithm parameters is required, and achieves high correlations between simulation and experimental data with R2 > 0.98. It uses modeling methods that could pave the way for real-time applications in intensive care. This open-source framework provides a valuable tool for the systematic evaluation of combined ECMO and CRRT, which can be used to develop standardized treatment protocols and improve patient outcomes in critical care. This model provides a good basis for addressing research questions related to mechanical circulatory and respiratory support and presents tools to help move towards a digital twin in healthcare.
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Affiliation(s)
- Jan-Niklas Thiel
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Forckenbeckstraße 55, 52074, Aachen, Germany.
| | - Ana Martins Costa
- Engineering Organ Support Technologies group, Department of Biomechanical Engineering, University of Twente, Drienerlolaan 5, 7522, NB, Enschede, the Netherlands
| | - Bettina Wiegmann
- Department for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany; Implant Research and Development (NIFE), Lower Saxony Center for Biomedical Engineering, Stadtfelddamm 34, 30625, Hannover, Germany; German Center for Lung Research (DZL), Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Jutta Arens
- Engineering Organ Support Technologies group, Department of Biomechanical Engineering, University of Twente, Drienerlolaan 5, 7522, NB, Enschede, the Netherlands
| | - Ulrich Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Forckenbeckstraße 55, 52074, Aachen, Germany
| | - Michael Neidlin
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Forckenbeckstraße 55, 52074, Aachen, Germany
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Blanco PJ, Müller LO. One-Dimensional Blood Flow Modeling in the Cardiovascular System. From the Conventional Physiological Setting to Real-Life Hemodynamics. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2025; 41:e70020. [PMID: 40077955 DOI: 10.1002/cnm.70020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Revised: 01/13/2025] [Accepted: 02/07/2025] [Indexed: 03/14/2025]
Abstract
Research in the dynamics of blood flow is essential to the understanding of one of the major driving forces of human physiology. The hemodynamic conditions experienced within the cardiovascular system generate a highly variable mechanical environment that propels its function. Modeling this system is a challenging problem that must be addressed at the systemic scale to gain insight into the interplay between the different time and spatial scales of cardiovascular physiology processes. The vast majority of scientific contributions on systemic-scale distributed parameter-based blood flow modeling have approached the topic under relatively simple scenarios, defined by the resting state, the supine position, and, in some cases, by disease. However, the physiological states experienced by the cardiovascular system considerably deviate from such conditions throughout a significant part of our life. Moreover, these deviations are, in many cases, extremely beneficial for sustaining a healthy life. On top of this, inter-individual variability carries intrinsic complexities, requiring the modeling of patient-specific physiology. The impact of modeling hypotheses such as the effect of respiration, control mechanisms, and gravity, the consideration of other-than-resting physiological conditions, such as those encountered in exercise and sleeping, and the incorporation of organ-specific physiology and disease have been cursorily addressed in the specialized literature. In turn, patient-specific characterization of cardiovascular system models is in its early stages. As for models and methods, these conditions pose challenges regarding modeling the underlying phenomena and developing methodological tools to solve the associated equations. In fact, under certain conditions, the mathematical formulation becomes more intricate, model parameters suffer greater variability, and the overall uncertainty about the system's working point increases. This paper reviews current advances and opportunities to model and simulate blood flow in the cardiovascular system at the systemic scale in both the conventional resting setting and in situations experienced in everyday life.
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Affiliation(s)
- Pablo J Blanco
- Laboratório Nacional de Computação Científica, Petrópolis, Brazil
- Instituto Nacional de Ciência e Tecnologia em Medicina Assistida por Computação Científica, Petrópolis, Brazil
| | - Lucas O Müller
- Department of Mathematics, Università degli Studi di Trento, Trento, Italy
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Zhang XC, Zhang Q, Wu GF, Hu HT, Lin L, Tian S, Hao LL, Wang T. Evaluation of enhanced external counterpulsation for diabetic foot based on a patient-specific 0D-1D cardiovascular system model. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 255:108333. [PMID: 39047576 DOI: 10.1016/j.cmpb.2024.108333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 07/07/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND AND OBJECTIVE Diabetic foot (DF) complications often lead to severe vascular issues. This study investigated the effectiveness of enhanced external counterpulsation (EECP) and its derived innovative compression strategies in addressing poor perfusion in DF. Although developing non-invasive and efficient treatment methods for DF is critical, the hemodynamic alterations during EECP remain underexplored despite promising outcomes in microcirculation. This research sought to address this gap by developing a patient-specific 0D-1D model based on clinical ultrasound data to identify potentially superior compression strategies that could substantially enhance blood flow in patients with DF complications. METHODS Data were gathered from 10 patients with DF utilizing ultrasound for blood flow rate and computed tomography angiography (CTA) to identify lower limb conditions. Clinical measurements during standard EECP, with varying cuff pressures, facilitated the creation of a patient-specific 0D-1D model through a two-step parameter estimation process. The accuracy of this model was verified via comparison with the clinical measurements. Four compression strategies were proposed and rigorously evaluated using this model: EECP-Simp-I (removing hip cuffs), EECP-Simp-II (further removing the cuffs around the lower leg), EECP-Impr-I (removing all cuffs around the affected side), and EECP-Impr-II (building a loop circulation from the healthy side to the affected side). RESULTS The predicted results under the rest and standard EECP states were generally closely aligned with clinical measurements. The patient-specific 0D-1D model demonstrated that EECP-Simp-I and EECP-Impr-I contributed similar enhancement to perfusion in the dorsal artery (DA) and were comparable to standard EECP, while EECP-Simp-II had the least effect and EECP-Impr-II displayed the most significant enhancement. Pressure at the aortic root (AO) remained consistent across strategies. CONCLUSIONS EECP-Simp-I is recommended for patients with DF, emphasizing device simplification. However, EECP-Simp-II is discouraged as it significantly diminished blood perfusion in this study, except in cases of limb fragility. EECP-Impr-II showed superior enhancement of blood perfusion in DA to all other strategies but required a more complex EECP device. Despite increased AO pressure in all the proposed compression strategies, safety could be guaranteed as the pressue remained within a safe range.
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Affiliation(s)
- Xiao-Cong Zhang
- Department of Emergency, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong 518033, China; Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong 518033, China; Department of Cardiology, Foshan Fosun Chancheng Hospital, Foshan, Guangdong 528000, China
| | - Qi Zhang
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong 518033, China; College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning 110167, China
| | - Gui-Fu Wu
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong 518033, China
| | - Hai-Tao Hu
- Department of Wound Repairment, Foshan Fosun Chancheng Hospital, Foshan, Guangdong 528000, China
| | - Ling Lin
- Department of Radiology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong 518033, China
| | - Shuai Tian
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong 518033, China.
| | - Li-Ling Hao
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning 110167, China.
| | - Tong Wang
- Department of Emergency, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong 518033, China.
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Liu Z, Zhang M, Wang C, Wang Z, Liao X, Ou C, Si W. Flow diverters treatment planning of small- and medium-sized intracranial saccular aneurysms on the internal carotid artery via constraint-based virtual deployment. Int J Comput Assist Radiol Surg 2024; 19:1175-1183. [PMID: 38619792 DOI: 10.1007/s11548-024-03124-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 03/25/2024] [Indexed: 04/16/2024]
Abstract
PURPOSE The internal carotid artery (ICA) is a region with a high incidence for small- and medium-sized saccular aneurysms. However, the treatment relies heavily on the surgeon's experience to achieve optimal outcome. Although the finite element method (FEM) and computational fluid dynamics can predict the postoperative outcomes, due to the computational complexity of traditional methods, there is an urgent need for investigating the fast but versatile approaches related to numerical simulations of flow diverters (FDs) deployment coupled with the hemodynamic analysis to determine the treatment plan. METHODS We collected the preoperative and postoperative data from 34 patients (29 females, 5 males; mean age 55.74 ± 9.98 years) who were treated with a single flow diverter for small- to medium-sized intracranial saccular aneurysms on the ICA. The constraint-based virtual deployment (CVD) method is proposed to simulate the FDs expanding outward along the vessel centerline while be constrained by the inner wall of the vessel. RESULTS The results indicate that there were no significant differences in the reduction rates of wall shear stress and aneurysms neck velocity between the FEM and methods. However, the solution time of CVD was greatly reduced by 98%. CONCLUSION In the typical location of small- and medium-sized saccular aneurysms, namely the ICA, our virtual FDs deployment simulation effectively balances the computational accuracy and efficiency. Combined with hemodynamics analysis, our method can accurately represent the blood flow changes within the lesion region to assist surgeons in clinical decision-making.
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Affiliation(s)
- Zehua Liu
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Xueyuan street 1068, Shenzhen University Town, Nanshan District, Shenzhen, 518000, China
| | - Meng Zhang
- Department of Neurosurgery, Shenzhen Second People's Hospital, Sungang West Road 3002, Futian District, Guangdong, 510000, China
| | - Chao Wang
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tian Tan Hospital, Capital Medical University, TiantanXili 6, Dongcheng District, Beijing, 100000, China
| | - Zhongxiao Wang
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tian Tan Hospital, Capital Medical University, TiantanXili 6, Dongcheng District, Beijing, 100000, China
| | - Xiangyun Liao
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Xueyuan street 1068, Shenzhen University Town, Nanshan District, Shenzhen, 518000, China
| | - Chubin Ou
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Zhongshan 2nd Road 106, Yuexiu District, Guangdong, 510000, China.
| | - Weixin Si
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Xueyuan street 1068, Shenzhen University Town, Nanshan District, Shenzhen, 518000, China.
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Koopsen T, van Osta N, van Loon T, Meiburg R, Huberts W, Beela AS, Kirkels FP, van Klarenbosch BR, Teske AJ, Cramer MJ, Bijvoet GP, van Stipdonk A, Vernooy K, Delhaas T, Lumens J. Parameter subset reduction for imaging-based digital twin generation of patients with left ventricular mechanical discoordination. Biomed Eng Online 2024; 23:46. [PMID: 38741182 DOI: 10.1186/s12938-024-01232-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 04/02/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Integration of a patient's non-invasive imaging data in a digital twin (DT) of the heart can provide valuable insight into the myocardial disease substrates underlying left ventricular (LV) mechanical discoordination. However, when generating a DT, model parameters should be identifiable to obtain robust parameter estimations. In this study, we used the CircAdapt model of the human heart and circulation to find a subset of parameters which were identifiable from LV cavity volume and regional strain measurements of patients with different substrates of left bundle branch block (LBBB) and myocardial infarction (MI). To this end, we included seven patients with heart failure with reduced ejection fraction (HFrEF) and LBBB (study ID: 2018-0863, registration date: 2019-10-07), of which four were non-ischemic (LBBB-only) and three had previous MI (LBBB-MI), and six narrow QRS patients with MI (MI-only) (study ID: NL45241.041.13, registration date: 2013-11-12). Morris screening method (MSM) was applied first to find parameters which were important for LV volume, regional strain, and strain rate indices. Second, this parameter subset was iteratively reduced based on parameter identifiability and reproducibility. Parameter identifiability was based on the diaphony calculated from quasi-Monte Carlo simulations and reproducibility was based on the intraclass correlation coefficient ( ICC ) obtained from repeated parameter estimation using dynamic multi-swarm particle swarm optimization. Goodness-of-fit was defined as the mean squared error (χ 2 ) of LV myocardial strain, strain rate, and cavity volume. RESULTS A subset of 270 parameters remained after MSM which produced high-quality DTs of all patients (χ 2 < 1.6), but minimum parameter reproducibility was poor (ICC min = 0.01). Iterative reduction yielded a reproducible (ICC min = 0.83) subset of 75 parameters, including cardiac output, global LV activation duration, regional mechanical activation delay, and regional LV myocardial constitutive properties. This reduced subset produced patient-resembling DTs (χ 2 < 2.2), while septal-to-lateral wall workload imbalance was higher for the LBBB-only DTs than for the MI-only DTs (p < 0.05). CONCLUSIONS By applying sensitivity and identifiability analysis, we successfully determined a parameter subset of the CircAdapt model which can be used to generate imaging-based DTs of patients with LV mechanical discoordination. Parameters were reproducibly estimated using particle swarm optimization, and derived LV myocardial work distribution was representative for the patient's underlying disease substrate. This DT technology enables patient-specific substrate characterization and can potentially be used to support clinical decision making.
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Affiliation(s)
- Tijmen Koopsen
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.
| | - Nick van Osta
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Tim van Loon
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Roel Meiburg
- Group SIMBIOTX, Institut de Recherche en Informatique et en Automatique (INRIA), Paris, France
| | - Wouter Huberts
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Ahmed S Beela
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Cardiology, Suez Canal University, Ismailia, Egypt
| | - Feddo P Kirkels
- Division of Heart and Lungs, Department of Cardiology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Bas R van Klarenbosch
- Division of Heart and Lungs, Department of Cardiology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Arco J Teske
- Division of Heart and Lungs, Department of Cardiology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Maarten J Cramer
- Division of Heart and Lungs, Department of Cardiology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Geertruida P Bijvoet
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Cardiology, Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - Antonius van Stipdonk
- Department of Cardiology, Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - Kevin Vernooy
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Cardiology, Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
- Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tammo Delhaas
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Joost Lumens
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.
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Wołos K, Pstras L, Debowska M, Dabrowski W, Siwicka-Gieroba D, Poleszczuk J. Non-invasive assessment of stroke volume and cardiovascular parameters based on peripheral pressure waveform. PLoS Comput Biol 2024; 20:e1012013. [PMID: 38635856 PMCID: PMC11060565 DOI: 10.1371/journal.pcbi.1012013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 04/30/2024] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
Cardiovascular diseases are the leading cause of death globally, making the development of non-invasive and simple-to-use tools that bring insights into the state of the cardiovascular system of utmost importance. We investigated the possibility of using peripheral pulse wave recordings to estimate stroke volume (SV) and subject-specific parameters describing the selected properties of the cardiovascular system. Peripheral pressure waveforms were recorded in the radial artery using applanation tonometry (SphygmoCor) in 35 hemodialysis (HD) patients and 14 healthy subjects. The pressure waveforms were then used to estimate subject-specific parameters of a mathematical model of pulse wave propagation coupled with the elastance-based model of the left ventricle. Bioimpedance cardiography measurements (PhysioFlow) were performed to validate the model-estimated SV. Mean absolute percentage error between the simulated and measured pressure waveforms was 4.0% and 2.8% for the HD and control group, respectively. We obtained a moderate correlation between the model-estimated and bioimpedance-based SV (r = 0.57, p<0.05, and r = 0.58, p<0.001, for the control group and HD patients, respectively). We also observed a correlation between the estimated end-systolic elastance of the left ventricle and the peripheral systolic pressure in both HD patients (r = 0.84, p<0.001) and the control group (r = 0.70, p<0.01). These preliminary results suggest that, after additional validation and possibly further refinement to increase accuracy, the proposed methodology could support non-invasive assessment of stroke volume and selected heart function parameters and vascular properties. Importantly, the proposed method could be potentially implemented in the existing devices measuring peripheral pressure waveforms.
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Affiliation(s)
- Kamil Wołos
- Laboratory of Mathematical Modeling of Physiological Processes, Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Leszek Pstras
- Laboratory of Mathematical Modeling of Physiological Processes, Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Malgorzata Debowska
- Laboratory of Mathematical Modeling of Physiological Processes, Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Wojciech Dabrowski
- Department of Anesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | - Dorota Siwicka-Gieroba
- Department of Anesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | - Jan Poleszczuk
- Laboratory of Mathematical Modeling of Physiological Processes, Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
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Zhang Q, Zhang YH, Hao LL, Xu XH, Wu GF, Lin L, Xu XL, Qi L, Tian S. A numerical study on the siphonic effect of enhanced external counterpulsation at lower extremities with a coupled 0D-1D closed-loop personalized hemodynamics model. J Biomech 2024; 166:112057. [PMID: 38520934 DOI: 10.1016/j.jbiomech.2024.112057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/05/2024] [Accepted: 03/18/2024] [Indexed: 03/25/2024]
Abstract
Enhanced external counterpulsation (EECP) is a treatment and rehabilitation approach for ischemic diseases, including coronary artery disease. Its therapeutic benefits are primarily attributed to the improved blood circulation achieved through sequential mechanical compression of the lower extremities. However, despite the crucial role that hemodynamic effects in the lower extremity arteries play in determining the effectiveness of EECP treatment, most studies have focused on the diastole phase and ignored the systolic phase. In the present study, a novel siphon model (SM) was developed to investigate the interdependence of several hemodynamic parameters, including pulse wave velocity, femoral flow rate, the operation pressure of cuffs, and the mean blood flow changes in the femoral artery throughout EECP therapy. To verify the accuracy of the SM, we coupled the predicted afterload in the lower extremity arteries during deflation using SM with the 0D-1D patient-specific model. Finally, the simulation results were compared with clinical measurements obtained during EECP therapy to verify the applicability and accuracy of the SM, as well as the coupling method. The precision and reliability of the previously developed personalized approach were further affirmed in this study. The average waveform similarity coefficient between the simulation results and the clinical measurements during the rest state exceeded 90%. This work has the potential to enhance our understanding of the hemodynamic mechanisms involved in EECP treatment and provide valuable insights for clinical decision-making.
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Affiliation(s)
- Qi Zhang
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning 110167, China
| | - Ya-Hui Zhang
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518033, China
| | - Li-Ling Hao
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning 110167, China.
| | - Xuan-Hao Xu
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518033, China
| | - Gui-Fu Wu
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518033, China
| | - Ling Lin
- Department of Radiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518033, China
| | - Xiu-Li Xu
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518033, China.
| | - Lin Qi
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning 110167, China.
| | - Shuai Tian
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518033, China.
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Ding CCA, Dokos S, Bakir AA, Zamberi NJ, Liew YM, Chan BT, Md Sari NA, Avolio A, Lim E. Simulating impaired left ventricular-arterial coupling in aging and disease: a systematic review. Biomed Eng Online 2024; 23:24. [PMID: 38388416 PMCID: PMC10885508 DOI: 10.1186/s12938-024-01206-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/11/2024] [Indexed: 02/24/2024] Open
Abstract
Aortic stenosis, hypertension, and left ventricular hypertrophy often coexist in the elderly, causing a detrimental mismatch in coupling between the heart and vasculature known as ventricular-vascular (VA) coupling. Impaired left VA coupling, a critical aspect of cardiovascular dysfunction in aging and disease, poses significant challenges for optimal cardiovascular performance. This systematic review aims to assess the impact of simulating and studying this coupling through computational models. By conducting a comprehensive analysis of 34 relevant articles obtained from esteemed databases such as Web of Science, Scopus, and PubMed until July 14, 2022, we explore various modeling techniques and simulation approaches employed to unravel the complex mechanisms underlying this impairment. Our review highlights the essential role of computational models in providing detailed insights beyond clinical observations, enabling a deeper understanding of the cardiovascular system. By elucidating the existing models of the heart (3D, 2D, and 0D), cardiac valves, and blood vessels (3D, 1D, and 0D), as well as discussing mechanical boundary conditions, model parameterization and validation, coupling approaches, computer resources and diverse applications, we establish a comprehensive overview of the field. The descriptions as well as the pros and cons on the choices of different dimensionality in heart, valve, and circulation are provided. Crucially, we emphasize the significance of evaluating heart-vessel interaction in pathological conditions and propose future research directions, such as the development of fully coupled personalized multidimensional models, integration of deep learning techniques, and comprehensive assessment of confounding effects on biomarkers.
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Affiliation(s)
- Corina Cheng Ai Ding
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Graduate School of Biomedical Engineering, Faculty of Engineering, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Socrates Dokos
- Graduate School of Biomedical Engineering, Faculty of Engineering, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Azam Ahmad Bakir
- University of Southampton Malaysia Campus, 79200, Iskandar Puteri, Johor, Malaysia
| | - Nurul Jannah Zamberi
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Graduate School of Biomedical Engineering, Faculty of Engineering, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Yih Miin Liew
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Bee Ting Chan
- Department of Mechanical, Materials and Manufacturing Engineering, Faculty of Science and Engineering, University of Nottingham Malaysia, 43500, Selangor, Malaysia
| | - Nor Ashikin Md Sari
- Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Alberto Avolio
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Einly Lim
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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10
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Liu J, Hao L, van de Vosse F, Xu L. A noninvasive method of estimating patient-specific left ventricular pressure waveform. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 227:107192. [PMID: 36323176 DOI: 10.1016/j.cmpb.2022.107192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/16/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE The left ventricular pressure waveform is indispensable for the construction of the pressure strain loop when investigating coronary artery disease (CAD) patients. In previous studies by others, exclusion of CAD patients has not allowed a reliable estimation of the left ventricular pressure waveform from the pressure strain loop of these patients. To remedy this, we propose a patient-specific noninvasive method for the estimation of left ventricular pressure. METHODS A simplified systemic circulation model consisting primarily of a single fiber model and a 1D simulation of the arterial tree was used. Sensitivity analysis based on the Morris method was performed to select a subset of the important parameters. Following this, the important parameter subset and the set of all the parameters were identified in the model using the pressure waveform of a peripheral artery as input, in a two-step process. In addition, the left ventricular pressure waveform was estimated using the set of all parameters. RESULTS Reducing the size of the parameter subset significantly decreases the computational cost of parameter optimization in the first step and greatly simplifies the identification of the full parameter set in the second step. Comparison with the reference left ventricular pressure waveform from CAD patients, showed that the proposed method provides a good estimate of the reference left ventricular pressure waveform. The correlation coefficients between the estimated and reference were r = 0.907, r = 0.904 and r = 0.780 for systolic blood pressure, pulse pressure and mean blood pressure, respectively. CONCLUSIONS This work may provide a convenient surrogate for the estimation of the left ventricular pressure waveform.
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Affiliation(s)
- Jun Liu
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China; Department of Biomedical Engineering, China Medical University, Shenyang 110122, China
| | - Liling Hao
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China
| | - Frans van de Vosse
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven 5600MB, the Netherlands
| | - Lisheng Xu
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China; Neusoft Research of Intelligent Healthcare Technology, Co. Ltd., Shenyang 110167, China.
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11
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Zhang Q, Zhang Y, Hao L, Zhong Y, Wu K, Wang Z, Tian S, Lin Q, Wu G. A personalized 0D-1D model of cardiovascular system for the hemodynamic simulation of enhanced external counterpulsation. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 227:107224. [PMID: 36379202 DOI: 10.1016/j.cmpb.2022.107224] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/21/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE Enhanced external counterpulsation (EECP) is a non-invasive treatment modality capable of treating a variety of ischemic diseases. Currently, no effective methods of predicting the patient-specific hemodynamic effects of EECP are available. In this study, a personalized 0D-1D model of the cardiovascular system was developed for hemodynamic simulation to simulate the changes in blood flow in the EECP state and develop the best treatment protocol for each individual. METHODS A 0D-1D closed-loop model of the cardiovascular system was developed for hemodynamic simulation, consisting of a 1D wave propagation model for arteries, a 0D model for veins and capillaries, and a one-fiber model for the heart. Additionally, a simulation model coupling EECP with a 1D model was established. Physiological data, including the blood flow in different arteries, were clinically collected from 22 volunteers at rest and in the EECP state. Sensitivity analysis and a simulated annealing algorithm were used to build personalized 0D-1D models using the clinical data in the rest state as optimization objectives. Then, the clinical data on EECP were used to verify the applicability and accuracy of the personalized models. RESULTS The simulation results and clinical data were found to be in agreement for all 22 subjects, with waveform similarity coefficients (r) exceeding 90% for most arteries at rest and 80% for most arteries during EECP. CONCLUSIONS The 0D-1D closed-loop model and the optimized method can facilitate personalized modeling of the cardiovascular system using the data in the rest state and effectively predict the hemodynamic changes in the EECP state, which is significant for the numerical simulation of personalized hemodynamics. The model can also potentially be used to make decisions regarding patient-specific treatment.
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Affiliation(s)
- Qi Zhang
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning, 110167, China
| | - Yahui Zhang
- Department of Cardiology, The Eighth Affiliated Hospital Sun Yat-sen University, Shenzhen, Guangdong, 518033, China; School of Rehabilitation Sciences and Engineering, University of Health and Rehabilitation Sciences, Qingdao, Shandong, 266071, China
| | - Liling Hao
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning, 110167, China.
| | - Yujia Zhong
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning, 110167, China
| | - Kunlin Wu
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning, 110167, China
| | - Zhuo Wang
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning, 110167, China
| | - Shuai Tian
- Department of Cardiology, The Eighth Affiliated Hospital Sun Yat-sen University, Shenzhen, Guangdong, 518033, China
| | - Qi Lin
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning, 110167, China
| | - Guifu Wu
- Department of Cardiology, The Eighth Affiliated Hospital Sun Yat-sen University, Shenzhen, Guangdong, 518033, China.
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12
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Flores Gerónimo J, Keramat A, Alastruey J, Duan HF. Computational modelling and application of mechanical waves to detect arterial network anomalies: Diagnosis of common carotid stenosis. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 227:107213. [PMID: 36356386 DOI: 10.1016/j.cmpb.2022.107213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE This paper proposes a novel strategy to localize anomalies in the arterial network based on its response to controlled transient waves. The idea is borrowed from system identification theories in which wave reflections can render significant information about a target system. Cardiovascular system studies often focus on the waves originating from the heart pulsations, which are of low bandwidth and, hence, can hardly carry information about the arteries with the desired resolution. METHODS Our strategy uses a relatively higher bandwidth transient signal to characterize healthy and unhealthy arterial networks through a frequency response function (FRF). We tested our novel approach on data simulated using a one-dimensional cardiovascular model that produced pulse waves in the larger arteries of the arterial network. Specifically, we excited the blood flow from the brachial artery with a relatively high bandwidth flow disturbance and collected the subsequent pressure waveform at peripheral positions. To better differentiate FRFs of healthy and unhealthy networks, we used a FRF that removes the effects of heart pulsations. RESULTS Results demonstrate the ability of the proposed FRF to detect and follow-up on the development of a common carotid artery (CCA) stenosis. We tested distinct geometrical variations of the stenosis (size, length and position) and observed differences between the FRFs of healthy and unhealthy networks in all cases; such differences were mainly due to geometrical variations determined by the stenosis. CONCLUSIONS We have provided a theoretical proof of concept that demonstrates the ability of our novel strategy to detect and track the development of CCA stenosis by using peripheral pressure waves that can be measured non-invasively in clinical practice.
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Affiliation(s)
- Joaquín Flores Gerónimo
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Alireza Keramat
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Jordi Alastruey
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Huan-Feng Duan
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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13
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Early Diagnosis of Intracranial Internal Carotid Artery Stenosis Using Extracranial Hemodynamic Indices from Carotid Doppler Ultrasound. Bioengineering (Basel) 2022; 9:bioengineering9090422. [PMID: 36134968 PMCID: PMC9495671 DOI: 10.3390/bioengineering9090422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/11/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022] Open
Abstract
Atherosclerotic intracranial internal carotid artery stenosis (IICAS) is a leading cause of strokes. Due to the limitations of major cerebral imaging techniques, the early diagnosis of IICAS remains challenging. Clinical studies have revealed that arterial stenosis may have complicated effects on the blood flow’s velocity from a distance. Therefore, based on a patient-specific one-dimensional hemodynamic model, we quantitatively investigated the effects of IICAS on extracranial internal carotid artery (ICA) flow velocity waveforms to identify sensitive hemodynamic indices for IICAS diagnoses. Classical hemodynamic indices, including the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI), were calculated on the basis of simulations with and without IICAS. In addition, the first harmonic ratio (FHR), which is defined as the ratio between the first harmonic amplitude and the sum of the amplitudes of the 1st−20th order harmonics, was proposed to evaluate flow waveform patterns. To investigate the diagnostic performance of the indices, we included 52 patients with mild-to-moderate IICAS (<70%) in a case−control study and considered 24 patients without stenosis as controls. The simulation analyses revealed that the existence of IICAS dramatically increased the FHR and decreased the PSV and EDV in the same patient. Statistical analyses showed that the average PSV, EDV, and RI were lower in the stenosis group than in the control group; however, there were no significant differences (p > 0.05) between the two groups, except for the PSV of the right ICA (p = 0.011). The FHR was significantly higher in the stenosis group than in the control group (p < 0.001), with superior diagnostic performance. Taken together, the FHR is a promising index for the early diagnosis of IICAS using carotid Doppler ultrasound methods.
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Yang SM, Lv S, Zhang W, Cui Y. Microfluidic Point-of-Care (POC) Devices in Early Diagnosis: A Review of Opportunities and Challenges. SENSORS (BASEL, SWITZERLAND) 2022; 22:1620. [PMID: 35214519 PMCID: PMC8875995 DOI: 10.3390/s22041620] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/07/2022] [Accepted: 02/11/2022] [Indexed: 12/12/2022]
Abstract
The early diagnosis of infectious diseases is critical because it can greatly increase recovery rates and prevent the spread of diseases such as COVID-19; however, in many areas with insufficient medical facilities, the timely detection of diseases is challenging. Conventional medical testing methods require specialized laboratory equipment and well-trained operators, limiting the applicability of these tests. Microfluidic point-of-care (POC) equipment can rapidly detect diseases at low cost. This technology could be used to detect diseases in underdeveloped areas to reduce the effects of disease and improve quality of life in these areas. This review details microfluidic POC equipment and its applications. First, the concept of microfluidic POC devices is discussed. We then describe applications of microfluidic POC devices for infectious diseases, cardiovascular diseases, tumors (cancer), and chronic diseases, and discuss the future incorporation of microfluidic POC devices into applications such as wearable devices and telemedicine. Finally, the review concludes by analyzing the present state of the microfluidic field, and suggestions are made. This review is intended to call attention to the status of disease treatment in underdeveloped areas and to encourage the researchers of microfluidics to develop standards for these devices.
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Grants
- BRA2017216, BE2018627,2020THRC-GD-7, D18003, LM201603, KFKT2018001 the 333 project of Jiangsu Province in 2017, the Primary Research & Development Plan of Jiangsu Province, the Taihu Lake talent plan, the Complex and Intelligent Research Center, School of Mechanical and Power Engineering, East China University of Scien
- NSFC81971511 the National Natural Sciences Foundation of China
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Affiliation(s)
- Shih-Mo Yang
- School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China; (S.-M.Y.); (S.L.)
| | - Shuangsong Lv
- School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China; (S.-M.Y.); (S.L.)
| | - Wenjun Zhang
- Division of Biomedical Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada;
| | - Yubao Cui
- Clinical Research Center, The Affiliated Wuxi People’s Hospital, Nanjing Medical University, 299 Qingyang Road, Wuxi 214023, China
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15
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Xu K, Li B, Liu J, Chen M, Zhang L, Mao B, Xi X, Sun H, Zhang Z, Liu Y. Model-based evaluation of local hemodynamic effects of enhanced external counterpulsation. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 214:106540. [PMID: 34848079 DOI: 10.1016/j.cmpb.2021.106540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/22/2021] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVES The treatment benefits of enhanced external counterpulsation (EECP) heavily depends on hemodynamics. Global hemodynamics of EECP can cause blood flow redistribution in the circulatory system whereas local hemodynamic effects act on vascular endothelial cells (VECs). Local hemodynamic effects of EECP on VECs are important in the treatment of atherosclerosis, but currently cannot be not evaluated. Herein we aim to establish evaluation models of local hemodynamic effects based on the global hemodynamic indicators. METHODS We established 0D/3D geometric multi-scale hemodynamic models of the coronary and cerebral artery of two healthy individuals to calculate the global hemodynamic indicators and the local hemodynamic effects. Clinical EECP trials were performed to verify the accuracy of the multi-scale hemodynamic model. The global hemodynamic indicators included diastolic blood pressure/systolic blood pressure (Q = D/S), mean arterial pressure (MAP), internal carotid artery flow (ICAF) and cerebral blood flow (CBF), whereas local hemodynamic effects focused on time-averaged wall shear stress (TAWSS). The correlation between these indicators was analyzed via Pearson correlation coefficient. Significantly related indicators were selected for curve-fitting to establish evaluation models of the coronary and cerebral artery. Moreover, clinical data of a coronary heart disease patient and a cerebral ischemic stroke patient were collected to verify the effectiveness of the application of the established evaluation models to real patients. RESULTS For coronary artery, TAWSS was correlated to Q = D/S and ICAF (P < 0.05), whereas for cerebral artery, TAWSS was correlated to MAP and CBF (P < 0.05). The mean square error (MSE) between the evaluated values using evaluation model and the calculated values using 0D/3D model of TAWSS of the coronary and cerebral artery were 5.4% and 1.0%, respectively. The MSE of evaluation model applied to real patients was greater than that applied to healthy individuals, but within an acceptable range. CONCLUSIONS The presented error demonstrated validity and accuracy of the evaluation models in clinical patients. Based on the evaluation models, global hemodynamic indicators could be used to evaluate the local hemodynamic effects under the current counterpulsation mode. With TAWSS range of 4-7 Pa as the target range, EECP strategies can further be optimized.
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Affiliation(s)
- Ke Xu
- Department of Biomedical Engineering, Beijing University of Technology, Beijing 100124, China
| | - Bao Li
- Department of Biomedical Engineering, Beijing University of Technology, Beijing 100124, China.
| | - Jincheng Liu
- Department of Biomedical Engineering, Beijing University of Technology, Beijing 100124, China
| | - Mingyan Chen
- Department of Biomedical Engineering, Beijing University of Technology, Beijing 100124, China
| | - Liyuan Zhang
- Department of Biomedical Engineering, Beijing University of Technology, Beijing 100124, China
| | - Boyan Mao
- Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xiaolu Xi
- Department of Biomedical Engineering, Beijing University of Technology, Beijing 100124, China
| | - Hao Sun
- Department of Biomedical Engineering, Beijing University of Technology, Beijing 100124, China
| | - Zhe Zhang
- Peking University Third Hospital, Beijing 100080, China
| | - Youjun Liu
- Department of Biomedical Engineering, Beijing University of Technology, Beijing 100124, China
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16
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Zhou Y, He Y, Wu J, Cui C, Chen M, Sun B. A method of parameter estimation for cardiovascular hemodynamics based on deep learning and its application to personalize a reduced-order model. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2022; 38:e3533. [PMID: 34585523 DOI: 10.1002/cnm.3533] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/26/2021] [Indexed: 06/13/2023]
Abstract
Precise model personalization is a key step towards the application of cardiovascular physical models. In this manuscript, we propose to use deep learning (DL) to solve the parameter estimation problem in cardiovascular hemodynamics. Based on the convolutional neural network (CNN) and fully connected neural network (FCNN), a multi-input deep neural network (DNN) model is developed to map the nonlinear relationship between measurements and the parameters to be estimated. In this model, two separate network structures are designed to extract the features of two types of measurement data, including pressure waveforms and a vector composed of heart rate (HR) and pulse transit time (PTT), and a shared structure is used to extract their combined dependencies on the parameters. Besides, we try to use the transfer learning (TL) technology to further strengthen the personalized characteristics of a trained-well network. For assessing the proposed method, we conducted the parameter estimation using synthetic data and in vitro data respectively, and in the test with synthetic data, we evaluated the performance of the TL algorithm through two individuals with different characteristics. A series of estimation results show that the estimated parameters are in good agreement with the true values. Furthermore, it is also found that the estimation accuracy can be significantly improved by a multicycle combination strategy. Therefore, we think that the proposed method has the potential to be used for parameter estimation in cardiovascular hemodynamics, which can provide an immediate, accurate, and sustainable personalization process, and deserves more attention in the future.
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Affiliation(s)
- Yang Zhou
- School of Mechanical Engineering, Southeast University, Nanjing, China
| | - Yuan He
- Internal Medicine-Cardiovascular Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jianwei Wu
- School of Mechanical Engineering, Southeast University, Nanjing, China
| | - Chang Cui
- Internal Medicine-Cardiovascular Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Minglong Chen
- Internal Medicine-Cardiovascular Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Beibei Sun
- School of Mechanical Engineering, Southeast University, Nanjing, China
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