Abstract
This study presents a numerical simulation of cardiovascular response in the heart failure condition under the support of a Berlin Heart INCOR impeller pump-type ventricular assist device (VAD). The model is implemented using the CellML modelling language. To investigate the potential of using the Berlin Heart INCOR impeller pump to produce physiologically meaningful arterial pulse pressure within the various physiological constraints, a series of VAD-assisted cardiovascular cases are studied, in which the pulsation ratio and the phase shift of the VAD motion profile are systematically changed to observe the cardiovascular responses in each of the studied cases. An optimization process is proposed, including the introduction of a cost function to balance the importance of the characteristic cardiovascular variables. Based on this cost function it is found that a pulsation ratio of 0.35 combined with a phase shift of 200° produces the optimal cardiovascular response, giving rise to a maximal arterial pulse pressure of 12.6 mm Hg without inducing regurgitant pump flow while keeping other characteristic cardiovascular variables within appropriate physiological ranges.
Highlights
Numerical simulation has been extensively applied to the study of cardiovascular dynamics in heart failure under support with a ventricular assist device (VAD), and this has greatly promoted the design and analysis of VADs to achieve optimized cardiovascular response
It is widely recognized that pulsatile flow has an important effect on circulation physiology: it promotes kidney and liver perfusion, and promotes microcirculation at the cell level, which is important in the early treatment of acute heart failure [2,3]
The numerical model described in Shi et al [11] is used to study the cardiovascular response in a heart failure condition under the support of a Berlin Heart INCOR impeller pump, and to optimize a simple control algorithm against the proposed cost function
Summary
Numerical simulation has been extensively applied to the study of cardiovascular dynamics in heart failure under support with a ventricular assist device (VAD), and this has greatly promoted the design and analysis of VADs to achieve optimized cardiovascular response. To evaluate the performance of VAD support and the effect of VAD interaction with the native cardiovascular system, it is necessary to determine which quantitative physiological criteria—including cardiac output, pressures in various parts of the circulation system, the balance of blood distribution between the systemic and the pulmonary circulation loops, the metabolic requirements of peripheral organs, the perfusion pressure of vital organs (such as brain and kidney) and VAD energy consumption—should be used to compare cardiovascular response under different VAD control strategies Those strategies that produce optimal performance against one of the physiological criteria offer degraded performance against others. The numerical model described in Shi et al [11] is used to study the cardiovascular response in a heart failure condition under the support of a Berlin Heart INCOR impeller pump, and to optimize a simple control algorithm against the proposed cost function Another difficulty that is faced when evaluating and integrating published results from different modelling groups is that rarely are the ranges of operation or the model implementations directly comparable. In the interests of transparency and portability, the CellML implementation of the model on which this paper is based has been made publicly available from the CellML model repository
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