Model-based evaluation of local hemodynamic effects of enhanced external counterpulsation.
Enhanced external counterpulsation
Evaluation model
Geometric multi-scale hemodynamic model
Global hemodynamic indicators
Local hemodynamic effects
Journal
Computer methods and programs in biomedicine
ISSN: 1872-7565
Titre abrégé: Comput Methods Programs Biomed
Pays: Ireland
ID NLM: 8506513
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
received:
20
07
2021
revised:
22
10
2021
accepted:
15
11
2021
pubmed:
2
12
2021
medline:
28
1
2022
entrez:
1
12
2021
Statut:
ppublish
Résumé
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. 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. 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. 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.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
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
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
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
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.
Identifiants
pubmed: 34848079
pii: S0169-2607(21)00614-3
doi: 10.1016/j.cmpb.2021.106540
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
106540Informations de copyright
Copyright © 2021 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that there is no conflict of interests of this article.