A real-time patient-specific treatment strategy for enhanced external counterpulsation.
enhanced external counterpulsation
haemodynamics
patient-specific treatment
real-time
wall shear stress
Journal
International journal for numerical methods in biomedical engineering
ISSN: 2040-7947
Titre abrégé: Int J Numer Method Biomed Eng
Pays: England
ID NLM: 101530293
Informations de publication
Date de publication:
26 Feb 2024
26 Feb 2024
Historique:
revised:
23
01
2024
received:
10
10
2023
accepted:
11
02
2024
medline:
27
2
2024
pubmed:
27
2
2024
entrez:
27
2
2024
Statut:
aheadofprint
Résumé
Diastolic/systolic blood pressure ratio (D/S) ≥ 1.2 is the gold standard of enhanced external counterpulsation (EECP) treatment, but it does not show a clear clinical correspondence with the configuration of the EECP mode. As such, a single target results in different treatment effects in different individuals. The local haemodynamic effect (wall shear stress, WSS) of EECP on vascular endothelial cells is conducive to promote the growth of collateral circulation vessels and restore the blood supply distal to the stenosis lesion. Considering the haemodynamic effects of WSS on human arteries, this study developed a real-time patient-specific treatment strategy of EECP for patients with cardio-cerebrovascular diseases. Based on patient-specific haemodynamic data from 113 individuals, an optimization algorithm was developed to achieve the individualization of a 0D lumped-parameter model of the human circulatory system, thereby simulating the patient-specific global haemodynamic effects. 0D/3D coupled cardio-cerebrovascular models of two subjects were established to simulate the local WSS. We then established statistical models to evaluate clinically unmeasurable WSS based on measurable global haemodynamic indicators. With the aim of attaining appropriate area- and time-averaged WSS (ATAWSS, 4-7 Pa), as evaluated by global haemodynamic indicators, a closed-loop feedback tuning method was developed to provide patient-specific EECP treatment strategies. Results showed that for clinical data collected from 113 individuals, the individualized 0D model can accurately simulate patient-specific global haemodynamic effects (average error <5%). Based on two subjects, the statistical models can be used to evaluate local ATAWSS (error <6%) for coronary arteries and for cerebral arteries. An EECP mode planned by the patient-specific treatment strategy can promote an appropriate ATAWSS within a 16 s calculation time. The real-time patient-specific treatment strategy of EECP is expected to improve the long-term outcome for each patient and have potential clinical significance.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e3808Subventions
Organisme : National Key Research and Development Program of China
ID : 2020YFC2004400
Organisme : Natural Science Foundation of Beijing Municipality
ID : 4242032
Organisme : National Natural Science Foundation of China
ID : 12202022
Organisme : National Natural Science Foundation of China
ID : 12102064
Organisme : National Natural Science Foundation of China
ID : 11832003
Organisme : National Natural Science Foundation of China
ID : 32271361
Informations de copyright
© 2024 John Wiley & Sons Ltd.
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