Monitoring of cardiovascular physiology augmented by a patient-specific biomechanical model during general anesthesia. A proof of concept study
Arthur Le Gall,Fabrice Vallée,Kuberan Pushparajah,Tarique Hussain,Alexandre Mebazaa,Dominique Chapelle,Dominique Chapelle,Etienne Gayat,Radomir Chabiniok +8 more
TLDR
This work demonstrated the application of fast-running patient-specific biophysical models to estimate PV loops and functional indicators of CV system using clinical data available during GA, paving the way for model-augmented hemodynamic monitoring at operating theatres or intensive care units to enhance the information on patient- specific physiology.Abstract:
During general anesthesia (GA), direct analysis of arterial pressure or aortic flow waveforms may be inconclusive in complex situations. Patient-specific biomechanical models, based on data obtained during GA and capable to perform fast simulations of cardiac cycles, have the potential to augment hemodynamic monitoring. Such models allow to simulate Pressure-Volume (PV) loops and estimate functional indicators of cardiovascular (CV) system, e.g. ventricular-arterial coupling (Vva), cardiac efficiency (CE) or myocardial contractility, evolving throughout GA. In this prospective observational study, we created patient-specific biomechanical models of heart and vasculature of a reduced geometric complexity for n = 45 patients undergoing GA, while using transthoracic echocardiography and aortic pressure and flow signals acquired in the beginning of GA (baseline condition). If intraoperative hypotension (IOH) appeared, diluted norepinephrine (NOR) was administered and the model readjusted according to the measured aortic pressure and flow signals. Such patients were a posteriori assigned into a so-called hypotensive group. The accuracy of simulated mean aortic pressure (MAP) and stroke volume (SV) at baseline were in accordance with the guidelines for the validation of new devices or reference measurement methods in all patients. After NOR administration in the hypotensive group, the percentage of concordance with 10% exclusion zone between measurement and simulation was >95% for both MAP and SV. The modeling results showed a decreased Vva (0.64±0.37 vs 0.88±0.43; p = 0.039) and an increased CE (0.8±0.1 vs 0.73±0.11; p = 0.042) in hypotensive vs normotensive patients. Furthermore, Vva increased by 92±101%, CE decreased by 13±11% (p < 0.001 for both) and contractility increased by 14±11% (p = 0.002) in the hypotensive group post-NOR administration. In this work we demonstrated the application of fast-running patient-specific biophysical models to estimate PV loops and functional indicators of CV system using clinical data available during GA. The work paves the way for model-augmented hemodynamic monitoring at operating theatres or intensive care units to enhance the information on patient-specific physiology.read more
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Biomechanical Modeling to Inform Pulmonary Valve Replacement in Tetralogy of Fallot Patients After Complete Repair
Maria Gusseva,Maria Gusseva,Tarique Hussain,Camille L. Hancock Friesen,Philippe Moireau,Philippe Moireau,Animesh Tandon,Cécile Patte,Cécile Patte,Martin Genet,Martin Genet,Keren Hasbani,Gerald F. Greil,Dominique Chapelle,Dominique Chapelle,Radomir Chabiniok +15 more
TL;DR: In this article, a biomechanical model of the heart can be used to incorporate multiple data sources (ECG, imaging, invasive hemodynamics) to assess comparative influences of residual right ventricular outflow tract obstruction and pulmonary regurgitation on ventricular health.
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Salt and drought stress tolerance with increased biomass in transgenic Pelargonium graveolens through heterologous expression of ACC deaminase gene from Achromobacter xylosoxidans
Pooja Singh,Shiv Shanker Pandey,Basant Kumar Dubey,Rashmi Raj,Deepti Barnawal,Ashish Chandran,Laiq ur Rahman +6 more
TL;DR: The transgenic P. graveolens showed enhanced tolerance to salt and drought stress as reflected as a result of higher leaf RWC, chlorophyll content, photosynthetic parameter, accumulation of proline and more antioxidant activity.
Journal ArticleDOI
Combining data assimilation and machine learning to build data-driven models for unknown long time dynamics-Applications in cardiovascular modeling.
Francesco Regazzoni,Francesco Regazzoni,Francesco Regazzoni,Dominique Chapelle,Dominique Chapelle,Philippe Moireau,Philippe Moireau +6 more
TL;DR: In this paper, the authors propose a method to discover differential equations describing the long-term dynamics of phenomena featuring a multiscale behavior in time, starting from measurements taken at the fast-scale.
Journal ArticleDOI
Coupling reduced-order blood flow and cardiac models through energy-consistent strategies: modeling and discretization
Jessica Manganotti,Jessica Manganotti,Federica Caforio,Federica Caforio,Federica Caforio,François Kimmig,François Kimmig,Philippe Moireau,Philippe Moireau,Sébastien Imperiale,Sébastien Imperiale +10 more
TL;DR: In this paper, an energy-consistent formulation for the classical 1D formulation of blood flow in an arterial segment is presented. But the authors do not consider the effect of the actin-myosin interaction.
Journal ArticleDOI
Prediction of Ventricular Mechanics After Pulmonary Valve Replacement in Tetralogy of Fallot by Biomechanical Modeling: A Step Towards Precision Healthcare.
Maria Gusseva,Maria Gusseva,Tarique Hussain,Camille Hancock Friesen,Gerald F. Greil,Dominique Chapelle,Dominique Chapelle,Radomir Chabiniok +7 more
TL;DR: In this article, the authors explored the ability of biomechanical modeling to predict the response of ventricular mechanics to the progressively decreasing afterload in repaired tetralogy of fallot (rTOF) patients undergoing pulmonary valve replacement (PVR) for significant residual right ventricular outflow tract obstruction (RVOTO).
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