An in vitro model to study suction events by a ventricular assist device: validation with clinical data

被引:3
|
作者
Rocchi, Maria [1 ]
Gross, Christoph [2 ,3 ]
Moscato, Francesco [3 ,4 ,5 ]
Schloeglhofer, Thomas [2 ,3 ,4 ]
Meyns, Bart [1 ,6 ]
Fresiello, Libera [1 ,7 ]
机构
[1] Katholieke Univ Leuven, Dept Cardiovasc Sci, Unit Cardiac Surg, Leuven, Belgium
[2] Med Univ Vienna, Dept Cardiac Surg, Vienna, Austria
[3] Med Univ Vienna, Ctr Med Phys & Biomed Engn, Vienna, Austria
[4] Ludwig Boltzmann Inst Cardiovasc Res, Vienna, Austria
[5] Austrian Cluster Tissue Regenerat, Vienna, Austria
[6] Univ Hosp Leuven, Dept Cardiac Surg, Leuven, Belgium
[7] Univ Twente, Cardiovasc & Resp Physiol, Enschede, Netherlands
基金
奥地利科学基金会;
关键词
ventricular assist device; suction; cardiovascular simulator; hybrid simulator; physiological controllers; validation; PHYSIOLOGICAL CONTROL-SYSTEMS; ROTARY BLOOD PUMPS;
D O I
10.3389/fphys.2023.1155032
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
Introduction: Ventricular assist devices (LVADs) are a valuable therapy for end-stage heart failure patients. However, some adverse events still persist, such as suction that can trigger thrombus formation and cardiac rhythm disorders. The aim of this study is to validate a suction module (SM) as a test bench for LVAD suction detection and speed control algorithms.Methods: The SM consists of a latex tube, mimicking the ventricular apex, connected to a LVAD. The SM was implemented into a hybrid in vitro-in silico cardiovascular simulator. Suction was induced simulating hypovolemia in a profile of a dilated cardiomyopathy and of a restrictive cardiomyopathy for pump speeds ranging between 2,500 and 3,200 rpm. Clinical data collected in 38 LVAD patients were used for the validation. Clinical and simulated LVAD flow waveforms were visually compared. For a more quantitative validation, a binary classifier was used to classify simulated suction and non-suction beats. The obtained classification was then compared to that generated by the simulator to evaluate the specificity and sensitivity of the simulator. Finally, a statistical analysis was run on specific suction features (e.g., minimum impeller speed pulsatility, minimum slope of the estimated flow, and timing of the maximum slope of the estimated flow).Results: The simulator could reproduce most of the pump waveforms observed in vivo. The simulator showed a sensitivity and specificity and of 90.0% and 97.5%, respectively. Simulated suction features were in the interquartile range of clinical ones.Conclusions: The SM can be used to investigate suction in different pathophysiological conditions and to support the development of LVAD physiological controllers.
引用
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页数:10
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