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引用次数: 0
摘要
机械循环支持是治疗方坦衰竭患者的一种潜在方法。在这项研究中,我们使用计算模型进行了理论分析,以明确全身性心室辅助装置(VAD)对衰竭的丰坦患者的影响。心腔和血管系统分别使用时变弹性模型和改进的 Windkessel 模型进行描述。VAD 被模拟为非线性函数。在收缩期和舒张期心室功能障碍及房室瓣反流模型中,全身性 VAD 增加了心脏指数,降低了中心静脉压(CVP)。然而,在高肺血管阻力模型中,当肺血管阻力指数(PVRI)超过 5 Wood 单位 m2 时,CVP 会变得非常高,超过 15 mmHg 才能维持心脏指数。对于心室功能不全或房室瓣反流的丰坦患者,系统性 VAD 可有效改善血液动力学。对于 PVRI > 5 伍德单位平方米的丰坦患者,全身 VAD 似乎无效。
Effects of systemic ventricular assist in failing Fontan patients: a theoretical analysis using a computational model.
Mechanical circulatory support is a potential treatment for failing Fontan patients. In this study, we performed a theoretical analysis using a computational model to clarify the effects of systemic ventricular assist device (VAD) in failing Fontan patients. Cardiac chambers and vascular systems were described using the time-varying elastance model and modified Windkessel model, respectively. A VAD was simulated as a nonlinear function. In systolic and diastolic ventricular dysfunction and atrioventricular valve regurgitation models, systemic VAD increased the cardiac index and decreased the central venous pressure (CVP). However, in the high pulmonary vascular resistance model, CVP became extremely high above 15 mmHg to maintain the cardiac index when the pulmonary vascular resistance index (PVRI) was above 5 Wood units m2. In Fontan patients with ventricular dysfunction or atrioventricular valve regurgitation, systemic VAD efficiently improves the hemodynamics. In Fontan patients with PVRI of > 5 Wood units m2, systemic VAD seems ineffective.
期刊介绍:
The Journal of Physiological Sciences publishes peer-reviewed original papers, reviews, short communications, technical notes, and letters to the editor, based on the principles and theories of modern physiology and addressed to the international scientific community. All fields of physiology are covered, encompassing molecular, cellular and systems physiology. The emphasis is on human and vertebrate physiology, but comparative papers are also considered. The process of obtaining results must be ethically sound.
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Biophysics
Cell sensors and signaling
Central nervous system and brain sciences
Endocrinology and metabolism
Excitable membranes and neural cell physiology
Exercise physiology
Gastrointestinal and kidney physiology
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Molecular and cellular physiology
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Physiome/systems biology
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Senses.