title: Automated drug delivery system for the management of hemodynamics and cardiac energetic in acute heart failure.
abstract: We have developed a novel automated drug delivery system for simultaneous control of systemic arterial pressure (AP), cardiac output (CO), and left atrial pressure (P(LA)) in acute heart failure. The circulatory equilibrium framework we established previously discloses that AP, CO, and P(LA) are determined by equilibrium of the mechanical properties of the circulation, i.e. pumping ability of the left heart, stressed blood volume and systemic arterial resistance. Our system directly controls the three mechanical properties with cardiovascular drugs including inotropes and vasodilators, thereby controlling AP, CO, and P(LA). Furthermore, by precisely controlling bradycardia and LV inotropy, our system enables to improve cardiac energetic efficiency while preserving AP, CO, and P(LA) within acceptable ranges. In conclusion, by directly controlling the mechanical properties of the heart and vessel, our automated system realizes comprehensive management of hemodynamics in acute heart failure.
authors.affiliation: National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka 5658565, Japan. kuemura@ri.ncvc.go.jp
authors.forename: Kazunori
authors.initials: K
authors.lastname: Uemura
authors.forename: Masaru
authors.initials: M
authors.lastname: Sugimachi
authors.forename: Toru
authors.initials: T
authors.lastname: Kawada
authors.forename: Kenji
authors.initials: K
authors.lastname: Sunagawa
mesh_terms: D000208:Acute Disease; D000818:Animals; D001331:Automation; D001919:Bradycardia / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D002302:Cardiac Output / Q000187:drug effects; D003198:Computer Simulation; D003911:Dextrans / Q000494:pharmacology / Q000627:therapeutic use; D004280:Dobutamine / Q000494:pharmacology / Q000627:therapeutic use; D004285:Dogs; D016503:Drug Delivery Systems / Q000379:methods*; D004621:Embolization, Therapeutic; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D006334:Heart Function Tests / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000502:physiology*; D009599:Nitroprusside / Q000494:pharmacology / Q000627:therapeutic use; D013599:Systole / Q000187:drug effects; D013997:Time Factors
chemical_list: D003911:Dextrans; D009599:Nitroprusside; D004280:Dobutamine