title: Assessment of cardiovascular function by combining clinical data with a computational model of the cardiovascular system.
abstract: OBJECTIVE
  A sufficient understanding of patients' cardiovascular status is necessary for doctors to make the best decisions with regard to the treatment of cardiovascular disease; however, it is often not available because of the limitation of clinical measurements. The objective of this study was to examine whether cardiovascular function can be assessed quantitatively and for specific patients by combining clinical data with a computational model of the cardiovascular system.
  
  
  METHODS
  Seven consecutive patients undergoing off-pump coronary artery bypass grafting were enrolled in this study. The clinical data were collected both during the preoperative diagnosis and during the operation. Sensitivity analysis was performed to select the major model parameters most relevant to the measured data. The major model parameters were then estimated through a data-fitting procedure, enabling a patient-specific quantitative assessment of various aspects of cardiovascular function.
  
  
  RESULTS
  The results revealed the prevalence of left ventricular diastolic dysfunction in the patients, although the severity of dysfunction exhibits significant interpatient variability (the estimated left ventricular passive elastance varies from 194% to 540% of its reference value). Moreover, 4 of the 7 patients studied had impaired left ventricular systolic function.
  
  
  CONCLUSIONS
  The current study demonstrates the feasibility of assessing cardiovascular function quantitatively by combining clinical data with a cardiovascular model. In particular, the assessment utilizes the measurements already in use or available in clinical settings, enhancing the clinical potential of the proposed method.
authors.affiliation: Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan. ksughimoto@gmail.com
authors.forename: Koichi
authors.initials: K
authors.lastname: Sughimoto
authors.forename: Fuyou
authors.initials: F
authors.lastname: Liang
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Takahara
authors.forename: Kenji
authors.initials: K
authors.lastname: Mogi
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Shu
authors.initials: S
authors.lastname: Takagi
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
mesh_terms: D000368:Aged; D001795:Blood Pressure Determination; D002407:Catheterization, Swan-Ganz; D003198:Computer Simulation; D047549:Coronary Artery Bypass, Off-Pump; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D003971:Diastole; D004452:Echocardiography; D005240:Feasibility Studies; D005260:Female; D006334:Heart Function Tests; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000503:physiopathology; D016277:Ventricular Function, Left; D017725:Ventricular Pressure