title: Computational model for estimating the short- and long-term cardiac response to arteriovenous fistula creation for hemodialysis.
abstract: Creation of an arteriovenous fistula (AVF) for hemodialysis may result in cardiac failure due to dramatic increases in cardiac output. To investigate the quantitative relations between AVF flow, changes in cardiac output, myocardial stress and strain and resulting left ventricular adaptation, a computational model is developed. The model combines a one-dimensional pulse wave propagation model of the arterial network with a zero-dimensional one-fiber model of cardiac mechanics and includes adaptation rules to capture the effect of the baro-reflex and long-term structural remodelling of the left ventricle. Using generic vascular and cardiac parameters based on literature, simulations are done that illustrate the model's ability to quantitatively reproduce the clinically observed increase in brachial flow and cardiac output as well as occurence of eccentric hypertrophy. Patient-specific clinical data is needed to investigate the value of the computational model for personalized predictions.
authors.affiliation: Department of Biomedical Engineering, Maastricht University, PO Box 616, 6200 MB, Maastricht, The Netherlands. wilco.kroon@maastrichtuniversity.nl
authors.forename: Wilco
authors.initials: W
authors.lastname: Kroon
authors.forename: Marielle
authors.initials: M
authors.lastname: Bosboom
authors.forename: Wouter
authors.initials: W
authors.lastname: Huberts
authors.forename: Jan
authors.initials: J
authors.lastname: Tordoir
authors.forename: Frans
authors.initials: F
authors.lastname: van de Vosse
mesh_terms: D001166:Arteriovenous Shunt, Surgical; D002302:Cardiac Output / Q000502:physiology; D003198:Computer Simulation; D006321:Heart / Q000033:anatomy & histology / Q000502:physiology; D006801:Humans; D008955:Models, Cardiovascular; D009206:Myocardium; D006435:Renal Dialysis; D016276:Ventricular Function