title: A cardiovascular simulator tailored for training and clinical uses.
abstract: OBJECTIVE
  In the present work a cardiovascular simulator designed both for clinical and training use is presented.
  
  
  METHODS
  The core of the simulator is a lumped parameter model of the cardiovascular system provided with several modules for the representation of baroreflex control, blood transfusion, ventricular assist device (VAD) therapy and drug infusion. For the training use, a Pre-Set Disease module permits to select one or more cardiovascular diseases with a different level of severity. For the clinical use a Self-Tuning module was implemented. In this case, the user can insert patient's specific data and the simulator will automatically tune its parameters to the desired hemodynamic condition. The simulator can be also interfaced with external systems such as the Specialist Decision Support System (SDSS) devoted to address the choice of the appropriate level of VAD support based on the clinical characteristics of each patient.
  
  
  RESULTS
  The Pre-Set Disease module permits to reproduce a wide range of pre-set cardiovascular diseases involving heart, systemic and pulmonary circulation. In addition, the user can test different therapies as drug infusion, VAD therapy and volume transfusion. The Self-Tuning module was tested on six different hemodynamic conditions, including a VAD patient condition. In all cases the simulator permitted to reproduce the desired hemodynamic condition with an error<10%.
  
  
  CONCLUSIONS
  The cardiovascular simulator could be of value in clinical arena. Clinicians and students can utilize the Pre-Set Diseases module for training and to get an overall knowledge of the pathophysiology of common cardiovascular diseases. The Self-Tuning module is prospected as a useful tool to visualize patient's status, test different therapies and get more information about specific hemodynamic conditions. In this sense, the simulator, in conjunction with SDSS, constitutes a support to clinical decision - making.
authors.affiliation: Department of Cardiac Surgery, Catholic University of Leuven, Leuven, Belgium; Institute of Clinical Physiology of the National Research Council, Rome and Pisa, Italy. Electronic address: libera.fresiello@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Fresiello
authors.affiliation: Institute of Clinical Physiology of the National Research Council, Rome and Pisa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ferrari
authors.affiliation: Institute of Clinical Physiology of the National Research Council, Rome and Pisa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Di Molfetta
authors.affiliation: Nałęcz Institute of Biocybernetics and Biomedical Engineering Polish Academy of Sciences, Warsaw, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Zieliński
authors.affiliation: Biomedical Research Institute-FORTH, Ioannina, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Tzallas
authors.affiliation: Department of Cardiac Surgery, Catholic University of Leuven, Leuven, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Jacobs
authors.affiliation: Nałęcz Institute of Biocybernetics and Biomedical Engineering Polish Academy of Sciences, Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Darowski
authors.affiliation: Nałęcz Institute of Biocybernetics and Biomedical Engineering Polish Academy of Sciences, Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Kozarski
authors.affiliation: Department of Cardiac Surgery, Catholic University of Leuven, Leuven, Belgium.
authors.forename: B
authors.initials: B
authors.lastname: Meyns
authors.affiliation: Biomedical Research Institute-FORTH, Ioannina, Greece.
authors.forename: N S
authors.initials: NS
authors.lastname: Katertsidis
authors.affiliation: Biomedical Research Institute-FORTH, Ioannina, Greece.
authors.forename: E C
authors.initials: EC
authors.lastname: Karvounis
authors.affiliation: Biomedical Research Institute-FORTH, Ioannina, Greece.
authors.forename: M G
authors.initials: MG
authors.lastname: Tsipouras
authors.affiliation: Institute of Clinical Physiology of the National Research Council, Rome and Pisa, Italy.
authors.forename: M G
authors.initials: MG
authors.lastname: Trivella
mesh_terms: D003198:Computer Simulation; D020000:Decision Support Systems, Clinical; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D008955:Models, Cardiovascular; D012984:Software
keywords: Cardiovascular simulator; Decision support system; Training tool; Ventricular assist device