title: Parametrization of an in-silico circulatory simulation by clinical datasets - towards prediction of ventricular function following assist device implantation.
abstract: BACKGROUND
  Left ventricular assist device (LVAD) therapy has revolutionized the way end stage heart failure is treated today. Analysis of LVAD interaction with the whole cardiovascular system and its biological feedback loops is often conducted by means of computer models. Generating real time pressure volume loops (PV-loops) in patients, not using conductance catheters but routine diagnostics to feed an in-silico model could help to predict postoperative complications.
  
  
  METHODS
  Routinely obtained hemodynamic measurements to evaluate myocardial function prior to LVAD implantation like pressure readings in the aorta, the left atrium and the left ventricle and simultaneous three-dimensional (3D) echocardiography recordings were assessed to parametrize a reduced computational model of the cardiovascular system. An automatic parameter identification procedure has been developed.
  
  
  RESULTS
  The results constitute a patient-individual computational simulation model. An exemplary in-silico study focusing on the effect of different ventricular assist device (VAD) speeds has been conducted. Results allow for estimation of the resulting hemodynamic parameters and changes of the PV-loops.
  
  
  CONCLUSIONS
  The model improves understanding and prediction of the interaction between pump and ventricles. Future modifications in exporting and merging routinely assessed real time hemodynamic patient data are necessary to investigate various clinical and pathological conditions of LVAD recipients.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University Hospital RWTH Aachen.
authors.forename: Ajay
authors.initials: A
authors.lastname: Moza
authors.affiliation: Institute of Automatic Control, RWTH Aachen University, Aachen.
authors.forename: Jonas
authors.initials: J
authors.lastname: Gesenhues
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University Hospital RWTH Aachen.
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Autschbach
authors.affiliation: Institute of Automatic Control, RWTH Aachen University, Aachen.
authors.forename: Dirk
authors.initials: D
authors.lastname: Abel
authors.affiliation: Department of Anaesthesiology, University Hospital RWTH Aachen.
authors.forename: Rolf
authors.initials: R
authors.lastname: Rossaint
authors.affiliation: Institute of Applied Medical Engineering, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Aachen.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schmitz-Rode
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University Hospital RWTH Aachen.
authors.forename: Andreas
authors.initials: A
authors.lastname: Goetzenich
mesh_terms: D020811:Biomedical Technology / Q000295:instrumentation; D003198:Computer Simulation; D016208:Databases, Factual; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D008955:Models, Cardiovascular; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013813:Therapy, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D016277:Ventricular Function, Left
keywords: assist device; circulatory support; simulation