Computational analysis of the hemodynamic characteristics under interaction influence of β-blocker and LVAD

Abstract

Background: Hemodynamic characteristics of the interaction influence among support level and model of LVAD, and coupling β-blocker has not been reported.

Methods: In this study, the effect of support level and model of LVAD on cardiovascular hemodynamic characteristics is investigated. In addition, the effect of β-blocker on unloading with LVAD is analyzed to elucidate the mechanism of LVAD coupling β-blocker. A multi-scale model from cell level to system level is proposed. Moreover, LVAD coupling β-blocker has been researching to explain the hemodynamics of cardiovascular system.

Results: Myocardial force was decreased along with the increase of support level of LVAD, and co-pulse mode was the lowest among the three support modes. Additionally, the β-blocker combined with LVAD significantly reduced the left ventricular volume compared with LVAD support without β-blocker. However, the left ventricular pressure under both cases has no significant difference. External work of right ventricular was increased along with the growth of support level of only LVAD. The LVAD under co-pulse mode achieved the lowest right-ventricular EW among the three support modes.

Conclusions: Co-pulse mode with β-blocker could be an optimal strategy for promoting cardiac structure and function recovery.

Keywords: Hemodynamics; Left ventricular assist devices; Multi-scale model; β-Adrenergic receptor antagonists.

Fig. 1

Schematic of multi-scale model. a Multi-scale lumped parameters model; b schematic of the interconnect model of the cardiovascular system

Fig. 2

The curve of intracellular calcium transient, left ventricular pressure and aorta pressure. a The curve of intracellular calcium transient; b the left ventricular pressure and aorta pressure

Fig. 3

The change of hemodynamics parameters along with BAI. a The change of myocardial force with BAI; b The change of right ventricular pressure with BAI; c The change of left ventricular pressure with BAI; d The change of arterial pressure with BAI

Fig. 4

The curve of pressure–volume loop. a Left ventricular PV loop with support level (BAI); b right ventricular PV loop with support level (BAI)

Fig. 5

The mean flow of aortic valve, pulsatile ratio and external work. a The mean flow of aortic valve with support level (BAI) of LVAD; b PR of pulmonary artery pressure and arterial pressure with support level (BAI); c: EW of left ventricular and right ventricular with support level (BAI)

Fig. 6

The effect of support model of LVAD on cardiovascular hemodynamic. a, b The curve of myocardical force and left ventricular pressure with support model of LVAD and LVAD coupling β-blocker at the same perfusion pressure; c and d left ventricular and right ventricular PV loop with support model and LVAD coupling β-blocker at the same perfusion pressure; e PR of pulmonary artery pressure and arterial pressure with constant speed, co-pulse and counter-pulse of LVAD at the same perfusion pressure; f EW of left ventricular and right ventricular with constant speed, co-pulse and counter-pulse of LVAD at the same perfusion pressure

Fig. 7

The mean pulsatile ratio and external work. a PR of pulmonary artery pressure with constant speed, co-pulse and counter-pulse of LVAD and LVAD with β-blocker; b PR of arterial pressure with constant speed, co-pulse and counter-pulse of LVAD and LVAD with β-blocker; c EW of left ventricular with constant speed, co-pulse and counter-pulse of LVAD and LVAD with β-blocker