Computational Study on Cardiac-Coronary Interaction in Terms of Coronary Flow-Pressure Waveforms in Presence of Drugs: Comparison Between Simulated and In Vivo Data

Cardiovascular human simulator can be a useful tool in understanding complex physiopathological process in cardiocirculatory system. It can also be a useful tool in order to investigate the effects of different drugs on hemodynamic parameters. The aim of this work is to test the potentiality of our cardiovascular numerical simulator CARDIOSIM© in reproducing flow/pressure coronary waveforms in presence of two different drugs: Amlodipine (AMLO) and Adenosine (ADO). In particular a time-varying intramyocardial compression, assumed to be proportional to the left ventricular pressure, was related to the venous coronary compliances in order to study its effects on the coronary blood flow and the flow/pressure loop. Considering that coronary circulation dynamics is strongly interrelated with the mechanics of the left ventricular contraction, relaxation, and filling, the numerical model allowed to analyze the effects induced by the left ventricular pressure on the coronary flow.




References:
[1] R.B. Colquitt, D.A. Colquhoun, R.H. Thiele, In silico modelling of
physiologic systems, Best Practice & Research Clinical
Anaesthesiology, vol. 25, pp. 499-510, 2011.
[2] C. De Lazzari, Modelling Cardiovascular System and Mechanical
Circulatory Support. Rome: National Research Council, 2007.
[3] C. De Lazzari, Interaction between the septum and the left (right)
ventricular free wall in order to evaluate the effects on coronary blood
flow: numerical simulation, Comput Methods Biomech Biomed Engin.,
pp. 1-10, Aug. 2011, doi: 10.1080/10255842.2011.597354.
[4] G.S. Aldea, H. Mori, W.K. Husseini, R.E. Austin, and J.I.E. Hoffman,
Effects of increased pressure inside or outside ventricles on total and
regional myocardial blood flow, Am J Physiol Heart Circ Physiol, vol.
279, pp. H2927-H2938, July 2000.
[5] C. De Lazzari, A. L-Abbate, M. Micalizzi, M.G. Trivella and D. Neglia,
Effects of Amlodipine and Adenosine on coronary hemodynamics: in
vivo study and numerical simulation, Comput Methods Biomech Biomed
Engin., in press.
[6] R. Krams, F.J Ten Cate, S.G. Carlier, A.F.W. van der Steen, P.W.
Serruys, Diastolic Coronary Vascular Reserve: A New Index to Detect
Changes in the Coronary Microcirculation in Hypertrophic
Cardiomyopathy, J Am Coll Cardiol, vol. 43, pp. 670-677, 2004.
[7] C. Di Mario, R. Kramas, R. Gil, P.W. Serruys, Slope of the
instantaneous hyperemic diastolic coronary flow velocity-pressure
relation. A new index for assessment of the physiological significance of
coronary stenosis in humans, Circulation, vol. 90, pp. 1215-24, 1994.
[8] C. De Lazzari, D. Neglia, G. Ferrari, F. Bernini, M. Micalizzi, A.
L-Abbate, M.G. Trivella, Computer simulation of coronary flow
waveforms during caval occlusion, Methods Inf Med, vol. 48 pp. 113-
122, 2009.
[9] C. De Lazzari, M. Darowski, P. Wolski, G. Ferrari, G. Tosti, D.M.
Pisanelli, In Vivo and Simulation Study of Artificial Ventilation Effects
on Energetic Variables in Cardiosurgical Patients. Methods Inf Med, vol.
44-(1), pp. 98-105, 2005.
[10] C. De Lazzari, M. Darowski, G. Ferrari, D.M. Pisanelli, G. Tosti,
Modelling in the study of interaction of Hemopump device and artificial
ventilation, Comput Biol Med; vol. 36-(11), pp. 1235-51, 2006.
[11] K. Sagawa, W.L. Maughan, H. Suga, K. Sunagawa, Cardiac contraction
and the Pressure-Volume relationships, New York: Oxford University
Press, 1988.
[12] W.L. Maughan, K. Sunagawa and K. Sagawa K, Ventricular systolic
interdependence: volume elastance model in isolated canine hearts, Am J
Physiol Heart Circ Physiol, vol. 253, pp.H1381-H1390, 1987.
[13] C. De Lazzari, A. Di Molfetta, L. Fresiello, Comprehensive models of
cardiovascular and respiratory system. Their mechanical support and
interactions. New York: Nova Science, 2009, ch. 2.
[14] J.A. Spaan, N.P. Nreuls, J.D. Laird, Diastolic-systolic coronary flow
differences are caused by intramyocardial pump action in the
anesthetized dog, Circ Res, vol. 49, pp. 584-593, 1981.
[15] C. Di Mario, R. Kramas, R. Gil, P.W. Serruys, Slope of the
instantaneous hyperemic diastolic coronary flow velocity-pressure
relation. A new index for assessment of the physiological significance of
coronary stenosis in humans, Circulation, vol. 90, pp. 1215-1224, 1994.
[16] J.A. Spaan, J.J. Piek, J.I.E. Hoffman and M. Siebes, Physiological basis
of clinically used coronary hemodynamic indices, Circulation, vol. 113,
pp. 446-455, 2006.