Med Biol Eng Comput - Computational model for estimating the short- and long-term cardiac response to arteriovenous fistula creation for hemodialysis.

Tópicos

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Resumo

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.

Resumo Limpo

creation arterioven fistula avf hemodialysi may result cardiac failur due dramat increas cardiac output investig quantit relat avf flow chang cardiac output myocardi stress strain result left ventricular adapt comput model develop model combin onedimension puls wave propag model arteri network zerodimension onefib model cardiac mechan includ adapt rule captur effect baroreflex longterm structur remodel left ventricl use generic vascular cardiac paramet base literatur simul done illustr model abil quantit reproduc clinic observ increas brachial flow cardiac output well occur eccentr hypertrophi patientspecif clinic data need investig valu comput model person predict

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