IABP timing and ventricular performance - Comparison between a compliant and a stiffer aorta: A hybrid model study including baroreflex

Libera Fresiello, Ashraf W. Khir, Arianna Di Molfetta, Maciej Kozarski, Gianfranco Ferrari

Research output: Contribution to journalArticle

Abstract

Introduction: The aim of this study was to investigate the effects of the intra aortic balloon pump (IABP) and of aortic compliance on left ventricular performance, including the effects of baroreflex control. Methods: The study was conducted using a hybrid cardiovascular simulator, including a computational cardiovascular sub-model, a hydraulic sub-model of the descending aorta, and a baroreflex computational sub-model. A 40 cc balloon was inserted into a rubber tube component of the hydraulic sub-model. A comparative analysis was conducted for two aortic compliances (C1 = 2.4 and C2 = 1.43 cm3/mmHg, corresponding to an aortic pulse pressure of 23 mmHg and 35 mmHg, respectively), driving the balloon for different trigger timings. Results: Under C1 conditions, the IABP induced higher effects on baroreflex activity (decrement of sympathetic efferent activity: 10% for C1 and 14.7% for C2) and ventricular performance (increment of cardiac output (CO): 3.7% for C1 and 5.2% for C2, increment of endocardial viability ratio (EVR): 24.8% for C1 and 55% for C2). The best balloon timing was different for C1 and C2: inflation trigger timing (from the dicrotic notch) -0.09 s for C1 and -0.04 s for C2, inflation duration 0.25 s for C1 and 0.2 s for C2. Conclusions: Early inflation ensures better EVR, CO, and an increment of the afferent nerve activity, hence causing peripheral resistance and heart rate to decrease. The best balloon timing depends on aortic compliance, thus suggesting the need for a therapy tailored to the specific conditions of individual patients.

Original languageEnglish
Pages (from-to)749-757
Number of pages9
JournalInternational Journal of Artificial Organs
Volume36
Issue number11
DOIs
Publication statusPublished - Nov 2013

Fingerprint

Baroreflex
Balloons
Economic Inflation
Compliance
Aorta
Pumps
Cardiac Output
Cardiovascular Models
Rubber
Thoracic Aorta
Vascular Resistance
Arterial Pressure
Heart Rate
Hydraulics
Simulators
Therapeutics

Keywords

  • Baroreflex
  • Cardiovascular lumped parameter model
  • Hybrid model
  • IABP

ASJC Scopus subject areas

  • Biomaterials
  • Biomedical Engineering
  • Bioengineering
  • Medicine (miscellaneous)

Cite this

IABP timing and ventricular performance - Comparison between a compliant and a stiffer aorta : A hybrid model study including baroreflex. / Fresiello, Libera; Khir, Ashraf W.; Di Molfetta, Arianna; Kozarski, Maciej; Ferrari, Gianfranco.

In: International Journal of Artificial Organs, Vol. 36, No. 11, 11.2013, p. 749-757.

Research output: Contribution to journalArticle

Fresiello, Libera ; Khir, Ashraf W. ; Di Molfetta, Arianna ; Kozarski, Maciej ; Ferrari, Gianfranco. / IABP timing and ventricular performance - Comparison between a compliant and a stiffer aorta : A hybrid model study including baroreflex. In: International Journal of Artificial Organs. 2013 ; Vol. 36, No. 11. pp. 749-757.
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AB - Introduction: The aim of this study was to investigate the effects of the intra aortic balloon pump (IABP) and of aortic compliance on left ventricular performance, including the effects of baroreflex control. Methods: The study was conducted using a hybrid cardiovascular simulator, including a computational cardiovascular sub-model, a hydraulic sub-model of the descending aorta, and a baroreflex computational sub-model. A 40 cc balloon was inserted into a rubber tube component of the hydraulic sub-model. A comparative analysis was conducted for two aortic compliances (C1 = 2.4 and C2 = 1.43 cm3/mmHg, corresponding to an aortic pulse pressure of 23 mmHg and 35 mmHg, respectively), driving the balloon for different trigger timings. Results: Under C1 conditions, the IABP induced higher effects on baroreflex activity (decrement of sympathetic efferent activity: 10% for C1 and 14.7% for C2) and ventricular performance (increment of cardiac output (CO): 3.7% for C1 and 5.2% for C2, increment of endocardial viability ratio (EVR): 24.8% for C1 and 55% for C2). The best balloon timing was different for C1 and C2: inflation trigger timing (from the dicrotic notch) -0.09 s for C1 and -0.04 s for C2, inflation duration 0.25 s for C1 and 0.2 s for C2. Conclusions: Early inflation ensures better EVR, CO, and an increment of the afferent nerve activity, hence causing peripheral resistance and heart rate to decrease. The best balloon timing depends on aortic compliance, thus suggesting the need for a therapy tailored to the specific conditions of individual patients.

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