Initial clinical validation of a hybrid in silico—in vitro cardiorespiratory simulator for comprehensive testing of mechanical circulatory support systems
Simulators are expected to assume a prominent role in the process of design—development and testing of cardiovascular medical devices. For this purpose, simulators should capture the complexity of human cardiorespiratory physiology in a realistic way. High fidelity simulations of pathophysiology do...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2022.967449/full |
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| author | Libera Fresiello Libera Fresiello Kavitha Muthiah Kaatje Goetschalckx Christopher Hayward Christopher Hayward Maria Rocchi Maxime Bezy Jo P. Pauls Bart Meyns Dirk W. Donker Dirk W. Donker Krzysztof Zieliński |
| author_facet | Libera Fresiello Libera Fresiello Kavitha Muthiah Kaatje Goetschalckx Christopher Hayward Christopher Hayward Maria Rocchi Maxime Bezy Jo P. Pauls Bart Meyns Dirk W. Donker Dirk W. Donker Krzysztof Zieliński |
| author_sort | Libera Fresiello |
| collection | DOAJ |
| description | Simulators are expected to assume a prominent role in the process of design—development and testing of cardiovascular medical devices. For this purpose, simulators should capture the complexity of human cardiorespiratory physiology in a realistic way. High fidelity simulations of pathophysiology do not only allow to test the medical device itself, but also to advance practically relevant monitoring and control features while the device acts under realistic conditions. We propose a physiologically controlled cardiorespiratory simulator developed in a mixed in silico-in vitro simulation environment. As inherent to this approach, most of the physiological model complexity is implemented in silico while the in vitro system acts as an interface to connect a medical device. As case scenarios, severe heart failure was modeled, at rest and at exercise and as medical device a left ventricular assist device (LVAD) was connected to the simulator. As initial validation, the simulator output was compared against clinical data from chronic heart failure patients supported by an LVAD, that underwent different levels of exercise tests with concomitant increase in LVAD speed. Simulations were conducted reproducing the same protocol as applied in patients, in terms of exercise intensity and related LVAD speed titration. Results show that the simulator allows to capture the principal parameters of the main adaptative cardiovascular and respiratory processes within the human body occurring from rest to exercise. The simulated functional interaction with the LVAD is comparable to the one clinically observed concerning ventricular unloading, cardiac output, and pump flow. Overall, the proposed simulation system offers a high fidelity in silico-in vitro representation of the human cardiorespiratory pathophysiology. It can be used as a test bench to comprehensively analyze the performance of physically connected medical devices simulating clinically realistic, critical scenarios, thus aiding in the future the development of physiologically responding, patient-adjustable medical devices. Further validation studies will be conducted to assess the performance of the simulator in other pathophysiological conditions. |
| first_indexed | 2024-04-13T19:01:32Z |
| format | Article |
| id | doaj.art-b9c9c623888c478885eb18baae3fc76d |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-04-13T19:01:32Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-b9c9c623888c478885eb18baae3fc76d2022-12-22T02:34:05ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2022-10-011310.3389/fphys.2022.967449967449Initial clinical validation of a hybrid in silico—in vitro cardiorespiratory simulator for comprehensive testing of mechanical circulatory support systemsLibera Fresiello0Libera Fresiello1Kavitha Muthiah2Kaatje Goetschalckx3Christopher Hayward4Christopher Hayward5Maria Rocchi6Maxime Bezy7Jo P. Pauls8Bart Meyns9Dirk W. Donker10Dirk W. Donker11Krzysztof Zieliński12Cardiovascular and Respiratory Physiology, University of Twente, Enschede, NetherlandsDepartment of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, BelgiumDepartment of Cardiology, St Vincent’s Hospital, Sydney, NSW, AustraliaDepartment of Cardiovascular Diseases, University Hospitals Leuven, Leuven, BelgiumDepartment of Cardiology, St Vincent’s Hospital, Sydney, NSW, AustraliaVictor Chang Cardiac Research Institute, Sydney, NSW, AustraliaDepartment of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, BelgiumDepartment of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, BelgiumSchool of Engineering, Griffith University, Southport, QLD, AustraliaDepartment of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, BelgiumCardiovascular and Respiratory Physiology, University of Twente, Enschede, NetherlandsIntensive Care Center, University Medical Center Utrecht, Utrecht, NetherlandsNalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, PolandSimulators are expected to assume a prominent role in the process of design—development and testing of cardiovascular medical devices. For this purpose, simulators should capture the complexity of human cardiorespiratory physiology in a realistic way. High fidelity simulations of pathophysiology do not only allow to test the medical device itself, but also to advance practically relevant monitoring and control features while the device acts under realistic conditions. We propose a physiologically controlled cardiorespiratory simulator developed in a mixed in silico-in vitro simulation environment. As inherent to this approach, most of the physiological model complexity is implemented in silico while the in vitro system acts as an interface to connect a medical device. As case scenarios, severe heart failure was modeled, at rest and at exercise and as medical device a left ventricular assist device (LVAD) was connected to the simulator. As initial validation, the simulator output was compared against clinical data from chronic heart failure patients supported by an LVAD, that underwent different levels of exercise tests with concomitant increase in LVAD speed. Simulations were conducted reproducing the same protocol as applied in patients, in terms of exercise intensity and related LVAD speed titration. Results show that the simulator allows to capture the principal parameters of the main adaptative cardiovascular and respiratory processes within the human body occurring from rest to exercise. The simulated functional interaction with the LVAD is comparable to the one clinically observed concerning ventricular unloading, cardiac output, and pump flow. Overall, the proposed simulation system offers a high fidelity in silico-in vitro representation of the human cardiorespiratory pathophysiology. It can be used as a test bench to comprehensively analyze the performance of physically connected medical devices simulating clinically realistic, critical scenarios, thus aiding in the future the development of physiologically responding, patient-adjustable medical devices. Further validation studies will be conducted to assess the performance of the simulator in other pathophysiological conditions.https://www.frontiersin.org/articles/10.3389/fphys.2022.967449/fullcardiorespiratory simulatorlumped parameter model0D modelsin vitro simulatorexercise physiologyventricular assist device |
| spellingShingle | Libera Fresiello Libera Fresiello Kavitha Muthiah Kaatje Goetschalckx Christopher Hayward Christopher Hayward Maria Rocchi Maxime Bezy Jo P. Pauls Bart Meyns Dirk W. Donker Dirk W. Donker Krzysztof Zieliński Initial clinical validation of a hybrid in silico—in vitro cardiorespiratory simulator for comprehensive testing of mechanical circulatory support systems Frontiers in Physiology cardiorespiratory simulator lumped parameter model 0D models in vitro simulator exercise physiology ventricular assist device |
| title | Initial clinical validation of a hybrid in silico—in vitro cardiorespiratory simulator for comprehensive testing of mechanical circulatory support systems |
| title_full | Initial clinical validation of a hybrid in silico—in vitro cardiorespiratory simulator for comprehensive testing of mechanical circulatory support systems |
| title_fullStr | Initial clinical validation of a hybrid in silico—in vitro cardiorespiratory simulator for comprehensive testing of mechanical circulatory support systems |
| title_full_unstemmed | Initial clinical validation of a hybrid in silico—in vitro cardiorespiratory simulator for comprehensive testing of mechanical circulatory support systems |
| title_short | Initial clinical validation of a hybrid in silico—in vitro cardiorespiratory simulator for comprehensive testing of mechanical circulatory support systems |
| title_sort | initial clinical validation of a hybrid in silico in vitro cardiorespiratory simulator for comprehensive testing of mechanical circulatory support systems |
| topic | cardiorespiratory simulator lumped parameter model 0D models in vitro simulator exercise physiology ventricular assist device |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2022.967449/full |
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