Bonnemain Jean, Pegolotti Luca, Liaudet Lucas, Deparis Simone
Adult Intensive Care and Burn Unit, University Hospital and University of Lausanne, Lausanne, Switzerland.
SCI-SB-SD, School of Basic Sciences, Ecole Polytechnique Fédérale de Lausanne, Institute of Mathematics, Lausanne, Switzerland.
Front Physiol. 2020 Sep 11;11:1086. doi: 10.3389/fphys.2020.01086. eCollection 2020.
The evaluation of cardiac contractility by the assessment of the ventricular systolic elastance function is clinically challenging and cannot be easily obtained at the bedside. In this work, we present a framework characterizing left ventricular systolic function from clinically readily available data, including systemic and pulmonary arterial pressure signals. We implemented and calibrated a deep neural network (DNN) consisting of a multi-layer perceptron with 4 fully connected hidden layers and with 16 neurons per layer, which was trained with data obtained from a lumped model of the cardiovascular system modeling different levels of cardiac function. The lumped model included a function of circulatory autoregulation from carotid baroreceptors in pulsatile conditions. Inputs for the DNN were systemic and pulmonary arterial pressure curves. Outputs from the DNN were parameters of the lumped model characterizing left ventricular systolic function, especially end-systolic elastance. The DNN adequately performed and accurately recovered the relevant hemodynamic parameters with a mean relative error of less than 2%. Therefore, our framework can easily provide complex physiological parameters of cardiac contractility, which could lead to the development of invaluable tools for the clinical evaluation of patients with severe cardiac dysfunction.
通过评估心室收缩弹性功能来评价心脏收缩力在临床上具有挑战性,且难以在床边轻易获得。在这项工作中,我们提出了一个框架,可从临床上容易获得的数据(包括体循环和肺动脉压力信号)来表征左心室收缩功能。我们实现并校准了一个深度神经网络(DNN),它由一个具有4个全连接隐藏层且每层有16个神经元的多层感知器组成,该网络使用从模拟不同心功能水平的心血管系统集总模型获得的数据进行训练。集总模型包括在脉动条件下来自颈动脉压力感受器的循环自动调节功能。DNN的输入是体循环和肺动脉压力曲线。DNN的输出是集总模型中表征左心室收缩功能(特别是收缩末期弹性)的参数。DNN表现良好,能够准确恢复相关血流动力学参数,平均相对误差小于2%。因此,我们的框架能够轻松提供心脏收缩力的复杂生理参数,这可能会推动开发用于严重心功能不全患者临床评估的宝贵工具。