Karamolegkos Nikolaos, Albanese Antonio, Chbat Nicolas W
Columbia University New York NY 10027 USA.
Quadrus Medical Technologies White Plains NY 10607 USA.
IEEE Open J Eng Med Biol. 2021 Nov 17;2:324-341. doi: 10.1109/OJEMB.2021.3128629. eCollection 2021.
Heart-lung interaction mechanisms are generally not well understood. Mechanical ventilation, for example, accentuates such interactions and could compromise cardiac activity. Thereby, assessment of ventilation-induced changes in cardiac function is considered an unmet clinical need. We believe that mathematical models of the human cardiopulmonary system can provide invaluable insights into such cardiorespiratory interactions. In this article, we aim to use a mathematical model to explain heart-lung interaction phenomena and provide physiologic hypotheses to certain contradictory experimental observations during mechanical ventilation. To accomplish this task, we highlight three model components that play a crucial role in heart-lung interactions: 1) pericardial membrane, 2) interventricular septum, and 3) pulmonary circulation that enables pulmonary capillary compression due to lung inflation. Evaluation of the model's response under simulated ventilation scenarios shows good agreement with experimental data from the literature. A sensitivity analysis is also presented to evaluate the relative impact of the model's highlighted components on the cyclic ventilation-induced changes in cardiac function.
心肺相互作用机制通常尚未得到充分理解。例如，机械通气会加剧这种相互作用，并可能损害心脏活动。因此，评估通气引起的心脏功能变化被认为是一项尚未满足的临床需求。我们认为，人体心肺系统的数学模型可以为这种心肺相互作用提供宝贵的见解。在本文中，我们旨在使用数学模型来解释心肺相互作用现象，并为机械通气期间某些相互矛盾的实验观察结果提供生理学假设。为完成这项任务，我们重点介绍了在心肺相互作用中起关键作用的三个模型组件：1）心包膜，2）室间隔，3）由于肺膨胀而导致肺毛细血管受压的肺循环。对模拟通气场景下模型反应的评估与文献中的实验数据显示出良好的一致性。还进行了敏感性分析，以评估模型中突出组件对通气引起的心脏功能周期性变化的相对影响。
