College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning 110167, China.
Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518033, China.
J Biomech. 2024 Mar;166:112057. doi: 10.1016/j.jbiomech.2024.112057. Epub 2024 Mar 19.
Enhanced external counterpulsation (EECP) is a treatment and rehabilitation approach for ischemic diseases, including coronary artery disease. Its therapeutic benefits are primarily attributed to the improved blood circulation achieved through sequential mechanical compression of the lower extremities. However, despite the crucial role that hemodynamic effects in the lower extremity arteries play in determining the effectiveness of EECP treatment, most studies have focused on the diastole phase and ignored the systolic phase. In the present study, a novel siphon model (SM) was developed to investigate the interdependence of several hemodynamic parameters, including pulse wave velocity, femoral flow rate, the operation pressure of cuffs, and the mean blood flow changes in the femoral artery throughout EECP therapy. To verify the accuracy of the SM, we coupled the predicted afterload in the lower extremity arteries during deflation using SM with the 0D-1D patient-specific model. Finally, the simulation results were compared with clinical measurements obtained during EECP therapy to verify the applicability and accuracy of the SM, as well as the coupling method. The precision and reliability of the previously developed personalized approach were further affirmed in this study. The average waveform similarity coefficient between the simulation results and the clinical measurements during the rest state exceeded 90%. This work has the potential to enhance our understanding of the hemodynamic mechanisms involved in EECP treatment and provide valuable insights for clinical decision-making.
体外反搏(EECP)是一种治疗和康复缺血性疾病(包括冠状动脉疾病)的方法。其治疗益处主要归因于通过对下肢进行顺序机械压缩来改善血液循环。然而,尽管下肢动脉的血液动力学效应在决定 EECP 治疗效果方面起着至关重要的作用,但大多数研究都集中在舒张期,而忽略了收缩期。在本研究中,开发了一种新的虹吸管模型(SM)来研究几个血液动力学参数之间的相互依存关系,包括脉搏波速度、股动脉流量、袖带的操作压力和股动脉的平均血流变化在整个 EECP 治疗过程中。为了验证 SM 的准确性,我们使用 SM 预测了下肢动脉在放气过程中的后负荷,并将其与 0D-1D 患者特定模型耦合。最后,将模拟结果与 EECP 治疗期间获得的临床测量值进行比较,以验证 SM 以及耦合方法的适用性和准确性。在这项研究中,进一步证实了之前开发的个性化方法的精确性和可靠性。在休息状态下,模拟结果和临床测量值之间的平均波形相似系数超过 90%。这项工作有可能增强我们对 EECP 治疗中涉及的血液动力学机制的理解,并为临床决策提供有价值的见解。