School of Electronic Information, Wuhan University, Wuhan, Hubei, 430072, People's Republic of China.
The Advanced Technology Research Institute, University of Science and Technology of China, and Anhui Tongling Bionic Technology Co., Hefei, Anhui, 230026, People's Republic of China.
Physiol Meas. 2024 May 3;45(5). doi: 10.1088/1361-6579/ad3d29.
Significant aortic regurgitation is a common complication following left ventricular assist device (LVAD) intervention, and existing studies have not attempted to monitor regurgitation signals and undertake preventive measures during full support. Regurgitation is an adverse event that can lead to inadequate left ventricular unloading, insufficient peripheral perfusion, and repeated episodes of heart failure. Moreover, regurgitation occurring during full support due to pump position offset cannot be directly controlled through control algorithms. Therefore, accurate estimation of regurgitation during percutaneous left ventricular assist device (PLVAD) full support is critical for clinical management and patient safety.An estimation system based on the regurgitation model is built in this paper, and the unscented Kalman filter estimator (UKF) is introduced as an estimation approach. Three offset degrees and three heart failure states are considered in the investigation. Using the mock circulatory loop experimental platform, compare the regurgitation estimated by the UKF algorithm with the actual measured regurgitation; the errors are analyzed using standard confidence intervals of ±2 SDs, and the effectiveness of the mentioned algorithms is thus assessed. The generalization ability of the proposed algorithm is verified by setting different heart failure conditions and different rotational speeds. The root mean square error and correlation coefficient between the estimated and actual values are quantified and the statistical significance of accuracy differences in estimation is illustrated using one-way analysis of variance (One-Way ANOVA), which in turn assessed the accuracy and stability of the UKF algorithm.The research findings demonstrate that the regurgitation estimation system based on the regurgitation model and UKF can relatively accurately estimate the regurgitation status of patients during PLVAD full support, but the effect of myocardial contractility on the estimation accuracy still needs to be taken into account.The proposed estimation method in this study provides essential reference information for clinical practitioners, enabling them to promptly manage potential complications arising from regurgitation. By sensitively detecting LVAD adverse events, valuable insights into the performance and reliability of the LVAD device can be obtained, offering crucial feedback and data support for device improvement and optimization.
严重主动脉瓣反流是左心室辅助装置(LVAD)干预后的常见并发症,现有研究尚未尝试在完全支持期间监测反流信号并采取预防措施。反流是一种不良事件,可导致左心室卸载不足、外周灌注不足和心力衰竭反复发作。此外,由于泵位置偏移,在完全支持期间发生的反流不能通过控制算法直接控制。因此,准确估计经皮左心室辅助装置(PLVAD)完全支持期间的反流对于临床管理和患者安全至关重要。本文构建了基于反流模型的估计系统,并引入了无迹卡尔曼滤波器估计器(UKF)作为估计方法。在研究中考虑了三种偏移程度和三种心力衰竭状态。使用模拟循环回路实验平台,将 UKF 算法估计的反流与实际测量的反流进行比较;使用 ±2SD 的标准置信区间分析误差,并评估所述算法的有效性。通过设置不同的心力衰竭条件和不同的转速来验证所提出算法的泛化能力。量化了估计值和实际值之间的均方根误差和相关系数,并使用单向方差分析(One-Way ANOVA)说明了估计精度差异的统计显著性,从而评估了 UKF 算法的准确性和稳定性。研究结果表明,基于反流模型和 UKF 的反流估计系统可以相对准确地估计 PLVAD 完全支持期间患者的反流状况,但仍需要考虑心肌收缩力对估计精度的影响。本研究提出的估计方法为临床医生提供了重要的参考信息,使他们能够及时处理反流引起的潜在并发症。通过敏感地检测 LVAD 不良事件,可以获得 LVAD 设备性能和可靠性的有价值见解,为设备改进和优化提供关键的反馈和数据支持。