Arterial hemodynamics and its interaction with the left ventricle in heart failure
Description
TitleArterial hemodynamics and its interaction with the left ventricle in heart failure
Date Created2015
Other Date2015-10 (degree)
Extent1 online resource (v, 106 p. : ill.)
DescriptionMonitoring heart-arterial system (LV-AS) interactions of cardiovascular patients is important in achieving successful diagnosis and treatment. This is particularly true in the cases of hypertension and heart failure. However, there has been limited quantitative hemodynamic analysis aimed at improving the outcome for the 70-million hypertensive patients and millions of heart failure patients. This thesis develops a model-based strategy to provide a comprehensive evaluation of the state of the vascular system and its coupling to the heart, and ultimately aims to distinguish patient groups of heart failure with preserved or reduced ejection fraction (HFpEF and HFrEF). The first aspect of this study is analysis of arterial hemodynamics from animal experimental data collected during normotensive, vasodilation, and induced hypertension conditions. Total arterial compliance (C), peripheral resistance (Rs), and aortic characteristic impedance (Z0) based on the 3-element Windkessel model were obtained, together with frequency-domain impedance, wave reflection information, and parameters for assessing global cardiac function. Subsequently, clinical human data were collected and analyzed, focusing on the LV-AS interactions. We identified critical parameters in LV-AS interaction, i.e. effective arterial system elastance, Ea, LV systolic elastance, Emax, LV-AS coupling index, k (=Ea/Emax), and C. Results characterized hypertension by a significantly reduced C and increased Rs, confirmed by increased vascular impedance and wave reflections. Unloading the heart reversed these observations via vasodilator treatment. For human studies, we found C to be more effective than Ea in distinguishing groups of HFpEF and HFrEF patients. It was found that HFpEF patients tended to have a relatively independent coupling index, k, with respect to arterial parameter changes. The findings in this work can be incorporated into larger scale clinical studies that implement the use of pulse waveform analysis and the identified critical LV-AS interaction parameters to improve patient treatment and outcome.
NoteM.S.
NoteIncludes bibliographical references
Noteby Gina N. Hegyi
Genretheses, ETD graduate
Languageeng
CollectionGraduate School - New Brunswick Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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