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Minimally-invasive estimation of patient-specific end-systolic elastance using a biomechanical heart model

Abstract : The end-systolic elastance $(Ees)$-the slope of the end-systolic pressure-volume relationship (ESPVR) at the end of ejection phase-has become a reliable indicator of myocardial functional state. The estimation of $Ees$ by the original multiple-beat method is invasive, which limits its routine usage. By contrast, non-invasive single-beat estimation methods, based on the assumption of the linearity of ESPVR and the uniqueness of the normalised time-varying elastance curve $E N (t)$ across subjects and physiology states, have been applied in a number of clinical studies. It is however known that these two assumptions have a limited validity, as ESPVR can be approximated by a linear function only locally , and $E N (t)$ obtained from a multi-subject experiment includes a confidence interval around the mean function. Using datasets of 3 patients undergoing general anaesthesia (each containing aortic flow and pressure measurements at baseline and after introducing a vasopressor noradrenaline), we first study the sensitivity of two single-beat methods-by Sensaki et al. and by Chen et al.-to the uncertainty of $E N (t)$. Then, we propose a minimally-invasive method based on a patient-specific bio-physical modelling to estimate the whole time-varying elastance curve $E model (t)$. We compare $E model es$ with the two single-beat estimation methods , and the normalised varying elastance curve $E N,model (t)$ with $E N (t)$ from published physiological experiments.
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https://hal.archives-ouvertes.fr/hal-02153611
Contributor : Arthur Le Gall <>
Submitted on : Wednesday, June 12, 2019 - 1:22:27 PM
Last modification on : Thursday, April 9, 2020 - 5:08:18 PM

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  • HAL Id : hal-02153611, version 1

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Arthur Le Gall, Fabrice Vallée, Dominique Chapelle, Radomir Chabiniok. Minimally-invasive estimation of patient-specific end-systolic elastance using a biomechanical heart model. FIMH 2019 - 10th Functional Imaging and Modelling of the Heart, Jun 2019, Bordeaux, France. ⟨hal-02153611⟩

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