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This Article Full Text Full Text (PDF) All Versions of this Article: 288/4/H1874    most recent 00754.2004v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (9) Citing Articles via Google Scholar Google Scholar Articles by Garcia, D. Articles by Durand, L.-G. Search for Related Content PubMed PubMed Citation Articles by Garcia, D. Articles by Durand, L.-G.

A ventricular-vascular coupling model in presence of aortic stenosis

¹Clinical Research Institute of Montreal, Montreal, Quebec, Canada; ²Department of Cardiothoracic Surgery, Academic Hospital, Maastricht, The Netherlands; and ³Quebec Heart Institute, Laval Hospital, Laval University, Quebec, Canada

Submitted 27 July 2004 ; accepted in final form 8 December 2004

In patients with aortic stenosis, the left ventricular afterload is determined by the degree of valvular obstruction and the systemic arterial system. We developed an explicit mathematical model formulated with a limited number of independent parameters that describes the interaction among the left ventricle, an aortic stenosis, and the arterial system. This ventricular-valvular-vascular (V³) model consists of the combination of the time-varying elastance model for the left ventricle, the instantaneous transvalvular pressure-flow relationship for the aortic valve, and the three-element windkessel representation of the vascular system. The objective of this study was to validate the V³ model by using pressure-volume loop data obtained in six patients with severe aortic stenosis before and after aortic valve replacement. There was very good agreement between the estimated and the measured left ventricular and aortic pressure waveforms. The total relative error between estimated and measured pressures was on average (standard deviation) 7.5% (SD 2.3) and the equation of the corresponding regression line was y = 0.99x – 2.36 with a coefficient of determination r² = 0.98. There was also very good agreement between estimated and measured stroke volumes (y = 1.03x + 2.2, r² = 0.96, SEE = 2.8 ml). Hence, this mathematical V³ model can be used to describe the hemodynamic interaction among the left ventricle, the aortic valve, and the systemic arterial system.

mathematical modeling; cardiovascular system; cardiac catheterization; left ventricle

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