Study on direct ventricular assist loading mode based on a finite element method_Journal of Biomedical Engineering

Authors：

LI Chen ¹ , JIANG Xianjie ¹ , ZHANG Sheng ¹ , WANG Tianbo ² , LIU Xiaohan ² , ZHANG Yue ² , HUANG Gang ² ,  ZHANG Xiaogang ¹ ,  XU Junbo ² , JIN Zhongmin ¹

1. School of Mechanical Engineering, Southwest Jiaotong University, Chengdu 610031, P. R. China;
2. The third people’s hospital of Chengdu (Affiliated hospital of Southwest Jiaotong University), Chengdu 610031, P. R. China;

Corresponding author：

ZHANG Xiaogang, Email: xg@swjtu.edu.cn; XU Junbo, Email: xujunbo2000@sina.com

Keywords：

Heart failure; Epicardial assistance; Finite element; Hemodynamics

DOI：

10.7507/1001-5515.202312070

Video：

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To investigate the biomechanical effects of direct ventricular assistance and explore the optimal loading mode, this study established a left ventricular model of heart failure patients based on the finite element method. It proposed a loading mode that maintains peak pressure compression, and compared it with the traditional sinusoidal loading mode from both hemodynamic and biomechanical perspectives. The results showed that both modes significantly improved hemodynamic parameters, with ejection fraction increased from a baseline of 29.33% to 37.32% and 37.77%, respectively, while peak pressure, stroke volume, and stroke work parameters also increased. Additionally, both modes showed improvements in stress concentration and excessive fiber strain. Moreover, considering the phase error of the assist device's working cycle, the proposed assist mode in this study was less affected. Therefore, this research may provide theoretical support for the design and optimization of direct ventricular assist devices.

Citation： LI Chen, JIANG Xianjie, ZHANG Sheng, WANG Tianbo, LIU Xiaohan, ZHANG Yue, HUANG Gang, ZHANG Xiaogang, XU Junbo, JIN Zhongmin. Study on direct ventricular assist loading mode based on a finite element method. Journal of Biomedical Engineering, 2024, 41(4): 782-789. doi: 10.7507/1001-5515.202312070 Copy

1.	Hao G, Wang X, Chen Z, et al. Prevalence of heart failure and left ventricular dysfunction in China: the China Hypertension Survey, 2012-2015. Eur J Heart Fail, 2019, 21(11): 1329-1337.
2.	Bonnemain J, Del Nido P J, Roche E T. Direct cardiac compression devices to augment heart biomechanics and function. Annu Rev Biomed Eng, 2022, 24: 137-156.
3.	刘晓翰, 黄刚, 游月婷, 等. 心肌收缩力调节器治疗心力衰竭的机制及临床研究进展. 心血管病学进展, 2023, 44(9): 790-795.
4.	黄刚, 邓晓奇, 张小刚, 等. 2020德国永久性心脏辅助装置植入者紧急医疗处置共识. 心血管病学进展, 2020, 41(12): 1353-1358.
5.	Foster G. Third-generation ventricular assist devices. Mechanical Circulatory and Respiratory Support, 2018: 151-186.
6.	黄刚, 游月婷, 刘晓翰, 等. ESC-HFA非专科医务人员管理左心室辅助装置植入者的共识(三). 心血管病学进展, 2022, 43(3): 262-264.
7.	廖晓倩, 周晓辉. 非血液接触式心室辅助装置的现状及展望. 中国医疗设备, 2018, 33(11): 113-117.
8.	Williams M R, Artrip J H. Direct cardiac compression for cardiogenic shock with the CardioSupport system. Ann Thorac Surg, 2001, 71(3, Suppl): S188-S189.
9.	Bartlett R L, Stewart N J, Raymond J, et al. Comparative study of three methods of resuscitation: closed-chest, open-chest manual, and direct mechanical ventricular assistance. Ann Emerg Med, 1984, 13(9 Pt 2): 773-777.
10.	Aranda-Michel E, Waldman L K, Trumble D R. Left ventricular simulation of cardiac compression: Hemodynamics and regional mechanics. PLoS One, 2019, 14(10): e0224475.
11.	Soohoo E, Waldman L K, Trumble D R. Computational parametric studies investigating the global hemodynamic effects of applied apical torsion for cardiac assist. Ann Biomed Eng, 2017, 45(6): 1434-1448.
12.	Wise D, Davies G, Coats T, et al. Emergency thoracotomy: "how to do it". Emerg Med J, 2005, 22(1): 22-24.
13.	Radau P, Lu Y, Connelly K, et al. Evaluation framework for algorithms segmenting short axis cardiac MRI. The MIDAS Journal-MICCAI 2009 Workshop: Cardiac MR Left Ventricle Segmentation Challenge, 2009.
14.	Guan D, Mei Y, Xu L, et al. Effects of dispersed fibres in myocardial mechanics, Part I: passive response. Math Biosci Eng, 2022, 19(4): 3972-3993.
15.	Streeter D D, Spotnitz H M, Patel D P, et al. Fiber orientation in the canine left ventricle during diastole and systole. Circ Res, 1969, 24(3): 339-347.
16.	Ahmad F, Soe S, White N, et al. Region-Specific Microstructure in the Neonatal Ventricles of a Porcine Model. Ann Biomed Eng, 2018, 46(12): 2162-2176.
17.	Sommer G, Schriefl A J, Andrä M, et al. Biomechanical properties and microstructure of human ventricular myocardium. Acta Biomater, 2015, 24: 172-192.
18.	Li K, Ogden R W, Holzapfel G A. A discrete fibre dispersion method for excluding fibres under compression in the modelling of fibrous tissues. J R Soc Interface, 2018, 15(138): 20170766.
19.	Holzapfel G, Ogden R W. Constitutive modelling of passive myocardium: a structurally based framework for material characterization. Philos Trans A Math Phys Eng Sci, 2009, 367(1902): 3445-3475.
20.	Guan D, Yao J, Luo X, et al. Effect of myofibre architecture on ventricular pump function by using a neonatal porcine heart model: from DT-MRI to rule-based methods. R Soc Open Sci, 2020, 7(4): 191655.
21.	Guccione J M, McCulloch A D. Mechanics of active contraction in cardiac muscle: Part I--constitutive relations for fiber stress that describe deactivation. J Biomech Eng, 1993, 115(1): 72-81.
22.	Mangion K, Gao H, McComb C, et al. A novel method for estimating myocardial strain: assessment of deformation tracking against reference magnetic resonance methods in healthy volunteers. Sci Rep, 2016, 6: 38774.
23.	杨艳, 吴效明, 陈丽琳. 左心循环系统的建模与仿真. 中国医学物理学杂志, 2005, 22(6): 730-732,716.
24.	Guan D, Liang F, Gremaud P A. Comparison of the windkessel model and structured-tree model applied to prescribe outflow boundary conditions for a one-dimensional arterial tree model. J Biomech, 2016, 49(9): 1583-1592.
25.	Moriwaki K, Fujimoto N, Omori T, et al. Comparison of haemodynamic response to muscle reflex in heart failure with reduced vs. preserved ejection fraction. ESC Heart Fail, 2021, 8(6): 4882-4892.
26.	Obiajulu S C, Roche E, Pigula F, et al. Soft pneumatic artificial muscles with low threshold pressures for a cardiac compression device// Proceedings of the ASME 2013 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference, Portland: ASME, 2013: V06AT07A009.
27.	Aranda-Michel E, Waldman L K, Trumble D R. Exploring the timing and distribution effects of direct cardiac compression in a beating heart model. Shanghai Chest, 2022, 6. DOI: 10.21037/shc-21-24.
28.	Kuijer J P, Marcus J T, Götte M J, et al. Three-dimensional myocardial strains at end-systole and during diastole in the left ventricle of normal humans. J Cardiovasc Magn Reson, 2002, 4(3): 341-351.
29.	Badano L P, Muraru D. Twist mechanics of the left ventricle. Circ Cardiovasc Imaging, 2019, 12(4): e009085.

1. Hao G, Wang X, Chen Z, et al. Prevalence of heart failure and left ventricular dysfunction in China: the China Hypertension Survey, 2012-2015. Eur J Heart Fail, 2019, 21(11): 1329-1337.
2. Bonnemain J, Del Nido P J, Roche E T. Direct cardiac compression devices to augment heart biomechanics and function. Annu Rev Biomed Eng, 2022, 24: 137-156.
3. 刘晓翰, 黄刚, 游月婷, 等. 心肌收缩力调节器治疗心力衰竭的机制及临床研究进展. 心血管病学进展, 2023, 44(9): 790-795.
4. 黄刚, 邓晓奇, 张小刚, 等. 2020德国永久性心脏辅助装置植入者紧急医疗处置共识. 心血管病学进展, 2020, 41(12): 1353-1358.
5. Foster G. Third-generation ventricular assist devices. Mechanical Circulatory and Respiratory Support, 2018: 151-186.
6. 黄刚, 游月婷, 刘晓翰, 等. ESC-HFA非专科医务人员管理左心室辅助装置植入者的共识(三). 心血管病学进展, 2022, 43(3): 262-264.
7. 廖晓倩, 周晓辉. 非血液接触式心室辅助装置的现状及展望. 中国医疗设备, 2018, 33(11): 113-117.
8. Williams M R, Artrip J H. Direct cardiac compression for cardiogenic shock with the CardioSupport system. Ann Thorac Surg, 2001, 71(3, Suppl): S188-S189.
9. Bartlett R L, Stewart N J, Raymond J, et al. Comparative study of three methods of resuscitation: closed-chest, open-chest manual, and direct mechanical ventricular assistance. Ann Emerg Med, 1984, 13(9 Pt 2): 773-777.
10. Aranda-Michel E, Waldman L K, Trumble D R. Left ventricular simulation of cardiac compression: Hemodynamics and regional mechanics. PLoS One, 2019, 14(10): e0224475.
11. Soohoo E, Waldman L K, Trumble D R. Computational parametric studies investigating the global hemodynamic effects of applied apical torsion for cardiac assist. Ann Biomed Eng, 2017, 45(6): 1434-1448.
12. Wise D, Davies G, Coats T, et al. Emergency thoracotomy: "how to do it". Emerg Med J, 2005, 22(1): 22-24.
13. Radau P, Lu Y, Connelly K, et al. Evaluation framework for algorithms segmenting short axis cardiac MRI. The MIDAS Journal-MICCAI 2009 Workshop: Cardiac MR Left Ventricle Segmentation Challenge, 2009.
14. Guan D, Mei Y, Xu L, et al. Effects of dispersed fibres in myocardial mechanics, Part I: passive response. Math Biosci Eng, 2022, 19(4): 3972-3993.
15. Streeter D D, Spotnitz H M, Patel D P, et al. Fiber orientation in the canine left ventricle during diastole and systole. Circ Res, 1969, 24(3): 339-347.
16. Ahmad F, Soe S, White N, et al. Region-Specific Microstructure in the Neonatal Ventricles of a Porcine Model. Ann Biomed Eng, 2018, 46(12): 2162-2176.
17. Sommer G, Schriefl A J, Andrä M, et al. Biomechanical properties and microstructure of human ventricular myocardium. Acta Biomater, 2015, 24: 172-192.
18. Li K, Ogden R W, Holzapfel G A. A discrete fibre dispersion method for excluding fibres under compression in the modelling of fibrous tissues. J R Soc Interface, 2018, 15(138): 20170766.
19. Holzapfel G, Ogden R W. Constitutive modelling of passive myocardium: a structurally based framework for material characterization. Philos Trans A Math Phys Eng Sci, 2009, 367(1902): 3445-3475.
20. Guan D, Yao J, Luo X, et al. Effect of myofibre architecture on ventricular pump function by using a neonatal porcine heart model: from DT-MRI to rule-based methods. R Soc Open Sci, 2020, 7(4): 191655.
21. Guccione J M, McCulloch A D. Mechanics of active contraction in cardiac muscle: Part I--constitutive relations for fiber stress that describe deactivation. J Biomech Eng, 1993, 115(1): 72-81.
22. Mangion K, Gao H, McComb C, et al. A novel method for estimating myocardial strain: assessment of deformation tracking against reference magnetic resonance methods in healthy volunteers. Sci Rep, 2016, 6: 38774.
23. 杨艳, 吴效明, 陈丽琳. 左心循环系统的建模与仿真. 中国医学物理学杂志, 2005, 22(6): 730-732,716.
24. Guan D, Liang F, Gremaud P A. Comparison of the windkessel model and structured-tree model applied to prescribe outflow boundary conditions for a one-dimensional arterial tree model. J Biomech, 2016, 49(9): 1583-1592.
25. Moriwaki K, Fujimoto N, Omori T, et al. Comparison of haemodynamic response to muscle reflex in heart failure with reduced vs. preserved ejection fraction. ESC Heart Fail, 2021, 8(6): 4882-4892.
26. Obiajulu S C, Roche E, Pigula F, et al. Soft pneumatic artificial muscles with low threshold pressures for a cardiac compression device// Proceedings of the ASME 2013 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference, Portland: ASME, 2013: V06AT07A009.
27. Aranda-Michel E, Waldman L K, Trumble D R. Exploring the timing and distribution effects of direct cardiac compression in a beating heart model. Shanghai Chest, 2022, 6. DOI: 10.21037/shc-21-24.
28. Kuijer J P, Marcus J T, Götte M J, et al. Three-dimensional myocardial strains at end-systole and during diastole in the left ventricle of normal humans. J Cardiovasc Magn Reson, 2002, 4(3): 341-351.
29. Badano L P, Muraru D. Twist mechanics of the left ventricle. Circ Cardiovasc Imaging, 2019, 12(4): e009085.

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Study on direct ventricular assist loading mode based on a finite element method

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