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An advanced mock circulation loop for in vitro cardiovascular device evaluation

机译:用于体外心血管设备评估的高级模拟循环回路

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Abstract Controlled and repeatable in vitro evaluation of cardiovascular devices using a mock circulation loop (MCL) is essential prior to in vivo or clinical trials. MCLs often consist of only a systemic circulation with no autoregulatory responses and limited validation. This study aimed to develop, and validate against human data, an advanced MCL with systemic, pulmonary, cerebral, and coronary circulations with autoregulatory responses. The biventricular MCL was constructed with pneumatically controlled hydraulic circulations with Starling responsive ventricles and autoregulatory cerebral and coronary circulations. Hemodynamic repeatability was assessed and complemented by validation using impedance cardiography data from 50 healthy humans. The MCL successfully simulated patient scenarios including rest, exercise, and left heart failure with and without cardiovascular device support. End‐systolic pressure‐volume relationships for respective healthy and heart failure conditions had slopes of 1.27 and 0.54?mm?Hg?mL ?1 (left ventricle), and 0.18 and 0.10?mm?Hg?mL ?1 (right ventricle), aligning with the literature. Coronary and cerebral autoregulation showed a strong correlation ( R 2 : .99) between theoretical and experimentally derived circuit flow. MCL repeatability was demonstrated with correlation coefficients being statistically significant ( P ??.05) for all simulated conditions while MCL hemodynamics aligned well with human data. This advanced MCL is a valuable tool for inexpensive and controlled evaluation of cardiovascular devices.
机译:摘要在体内或临床试验之前,使用模拟循环回路(MCL)的心血管器件对心血管装置的控制和可重复评估。 MCLS通常仅由系统循环组成,没有自动调节反应和有限的验证。该研究旨在对人类数据进行开发和验证,其具有全身性,肺,脑和冠状动脉循环的先进MCL,具有自身调节反应。用气动控制的液压循环构建,具有晕酸响应性脑室和自身调节性脑和冠状动脉循环。通过使用50个健康人类的阻抗心脏造影数据进行评估和补充血流动力学重复性。 MCL成功模拟了患者场景,包括休息,运动和左心力衰竭,并且没有心血管装置支持。用于各自的健康和心力衰竭条件的末端 - 收缩压体积关系具有1.27和0.54Ω·mm的斜率为1.27和0.54Ω·hg?ml?1(左心室)和0.18和0.10≤mm≤h≤ml?1(右心室),与文献一致。冠状动脉和脑自动造粒在理论和实验衍生的电路流动之间显示出强烈的相关性(R 2:.99)。在MCL血流动力学与人类数据中对齐的同时,用相关系数对MCL重复性进行统计学意义(p≤05),而MCL重复性统计学意义(p≤05)。这种高级MCL是一种有价值的心血管器件评估的有价值的工具。

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