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Model-Based Quantification of Left Ventricular Diastolic Function in Critically Ill Patients with Atrial Fibrillation from Routine Data: A Feasibility Study
المؤلفون المشاركون
Kiefer, Nicholas
Oremek, Maximilian J.
Zenker, Sven
Hoeft, Andreas
المصدر
Computational and Mathematical Methods in Medicine
العدد
المجلد 2019، العدد 2019 (31 ديسمبر/كانون الأول 2019)، ص ص. 1-11، 11ص.
الناشر
Hindawi Publishing Corporation
تاريخ النشر
2019-05-16
دولة النشر
مصر
عدد الصفحات
11
التخصصات الرئيسية
الملخص EN
Introduction.
Left ventricular diastolic dysfunction (LVDD) and atrial fibrillation (AF) are connected by pathophysiology and prevalence.
LVDD remains underdiagnosed in critically ill patients despite potentially significant therapeutic implications since direct measurement cannot be performed in routine care at the bedside, and echocardiographic assessment of LVDD in AF is impaired.
We propose a novel approach that allows us to infer the diastolic stiffness, β, a key quantitative parameter of diastolic function, from standard monitoring data by solving the nonlinear, ill-posed inverse problem of parameter estimation for a previously described mechanistic, physiological model of diastolic filling.
The beat-to-beat variability in AF offers an advantageous setting for this.
Methods.
By employing a global optimization algorithm, β is inferred from a simple six parameter and an expanded seven parameter model of left ventricular filling.
Optimization of all parameters was limited to the interval ]0, 400[ and initialized randomly on large intervals encompassing the support of the likelihood function.
Routine ECG and arterial pressure recordings of 17 AF and 3 sinus rhythm (SR) patients from the PhysioNet MGH/MF Database were used as inputs.
Results.
Estimation was successful in 15 of 17 AF patients, while in the 3 SR patients, no reliable estimation was possible.
For both models, the inferred β (0.065 ± 0.044 ml−1 vs.
0.038 ± 0.033 ml−1 (p=0.02) simple vs.
expanded) was compatible with the previously described (patho) physiological range.
Aortic compliance, α, inferred from the expanded model (1.46 ± 1.50 ml/mmHg) also compared well with literature values.
Conclusion.
The proposed approach successfully inferred β within the physiological range.
This is the first report of an approach quantifying LVDF from routine monitoring data in critically ill AF patients.
Provided future successful external validation, this approach may offer a tool for minimally invasive online monitoring of this crucial parameter.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Kiefer, Nicholas& Oremek, Maximilian J.& Hoeft, Andreas& Zenker, Sven. 2019. Model-Based Quantification of Left Ventricular Diastolic Function in Critically Ill Patients with Atrial Fibrillation from Routine Data: A Feasibility Study. Computational and Mathematical Methods in Medicine،Vol. 2019, no. 2019, pp.1-11.
https://search.emarefa.net/detail/BIM-1130784
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Kiefer, Nicholas…[et al.]. Model-Based Quantification of Left Ventricular Diastolic Function in Critically Ill Patients with Atrial Fibrillation from Routine Data: A Feasibility Study. Computational and Mathematical Methods in Medicine No. 2019 (2019), pp.1-11.
https://search.emarefa.net/detail/BIM-1130784
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Kiefer, Nicholas& Oremek, Maximilian J.& Hoeft, Andreas& Zenker, Sven. Model-Based Quantification of Left Ventricular Diastolic Function in Critically Ill Patients with Atrial Fibrillation from Routine Data: A Feasibility Study. Computational and Mathematical Methods in Medicine. 2019. Vol. 2019, no. 2019, pp.1-11.
https://search.emarefa.net/detail/BIM-1130784
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references
رقم السجل
BIM-1130784
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
أضخم قاعدة بيانات عربية للاستشهادات المرجعية للمجلات العلمية المحكمة الصادرة في العالم العربي
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