Table 1.
Patients’ clinical characteristics.
Fig 1.
Left panel: State diagram of the cellular automata that represent nodal cells (yellow, botton) and myocardial cells (orange, top) and diagrams showing the correspondence of the automata’s transition parameters with the myocardial action potential dynamics. Right panel: Closed-loop model of the cardiovascular system. E: elastance; R: resistance; P: pressure; V: volume; pul: pulmonary; sys: systemic; pv: pulmonary vein; pa: pulmonary artery; ao: aorta; sa: systemic artery; sv: systemic veins; vc: vena cava; LA: left atrium; LV: left ventricle; RA: right atrium; RV: right ventricle. In the middle, a representation of the cardiac electrical system. On the right, a representation of the heart valve model.
Fig 2.
Calculation of positive and negative segmental work.
Positive (Pj) and negative (Ni) work are marked respectively as red and black. Phase S corresponds to isovolumic contraction and ejection. IVR is the isovolumic relaxation. S phase is defined by the time interval spanning from MVC to AVC, whereas the IVR phase is defined between AVC and MVO.
Fig 3.
Two steps of the identification process.
Step 1 consists in the minimization of Jstep1 for the identification of {XLV, Xart} from invasive LV pressure and non-invasive arterial pressure. Step 2 consists in the minimization of Jstep2 for the identification of {Xart} from non-invasive arterial pressure. Finally, is estimated for each patient from
and
.
Fig 4.
Example simulated LV and arterial pressure for a healthy (top) and an aortic stenosis subject (bottom).
Fig 5.
Most influential parameters on the gradient of systolic pressure between LV and aorta according to Morris sensitivity results.
For each parameter, the distance Di (green bars), the absolute mean μi* (purple bars) and the standard deviation σ (yellow bars) of the elementary effects are represented.
Fig 6.
LV pressure of the 12 AS patients from step 1: i) experimental (black) and ii) simulated curve (red) curves.
Fig 7.
LV pressure of the 12 AS patients from step 2: i) experimental curve (black), ii) average and standard deviation of simulated curve (red).
Fig 8.
Results of global work indices comparison, on all patients.
Scatter plots and Bland—Altman analysis of: a) Global Constructive Work (GCW), b) Global Wasted Work (GWW) and c) Global Work Efficiency (GWE).