A predictive computational model to estimate myocardial temperature during intracoronary hypothermia in acute myocardial infarction

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Abstract

Hypothermia, if provided before coronary reperfusion, reduces infarct size in animal models of acute myocardial infarction (AMI). Translation to humans has failed so far, because the target temperature is not reached in time within the endangered myocardium using systemic hypothermia method. Hence, a clinically applicable method has been developed to provide intracoronary hypothermia using cold saline, selectively infused locally into the infarct area. In this study, a lumped parameter model has been designed to support the clinical method and to describe this myocardial cooling process mathematically. This model is able to predict the myocardial temperature changes over time, which cannot be measured, based on the temperature and flow of the intracoronary injected cold saline and coronary arterial blood. It was validated using data from an isolated beating porcine heart model and applied on data from patients with AMI undergoing intracoronary hypothermia. In prospect, the computational model may be used as an assistive tool to calculate the patient specific flow rate and temperature of saline required for reliable achievement of the target myocardial temperature in the hypothermia enhanced clinical treatment of AMI.

LanguageEnglish
Pages65-75
JournalMedical Engineering and Physics
Volume68
Issue numberJune 2019
DOIs
StatePublished - 1 Jun 2019

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Hypothermia
Myocardial Infarction
Temperature
Myocardial Reperfusion
Myocardium
Animals
Blood
Swine
Animal Models
Flow rate
Cooling

Keywords

  • Acute myocardial infarction
  • Myocardial hypothermia
  • Lumped parameter model

Cite this

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title = "A predictive computational model to estimate myocardial temperature during intracoronary hypothermia in acute myocardial infarction",
abstract = "Hypothermia, if provided before coronary reperfusion, reduces infarct size in animal models of acute myocardial infarction (AMI). Translation to humans has failed so far, because the target temperature is not reached in time within the endangered myocardium using systemic hypothermia method. Hence, a clinically applicable method has been developed to provide intracoronary hypothermia using cold saline, selectively infused locally into the infarct area. In this study, a lumped parameter model has been designed to support the clinical method and to describe this myocardial cooling process mathematically. This model is able to predict the myocardial temperature changes over time, which cannot be measured, based on the temperature and flow of the intracoronary injected cold saline and coronary arterial blood. It was validated using data from an isolated beating porcine heart model and applied on data from patients with AMI undergoing intracoronary hypothermia. In prospect, the computational model may be used as an assistive tool to calculate the patient specific flow rate and temperature of saline required for reliable achievement of the target myocardial temperature in the hypothermia enhanced clinical treatment of AMI.",
keywords = "Acute myocardial infarction, Myocardial hypothermia, Lumped parameter model",
author = "{van Willigen}, Bettine and Otterspoor, {Luuk C.} and {van 't Veer}, Marcel and Tila{\"i} Rosalina and Nico Pijls and {van de Vosse}, Frans",
year = "2019",
month = "6",
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doi = "10.1016/j.medengphy.2019.03.011",
language = "English",
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journal = "Medical Engineering & Physics",
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TY - JOUR

T1 - A predictive computational model to estimate myocardial temperature during intracoronary hypothermia in acute myocardial infarction

AU - van Willigen,Bettine

AU - Otterspoor,Luuk C.

AU - van 't Veer,Marcel

AU - Rosalina,Tilaï

AU - Pijls,Nico

AU - van de Vosse,Frans

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Hypothermia, if provided before coronary reperfusion, reduces infarct size in animal models of acute myocardial infarction (AMI). Translation to humans has failed so far, because the target temperature is not reached in time within the endangered myocardium using systemic hypothermia method. Hence, a clinically applicable method has been developed to provide intracoronary hypothermia using cold saline, selectively infused locally into the infarct area. In this study, a lumped parameter model has been designed to support the clinical method and to describe this myocardial cooling process mathematically. This model is able to predict the myocardial temperature changes over time, which cannot be measured, based on the temperature and flow of the intracoronary injected cold saline and coronary arterial blood. It was validated using data from an isolated beating porcine heart model and applied on data from patients with AMI undergoing intracoronary hypothermia. In prospect, the computational model may be used as an assistive tool to calculate the patient specific flow rate and temperature of saline required for reliable achievement of the target myocardial temperature in the hypothermia enhanced clinical treatment of AMI.

AB - Hypothermia, if provided before coronary reperfusion, reduces infarct size in animal models of acute myocardial infarction (AMI). Translation to humans has failed so far, because the target temperature is not reached in time within the endangered myocardium using systemic hypothermia method. Hence, a clinically applicable method has been developed to provide intracoronary hypothermia using cold saline, selectively infused locally into the infarct area. In this study, a lumped parameter model has been designed to support the clinical method and to describe this myocardial cooling process mathematically. This model is able to predict the myocardial temperature changes over time, which cannot be measured, based on the temperature and flow of the intracoronary injected cold saline and coronary arterial blood. It was validated using data from an isolated beating porcine heart model and applied on data from patients with AMI undergoing intracoronary hypothermia. In prospect, the computational model may be used as an assistive tool to calculate the patient specific flow rate and temperature of saline required for reliable achievement of the target myocardial temperature in the hypothermia enhanced clinical treatment of AMI.

KW - Acute myocardial infarction

KW - Myocardial hypothermia

KW - Lumped parameter model

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DO - 10.1016/j.medengphy.2019.03.011

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SN - 1350-4533

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