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

Bettine G. van Willigen (Corresponding author), Luuk C. Otterspoor, Marcel van ’t Veer, Tilaï T. Rosalina, Nico H.J. Pijls, Frans N. van de Vosse

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Uittreksel

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.

TaalEngels
Pagina's65-75
TijdschriftMedical Engineering and Physics
Volume68
DOI's
StatusGepubliceerd - 1 jun 2019

Vingerafdruk

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

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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, Lumped, Myocardial hypothermia, Parameter model",
    author = "{van Willigen}, {Bettine G.} and Otterspoor, {Luuk C.} and {van ’t Veer}, Marcel and Rosalina, {Tila{\"i} T.} and Pijls, {Nico H.J.} and {van de Vosse}, {Frans N.}",
    year = "2019",
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    language = "English",
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    journal = "Medical Engineering & Physics",
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    AU - van Willigen,Bettine G.

    AU - Otterspoor,Luuk C.

    AU - van ’t Veer,Marcel

    AU - Rosalina,Tilaï T.

    AU - Pijls,Nico H.J.

    AU - van de Vosse,Frans N.

    PY - 2019/6/1

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    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 - Lumped

    KW - Myocardial hypothermia

    KW - Parameter model

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