体外反搏对典型冠状动脉疾病作用效果的集中参数建模仿真
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1.北京生物医学工程高精尖创新中心;2.中山大学附属第八医院 心内科

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Effects of external counterpulsation on typical coronary artery diseases: A simulation study
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    摘要:

    目的:研究体外反搏(EECP)疗法对典型冠脉血管病及微血管心绞痛的血流动力学影响。方法:使用集中参数建模方法,建立包含导管动脉与心肌微循环的右优势型冠脉生理模型。分别仿真单支狭窄、三支狭窄及微血管心绞痛等病理情况。建立EECP干预模型,结合上述病理模型,仿真EECP对病理模型的血流动力学作用。结果:本文建立的冠脉生理模型、病理模型及EECP干预模型仿真结果与相关文献中的实验数据相符合。EECP对本研究中的三种病理情况都有改善冠脉血流的效果。对单支狭窄,EECP在LMCA狭窄程度达到80%-85%之后便无法使血流恢复正常水平。 对三支狭窄,若三条分支狭窄程度有一超过90%,则无法使用EECP治疗。对微血管心绞痛,EECP有效的临界情况是充血MBF>1.03 mL/(min·g)、CFR>1.64。结论:本文建立的EECP干预冠脉血管病模型符合预期,获得的仿真数据对EECP的临床操作具有一定的参考价值。

    Abstract:

    Objective: Study the effect of enhanced external counter pulsation (EECP) on typical coronary artery diseases. Methods: Lumped parameter models were established to simulate coronary conduit arteries and coronary microcirculation under normal physiological condition, one-vessel lesion, three-vessel lesions and microcirculation angina. EECP interference was simulated on these models. Results: For models under normal condition, under three coronary diseases and EECP interference simulation, the blood flow patterns were in consistent with reported experiment data. EECP improved coronary blood flow under all three coronary diseases. For one-vessel lesion, EECP could recover LMCA blood flow to normal level as the degree of stenosis was lower than 80%-85%. For three-vessel lesions, EECP would be ineffective if one of the three vessels has a stenosis over 90%. For microcirculation angina, EECP would be effective as MBF>1.03 mL/(min·g) and CFR>1.64. Conclusions: The modeling of coronary circulation under EECP interference was accurate. And we obtained useful simulation data which might inspire new clinical studies about EECP on coronary diseases.

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  • 收稿日期:2023-03-30
  • 最后修改日期:2023-05-12
  • 录用日期:2023-05-15
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