Analysis of a cardiovascular model for the study of the autonomic response of Brugada syndrome patients

This paper describes the integration of mathematical models of the cardiac electrical activity, the cardiovascular system and the baroreceptor reflex control of the autonomic nervous system, with a model representing a head-up tilt test. Sensitivity analyses are performed in order to determine those model parameters producing the greatest significant effects on heart rate and blood pressure. An optimization step is then applied to the most influential parameters in order to find the best model fit to real cardiac data obtained from a patient suffering from Brugada syndrome and a healthy subject, in supine and upright postures during a tilt test. Results show the feasibility of the model to generate realistic autonomic responses to head-up tilt testing in health and disease.

[1]  Stefano Tarantola,et al.  Sensitivity Analysis as an Ingredient of Modeling , 2000 .

[2]  Guy Carrault,et al.  Improving ECG Beats Delineation With an Evolutionary Optimization Process , 2010, IEEE Transactions on Biomedical Engineering.

[3]  Max D. Morris,et al.  Factorial sampling plans for preliminary computational experiments , 1991 .

[4]  A. Saltelli,et al.  Tackling quantitatively large dimensionality problems , 1999 .

[5]  J Geoffrey Chase,et al.  Minimal haemodynamic system model including ventricular interaction and valve dynamics. , 2004, Medical engineering & physics.

[6]  David Guiraud,et al.  Model-Based Design and Experimental Validation of Control Modules for Neuromodulation Devices , 2016, IEEE Transactions on Biomedical Engineering.

[7]  A. Malliani,et al.  Heart rate variability. Standards of measurement, physiological interpretation, and clinical use , 1996 .

[8]  Albert Hagege,et al.  Analysis of a baroreflex model for the study of the chronotropic response to vagal nerve stimulation , 2015, 2015 7th International IEEE/EMBS Conference on Neural Engineering (NER).

[9]  A. Saltelli,et al.  Sensitivity analysis of an environmental model: an application of different analysis methods , 1997 .

[10]  Nikolaus Hansen,et al.  Evaluating the CMA Evolution Strategy on Multimodal Test Functions , 2004, PPSN.

[11]  James J. Smith.  Circulatory Response to the Upright Posture , 1990 .

[12]  S. Priori,et al.  Magnetic resonance investigations in Brugada syndrome reveal unexpectedly high rate of structural abnormalities. , 2009, European Heart Journal.

[13]  Guy Carrault,et al.  Model-based interpretation of cardiac beats by evolutionary algorithms: signal and model interaction , 2002, Artif. Intell. Medicine.

[14]  Jean-Louis Coatrieux,et al.  Special Issue on The Physiome and Beyond , 2006 .

[15]  J. Brugada,et al.  Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicenter report. , 1992, Journal of the American College of Cardiology.

[16]  E Magosso,et al.  Acute cardiovascular response to isocapnic hypoxia. I. A mathematical model. , 2000, American journal of physiology. Heart and circulatory physiology.

[17]  H. Kirchheim.  Systemic arterial baroreceptor reflexes. , 1976, Physiological reviews.

[18]  T. Wichter.  What role for autonomic dysfunction in Brugada Syndrome? Pathophysiological and prognostic implications. , 2008, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[19]  R. Mark,et al.  Computational modeling of cardiovascular response to orthostatic stress. , 2002, Journal of applied physiology.

[20]  Virginie Le Rolle,et al.  Recursive identification of an arterial baroreflex model for the evaluation of cardiovascular autonomic modulation , 2015, Comput. Biol. Medicine.

[21]  C. G. Blomqvist,et al.  Cardiovascular Adjustments to Gravitational Stress , 2011 .

[22]  Pierre-Yves Richard,et al.  An autonomic nervous system model applied to the analysis of orthostatic tests , 2008 .