Effect of high altitude exposure on the hemodynamics of the bidirectional Glenn physiology: Modeling incremented pulmonary vascular resistance and heart rate

Abstract The considerable blood mixing in the bidirectional Glenn (BDG) physiology further limits the capacity of the single working ventricle to pump enough oxygenated blood to the circulatory system. This condition is exacerbated under severe conditions such as physical activity or high altitude....

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Bibliographic Details
Published in:Journal of biomechanics 2014-06, Vol.47 (8), p.1846-1852
Main Authors: Vallecilla, Carolina, Khiabani, Reza H, Sandoval, Néstor, Fogel, Mark, Briceño, Juan Carlos, Yoganathan, Ajit P
Format: Article
Language:English
Subjects:
Altitude
Bidirectional
Cardiac Catheterization
Cardiology
Child, Preschool
Children & youth
Cohort Studies
Compliance
Congenital heart disease
Fontan
Fontan Procedure - methods
Heart
Heart Defects, Congenital - physiopathology
Heart Rate
Heart Ventricles - physiopathology
Hemodynamics
High altitude
Humans
Infant
Intubation
Mathematical analysis
Mathematical modeling
Mathematical models
Models, Cardiovascular
Mortality
Oxygen - chemistry
Patients
Physical Medicine and Rehabilitation
Physiology
Pulmonary arteries
Pulmonary vascular resistance
Sea level
Studies
Univentricular heart
Vascular Resistance - physiology
Veins & arteries
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Summary:Abstract The considerable blood mixing in the bidirectional Glenn (BDG) physiology further limits the capacity of the single working ventricle to pump enough oxygenated blood to the circulatory system. This condition is exacerbated under severe conditions such as physical activity or high altitude. In this study, the effect of high altitude exposure on hemodynamics and ventricular function of the BDG physiology is investigated. For this purpose, a mathematical approach based on a lumped parameter model was developed to model the BDG circulation. Catheterization data from 39 BDG patients at stabilized oxygen conditions was used to determine baseline flows and pressures for the model. The effect of high altitude exposure was modeled by increasing the pulmonary vascular resistance (PVR) and heart rate (HR) in increments up to 80% and 40%, respectively. The resulting differences in vascular flows, pressures and ventricular function parameters were analyzed. By simultaneously increasing PVR and HR, significant changes ( p
ISSN:0021-9290
1873-2380
DOI:10.1016/j.jbiomech.2014.03.021