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Computer assisted instruction system for therapy of heart failure based on simulation of cardiovascular system.

基于心血管系统模拟的心力衰竭治疗计算机辅助指导系统

基本信息

批准号：
60570406
负责人：
SATO Toshiro
金额：
$ 1.02万
依托单位：
Kitasato University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1985
资助国家：
日本
起止时间：
1985 至 1987
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-60570406/
关键词：
Heart filure Computer assisted system for diagnosis and treatment Computer simulation Model of cardiovascular dynamics Optimal control problem drug information 薬剤情報電子事典システム最適治療計画心力学モデル薬動力学コンピュータ診療支援システム心筋虚血指数

项目摘要

Adequate treatment of cardiac failure should reflect both clinical rules and quantitative evaluation of hemodynamics. The purpose of the project was to incorporate the simulatin technique into the computer assisted instructin system for the therapy of heart failure primarily based on the clinical empirical rules and statistical data.The model of the cardiovascular system was composed of sytemic and pulmonary networks and left and right cardiac dynamics. For the latter we adopted EMAX model with the parameters representing contractilities and diastolic stiffness. Heart failure of various types and effect of exercise testing on the circulation were well simulated by the model. The cardiovascular parameters of patients with heart failure could be estimated from the measured hemodynamic variables through the model and the optimal therapeutic regimen was formulated and solved with the technique of nonlinear programming.The CAI to help doctors at the bedside of cardiovasculasr clinic proceeds as follows: (1)Input of the patient's background, name of the disease, the severity according to NYHA criteria, the measured pressures at the various spots and cardiac output. (2) The computer responds to the input data and outputs the estimated parameter values and the suggested optimum therapeutic regimen. The drug informatin is also provided upon user's request.The CAI system, textbook of cardiology, pertinent graphs and tables, and the simulation programs were stored in their respective files and handled by a quick retrieval system (QRS by Takeuchi).The system was found useful for the physicians' decision-making in the clinical practice as well as for the students' understanding of basic cardiovascular physiology.

心衰的适当治疗应反映临床规律和血流动力学的定量评估。本课题主要是基于临床经验规律和统计数据，将模拟技术纳入心衰治疗的计算机辅助指导系统。该模型由全身和肺网络以及左右心动力学组成。对于后者，我们采用EMAX模型，参数代表收缩力和舒张刚度。该模型较好地模拟了不同类型心力衰竭及运动试验对血液循环的影响。通过该模型，可根据所测血流动力学变量估计心衰患者的心血管参数，并制定最佳治疗方案，并采用非线性规划技术求解。辅助心血管门诊床边医生的CAI操作如下：(1)输入患者的背景、疾病名称、NYHA标准的严重程度、各部位测得的压力和心输出量。(2)计算机对输入的数据作出响应，输出估计的参数值和建议的最佳治疗方案。药物信息也应用户要求提供。CAI系统、心脏科教材、相关图表和仿真程序分别存储在各自的文件中，并由Takeuchi快速检索系统（QRS）进行处理。该系统对医生在临床实践中的决策和学生对基本心血管生理学的理解都有帮助。