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

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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.