Key result
A lumped-parameter cardiac model incorporating the atrioventricular plane as a piston unit successfully reproduced normal physiological pressures and realistic AV piston velocity magnitudes (~10 cm/s).
A lumped-parameter cardiac model incorporating the AV plane as a piston unit successfully reproduces normal cardiac physiology, highlighting the importance of longitudinal movements in cardiac pumping.
Supports AV piston modeling in simulations; extends computational tools but leaves open validation in disease before any clinical use.
Medical imaging and clinical studies have proven that the heart pumps by means of minor outer volume changes and back-and-forth longitudinal movements in the atrioventricular (AV) region. The magnitude of AV-plane displacement has also shown to be a reliable index for diagnosis of heart failure. Despite this, AV-plane displacement is usually omitted from cardiovascular modelling. We present a lumped-parameter cardiac model in which the heart is described as a displacement pump with the AV plane functioning as a piston unit (AV piston). This unit is constructed of different upper and lower areas analogous with the difference in the atrial and ventricular cross-sections. The model output reproduces normal physiology, with a left ventricular pressure in the range of 8-130 mmHg, an atrial pressure of approximatly 9 mmHg, and an arterial pressure change between 75 mmHg and 130 mmHg. In addition, the model reproduces the direction of the main systolic and diastolic movements of the AV piston with realistic velocity magnitude (∼10 cm/s). Moreover, changes in the simulated systolic ventricular-contraction force influence diastolic filling, emphasizing the coupling between cardiac systolic and diastolic functions. The agreement between the simulation and normal physiology highlights the importance of myocardial longitudinal movements and of atrioventricular interactions in cardiac pumping.
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Maksuti et al. (2014) studied this question. Lumped-parameter cardiac model with AV piston unit was evaluated on Reproduction of normal physiology. A lumped-parameter cardiac model incorporating the atrioventricular plane as a piston unit successfully reproduced normal physiological pressures and realistic AV piston velocity magnitudes (~10 cm/s).
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