Methodological development of a pneumatic artificial muscle-driven left ventricular simulator using interpretive structural modeling

Q: What is the clinical evidence from this study?

Population: Left ventricular simulator development. Intervention: Pneumatic artificial muscle-driven left ventricular simulator. Primary outcome: Hemodynamic and cardio-mechanical performance (flow rate, twisting angle, apex shortening).

Q: What does this research mean for the field?

A pneumatic artificial muscle-driven left ventricular simulator can generate average flow rates of up to 2.25 L/min while replicating human-like cardiac wall motion with 21 degrees of apical rotation and 11 mm of apex shortening. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Turgut Batuhan Baturalp; Selim Bozkurt

doi:10.1371/journal.pone.0355859

August 13, 2026PLoS ONEOpen Access

Methodological development of a pneumatic artificial muscle-driven left ventricular simulator using interpretive structural modeling

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Key result

Pneumatic artificial muscle-driven LV simulator replicates human wall motion with flow rates up to 2.25 L/min.

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Why the study?

Existing mock circulation systems require complex driver and data acquisition systems, and animal models raise ethical concerns, creating a need for a less complex and realistic left ventricular simulator.

Key Points

To develop a less complex and biologically realistic left ventricular simulator using interpretive structural modeling to evaluate optimal actuation methods and materials.
Applied Interpretive Structural Modeling (ISM) to analyze interdependencies among ventricular design parameters, identifying pneumatic artificial muscles and latex rubber as the optimal configuration.
Fabricated a prototype utilizing four helically oriented pneumatic artificial muscles with one degree of freedom embedded in a latex chamber, integrated into a mock circulatory loop.
Tested hemodynamic and cardio-mechanical performance across simulated healthy and diseased conditions at heart rates of 50, 60, 70, and 80 bpm with variable systolic/diastolic ratios.
The simulator achieved average flow rates up to 2.25 L/min with an average pressure of 15 mm Hg, generating systolic aortic pressures around 30 mmHg and diastolic pressures below 10 mmHg.
Cardio-mechanical wall dynamics demonstrated human-like ventricular deformation with 21 degrees of apical twist angle and 11 mm of longitudinal apex shortening.
At a healthy 60 bpm condition, the contracted inner volume was approximately 85 mL, stroke volume reached 33 mL, and ejection fraction was 28%.

Structured PICO

P

Population

Benchtop left ventricular simulator model

I

Intervention

Pneumatic artificial muscle-driven left ventricular simulator

O

Outcome

Hemodynamic and cardio-mechanical performance (flow rate, pressure, twisting angle, apex shortening)

Limitations

Lack of aortic compliance and resistance components in the circulatory loop resulting in lower than physiological pressure values
Air bubbles in the system caused backflow and beating phenomena
Lack of aortic compliance and resistance components in the circulatory loop
Measured pressures reflect mechanical pumping capability within a low-load hydraulic environment rather than physiological conditions

Implication

A novel pneumatic artificial muscle-driven left ventricular simulator can replicate human-like ventricular twisting and contraction, offering a simplified platform for benchtop cardiovascular testing.

Abstract

Mock circulation systems can replicate a wide range of cardiac operating scenarios, such as cardiovascular diseases, particularly muscular dysfunctions. These systems are operated by sophisticated control algorithms which require complex driver and data acquisition systems, whereas animal models raise ethical concerns. Therefore, there is a need for novel testbeds to overcome the challenges in the existing systems. The aim of this study is to develop a less complex and realistic left ventricular (LV) simulator. The Interpretive Structural Modeling (ISM) approach was utilized to evaluate different left ventricular actuation methods and materials. ISM revealed that the most suitable method to actuate the LV is using the pneumatic artificial muscles and latex rubber. The performance of the new LV simulator was evaluated for healthy and diseased conditions at 50, 60, 70 and 80 bpm heart rates. The experiments revealed that the beating LV simulator can generate average flow rates of up to 2.25 L/min. The actual human LV-like wall motion was also verified by the twisting angle on the apex of the beating LV simulator with 21 degrees of rotation and 11 mm of apex shortening. The prototyped beating LV simulator is a promising preliminary platform and may reach actual human LV’s hemodynamic and cardio-mechanical performance with further improvements.

Discussion

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Cite This Study

Baturalp et al. (2026) studied Left ventricular simulator development. Pneumatic artificial muscle-driven left ventricular simulator was evaluated on Hemodynamic and cardio-mechanical performance (flow rate, twisting angle, apex shortening). The pneumatic artificial muscle-driven left ventricular simulator generated average flow rates up to 2.25 L/min and demonstrated human LV-like wall motion with 21 degrees of rotation and 11 mm of apex shortening.

synapsesocial.com/papers/6a8019f175c2e31742c862be https://doi.org/10.1371/journal.pone.0355859

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Methodological development of a pneumatic artificial muscle-driven left ventricular simulator using interpretive structural modeling

Figures

Key Points

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Methodological development of a pneumatic artificial muscle-driven left ventricular simulator using interpretive structural modeling

Figures

Key Points

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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