Patient-specific parameter estimation: coupling a heart model and experimental data.

This study develops a hemodynamic model involving the atrium, ventricle, veins, and arteries that can be calibrated to experimental results. It is a Windkessel model that incorporates an unsteady Bernoulli effect in the blood flow to the atrium. The model is represented by ordinary differential equations in terms of blood volumes in the compartments as state variables and it demonstrates the use of conductance instead of resistance to capture the effect of a non-leaking heart valve. The experimental results are blood volume data from 20 young (half of which are women) and 20 elderly (half of which are women) subjects during rest, inotropic stress (dobutamine), and chronotropic stress (glycopyrrolate). The model is calibrated to conform with data and physiological findings in 4 different levels. First, an optimization routine is devised to find model parameter values that give good fit between the model volume curves and blood volume data in the atrium and ventricle. Patient-specific information are used to get initial parameter values as a starting point of the optimization. Also, model pressure curves must show realistic behavior. Second, parametric bootstrapping is performed to establish the reliability of the optimal parameters. Third, statistical tests comparing mean optimal parameter values from young vs elderly subjects and women vs men are examined to support and present age and sex related differences in heart functions. Lastly, statistical tests comparing mean optimal parameter values from resting condition vs pharmacological stress are studied to verify and quantify the effects of dobutamine and glycopyrrolate to the cardiovascular system.