P136 SIMULATING MYOCARDIAL OXYGEN BALANCE CHANGES DUE TO ANTI-HYPERTENSIVE DRUGS

DOI

10.1016/j.artres.2018.10.189How to use a DOI?

Abstract

Background: Hypertension clinical treatment largely relies on different drugs. Some of these drugs are thought to exhibit specific protective functions in addition to those resulting from blood pressure reduction per se. Through a validated multiscale mathematical model of the cardiovascular system, we studied the impact of commonly-used antihypertensive drugs on myocardial oxygen supply–consumption balance, which plays a crucial role in type 2 myocardial infarction.

Methods: Forty-two wash-out hypertensive patients were included in this study. Patients’ demographics, heart rate, brachial pressure, Left Ventricular (LV) volumes and carotid-femoral pulse wave velocity were used to set to patient specific condition a largely accepted benchmark data set describing generic healthy subjects. Starting from literature data, drugs effects were modeled by means of six coefficients, describing LV function, heart rate, peripheral resistances and arterial stiffness. These drug-specific sextuplets were used to multiply some parameters of each patient model to simulate drugs impact.

Results: Our results ascribed the well-known major cardioprotective efficiency of β blockers to a positive change of myocardial oxygen balance. This was due to the concomitant reduction in LV work and increase in coronary flow. Similarly, RAAS blockers induced several positive changes, but to a reduced extent. In contrast, calcium channel blockers seem to induce some potentially negative effects on myocardial oxygen balance.

Conclusions: Patient specific multiscale mathematical model is able to reproduce clinically-relevant changes in coronary hemodynamics and ventricular function driven by anti-hypertensive drugs. Further studies are needed to evaluate eventual clinical usefulness of in-silico modeling of anti-hypertensive drugs.

Open Access

This is an open access article distributed under the CC BY-NC license.

Download article (PDF)
View full text (HTML)

TY  - JOUR
AU  - Andrea Guala
AU  - Dario Leone
AU  - Francesco Tosello
AU  - Alberto Milan
AU  - Luca Ridolfi
PY  - 2018
DA  - 2018/12/04
TI  - P136 SIMULATING MYOCARDIAL OXYGEN BALANCE CHANGES DUE TO ANTI-HYPERTENSIVE DRUGS
JO  - Artery Research
SP  - 118
EP  - 118
VL  - 24
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2018.10.189
DO  - 10.1016/j.artres.2018.10.189
ID  - Guala2018
ER  -