• 대한의용생체공학회:의공학회지
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• 제36권5호
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• pp.198-203
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• 2015

The purpose of the study is to examine the effects of pacemaker location on cardiac pumping efficacy theoretically. We used a three-dimensional finite element cardiac electromechanical model of canine ventricles with models of the circulatory system. Electrical activation time for normal sinus rhythm and artificial pacing in apex, left ventricular free wall, and right ventricular free wall were obtained from electrophysiological model. We applied the electrical activation time maps to the mechanical contraction model and obtained cardiac mechanical responses such as myocardial contractile ATP consumption, stroke work, stroke volume, ejection fraction, and etc. Among three artificial pacing methods, left ventricle pacing showed best performance in ventricular pumping efficacy.

• EDISON SW 활용 경진대회 논문집
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• 제6회(2017년)
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• pp.650-652
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• 2017

the aim of this study was to observe the combined effect of the CRT and LVAD on electromechanical cardiac behavior under LBBB and RBBB conditions computationally. We performed simulation by using advanced electromechanics model of failing ventricle combined with lumped model represents circulatory system, CRT and LVAD. We analyzed seven failing ventricle model including normal sinus rhythm, LBBB, LBBB coupled with CRT, LBBB coupled with CRT and LVAD, RBBB, RBBB coupled with CRT, and RBBB coupled with CRT and LVAD. We compared the effect from CRT and the effect from combined CRT and LVAD to both under LBBB and RBBB conditions. The results showed that the combined CRT and LVAD contributed a better hemodynamic compared to single CRT. This combined system synchronized the electrical activation greatly under LBBB and slightly under RBBB. It also shortened mechanical activation time which resulted short electromechanical delay. More importantly, the combined system produced better mechanical responses under both LBBB and RBBB conditions.

• The Korean Journal of Physiology and Pharmacology
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• 제23권1호
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• pp.63-70
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• 2019

We aimed to propose a novel computational approach to predict the electromechanical performance of pre- and post-mitral valve cerclage annuloplasty (MVCA). Furthermore, we tested a virtual estimation method to optimize the left ventricular basement tightening scheme using a pre-MVCA computer model. The present model combines the three-dimensional (3D) electromechanics of the ventricles with the vascular hemodynamics implemented in a lumped parameter model. 3D models of pre- and post-MVCA were reconstructed from the computed tomography (CT) images of two patients and simulated by solving the electromechanical-governing equations with the finite element method. Computed results indicate that reduction of the dilated heart chambers volume (reverse remodeling) appears to be dependent on ventricular stress distribution. Reduced ventricular stresses in the basement after MVCA treatment were observed in the patients who showed reverse remodeling of heart during follow up over 6 months. In the case who failed to show reverse remodeling after MVCA, more virtual tightening of the ventricular basement diameter than the actual model can induce stress unloading, aiding in heart recovery. The simulation result that virtual tightening of the ventricular basement resulted in a marked increase of myocardial stress unloading provides in silico evidence for a functional impact of MVCA treatment on cardiac mechanics and post-operative heart recovery. This technique contributes to establishing a pre-operative virtual rehearsal procedure before MVCA treatment by using patient-specific cardiac electromechanical modeling of pre-MVCA.

• 대한의용생체공학회:의공학회지
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• 제38권6호
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• pp.313-320
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• 2017

Myocardial infarction is a disease caused by stenosis of the coronary arteries. The high risk of sudden cardiac death due to myocardial infarction has triggered related researches that have been actively studied so far. However, these studies focused on the clinical results, which are mainly based on observations of symptoms due to infarction through electrocardiograms. Therefore, in this study, we tried to analyze the behavior of heart according to the position and volume of infarction lesion through the computer simulation study using three dimensional ventricular models. In order to implement infarction, commercial software was used to simulate cell necrosis due to blockage of a specific coronary. In addition, the conduction block due to infarction was mimicked by reducing the electrical conduction in the infarcted area, which was 100 times less than the electrical conduction of the whole ventricular lattice implemented by the finite element analysis method. Thus, this study classified the infarcted cases into the upper, middle, lower, and apex according to lattice data of eight different infraction areas. In other words, we assumed that myocardial infarction would have inherent electro-dynamic characteristics depending on the location and extent, and analyzed the ventricular electromechanical responses for infarction lesions using a three dimensional cardiac physiome model. The results showed that the volume of infarction did not directly affect the cardiac responses, but the location of the infarction lesions could influence the ventricular pumping efficiency. These suggest that the occlusion of specific coronary arteries may have a fatal effect on the decline in ventricular performance. In conclusion, although location of myocardial infarction lesions is considered to be an important variable to be considered clinically rather than lesion size, quantitative predictions should be made more in the future considering physiological factors such as lesion location and direction of myocardial fiber at that location.

• 대한기계학회논문집B
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• 제38권8호
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• pp.715-720
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• 2014

좌심실보조장치(LVAD)가 심실부하감소에 미치는 영향을 극대화 하기 위해, 심실보조장치 치료를 위한 최적의 심부전 심각도 단계를 찾는 것은 중요하다. 우리는 심부전 정도에 따른 LVAD 의 박동효율을 이론적으로 예측하였다. 우리는 혈관시스템의 6 컴파트먼트의 Wind-kessel 모델과 연동된 심실의 삼차원 유한요소모델을 사용하였다. 이 모델을 이용하여, LVAD 치료 하에서 심부전의 정도에 따라 심실의 수축성 ATP 소모율, 좌심실압력, 심박출량, 심박출 분획, 1 회심박출량 등과 같은 심장응답을 예측하였다. LVAD 치료 중에 에너지학적 부하조건을 암시하는 수축성 ATP 소모율은 5 단계 심부전 조건에서 가장 크게 감소하였다. 따라서, 우리는 LVAD 를 회복으로의 가교로서 고려하고 있을 때, 심부전 5 단계에서 LVAD 치료를 시작하는 것이 가장 적절하다는 결론을 내린다.

• 대한의용생체공학회:의공학회지
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• 제14권1호
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• pp.41-50
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• 1993

This paper proposes an adaptive technique for the cardiac output regulation of a pendulum type electromechanical TAH. This techinque, which consists of two RLSE's and two PASTC' 5, performs Its controllability over the TAIB so that the m(RAP) and m(LAP) values re- main close to their desired values under she assumption that the variation of m(RAP) and m (LAP) are dominated by the variation of C.0. and the difference between the left and right ventricular output, respectively. To evaluate the performance of the proposed control system, a simulation is performed by using a human model which contains physiologic, drug and treatment, artificial heart and noise models. As a result, dual adaptive controller showed that abnormal m(LAP) and m(RAP) could be recovered to the normal range within 10minute and maintained desired value in steady state. The operation of this controller prored to be robust in spite of the rapid variation of human status.