Neuromodulation based adaptive controller for mitral stenosis

Patent metadata

Field	Value
Publication number	US-11728040-B2
Application number	US-202117149059-A
Country	US
Kind code	B2
Filing date	Jan 14, 2021
Priority date	Jan 29, 2020
Publication date	Aug 15, 2023
Grant date	Aug 15, 2023

Abstract

This disclosure provides a simulation platform to study and perform predictive analysis on valvular heart disease, Mitral stenosis (MS) and provides a control approach to correct hemodynamic imbalances during MS conditions. Conventional approaches of valve repair or replacement are often associated with risk of thromboembolism, need for anticoagulation, prosthetic endocarditis, and impaired left ventricle function. The cardiovascular hemodynamics model of the present disclosure helps to create ‘what if’ conditions to study variations in different hemodynamic parameters like blood flow, aortic and ventricular pressure, etc. during normal and pathological conditions. An adaptive control system in conjunction with the hemodynamic cardiovascular system (CVS) is provided to handle hemodynamic disbalance during moderate to severe MS conditions. The adaptive controller is hypothesized in line with the neuromodulation approach and modulates left ventricular contractility and vagal tone to counter the symptoms associated with MS.

First claim

What is claimed is:

1. A processor implemented method ( 400 ) for enhancing cardiac output (CO) in a subject having Mitral Stenosis (MS), the method comprising the steps of:
receiving, via one or more hardware processors serving as a first controller, an error e1 between an actual left ventricular pressure P lv obtained from an adaptive controller comprising a hemodynamic cardiovascular system (CVS) model representative of the subject having MS and a desired left ventricular pressure pa wherein the desired left ventricular pressure corresponds to a healthy cardiovascular system ( 402 );
generating an updated left ventricle end diastolic compliance {tilde over (c)} lv,d via the first controller, by minimizing the error e1 ( 404 );
receiving, via one or more hardware processors serving as a second controller, an error e2 between an actual aortic pressure P sa obtained from an adaptive controller comprising the hemodynamic CVS model and a desired aortic pressure P sa d , wherein the desired aortic pressure corresponds to the healthy cardiovascular system ( 406 );
generating an updated systemic vascular resistance {tilde over (R)} s , via the second controller, by minimizing the error e2 ( 408 );
receiving, via one or more hardware processors serving as a third controller, the updated left ventricle end diastolic compliance {tilde over (c)} lv,d and the updated systemic vascular resistance {tilde over (R)} s to generate control inputs u 1 and u 2 for opening and closing a mitral valve and an aortic valve respectively ( 410 ) of the subject;
receiving, via the adaptive controller comprising the hemodynamic CVS model, the updated left ventricle end diastolic compliance {tilde over (c)} lv,d , the updated systemic vascular resistance {tilde over (R)} s and the generated control inputs u 1 and u 2 ( 412 ); and
enhancing, via the one or more hardware processors serving as the first controller, the second controller and the third controller, the CO in the subject having MS by using the generated control inputs u 1 and u 2 and adaptively controlling via the hemodynamic CVS model, the parameters of updated left ventricle end diastolic compliance {tilde over (c)} lv,d , and the updated systemic vascular resistance {tilde over (R)} s by neuromodulation.

2. The processor implemented method of claim 1 , wherein the updated left ventricle end diastolic compliance {tilde over (c)} lv,d is based on the actual left ventricular pressure P lv , a rate of change of the desired left ventricular pressure {dot over (P)} lv d and a diastolic time duration T−T s , and wherein T represents duration of a cardiac cycle having a systolic duration T s , such that the {tilde over (c)} lv,d is limited to a physiological acceptable range for left ventricle end diastolic compliance [c lv,d min , c lv,d max ].

3. The processor implemented method of claim 2 , wherein the updated left ventricle end diastolic compliance {tilde over (c)} lv,d is represented according to the equation

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Assignees

• Tata Consultancy Services Ltd

Inventors

• Roy Dibyendu
• Mazumder Oishee
• Sinha Aniruddha
• Khandelwal Sundeep

Classifications

• G16H50/50 Primary

  for simulation or modelling of medical disorders · CPC title

• G16H20/30

  relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising · CPC title

• G16H40/67

  for remote operation · CPC title

• G16H50/70

  for mining of medical data, e.g. analysing previous cases of other patients · CPC title

• G16H70/60

  relating to pathologies · CPC title