Neuromodulation based adaptive controller for mitral stenosis

Patent metadata

Field	Value
Publication number	US-2021280319-A1
Application number	US-202117149059-A
Country	US
Kind code	A1
Filing date	Jan 14, 2021
Priority date	Jan 29, 2020
Publication date	Sep 9, 2021
Grant date	—

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 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 from a hemodynamic cardiovascular system (CVS) model representative of the subject having MS and a desired left ventricular pressure P lv d , wherein the desired left ventricular pressure corresponds to a healthy cardiovascular system; generating an updated left ventricle end diastolic compliance {tilde over (c)} lv,d via the first controller, by minimizing the error e1; receiving, via one or more hardware processors serving as a second controller, an error e2 between an actual aortic pressure P sa from the hemodynamic CVS model and a desired aortic pressure P sa d , wherein the desired aortic pressure corresponds to the healthy cardiovascular system; generating an updated systemic vascular resistance {tilde over (R)} s , via the second controller, by minimizing the error e2; 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; and receiving, via 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 ; wherein the {tilde over (c)} lv,d and the {tilde over (R)} s represent parameters that are adaptively controlled by neuromodulation for enhancing the CO in the subject having MS.

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

• A61B5/02028

  Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction · CPC title

• A61N1/36114

  Cardiac control, e.g. by vagal stimulation (stimulating the heart A61N1/362) · CPC title

• A61B5/021

  Measuring pressure in heart or blood vessels · CPC title

• 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