Modeling of cardiovascular circulation for the early detection of coronary arterial blockage

Abstract

Coronary arteries are responsible for maintaining blood supply to the heart. When these arteries get blocked due to plaque deposition, the corresponding pathological condition is referred to as coronary artery disease. This disease develops gradually over the years and consequently, the function of the heart deteriorates, leading to a heart attack in many cases. As the symptoms manifest themselves only when it has become severe, detection of the disease often gets delayed. In order to detect it early and take preventive action, this work is aimed at detecting the arterial blockage in its early stage via cardiovascular modeling. To achieve this, the cardiovascular circulation has been modeled as a sixth order nonlinear system. Blood circulation in a body is viewed as an electrical system using the pressure-voltage analogy. In this case, the heart is considered as a self-excited generator. The rest of the body tissues form a systemic load. In the models reported in the literature, coronary circulation has been assumed to be a part of the systemic load. However, this circulation path has its own importance as it is responsible for the blood supply to the heart. Therefore, in our work, the coronary path is separated out from the rest of the body tissues. This enables us to explicitly model the coronary arterial resistance and thereby helps us to detect coronary arterial blockage condition by estimating this parameter from blood pressure measurements. Increase in the coronary resistance is found to reduce the left ventricular ejection fraction; this information can therefore be used as an index for coronary arterial blockage. It has been shown that the systolic function of the heart deteriorates when the resistance of the coronary path increases beyond a critical value; the situation can be related to a severe blockage condition. The model has been tested on a chosen sample of 20 subjects suffering from coronary artery disease and the results are found to be quite promising.

Keywords: Blood pressure; Cardiovascular model; Coronary arterial blockage; Ejection fraction; Heart; Nonlinear system.