Anaemia is common in end-stage heart failure patients supported with continuous flow left ventricular assist device (CF-LVAD) and is associated with adverse outcomes such as heart failure readmission. This study evaluates the haemodynamic effects of anaemia on cardiac function and cerebral blood flow in heart failure patients supported with CF-LVAD using computational simulations. A dynamic model simulating cardiac function, systemic, pulmonary and cerebral circulations, cerebral flow autoregulatory mechanisms and gas contents in blood was used to evaluate the effects of anaemia and iron deficiency in heart failure and during CF-LVAD support. CF-LVAD therapy was simulated by a model describing HeartMate 3. Anaemia and iron deficiency were simulated by reducing the haemoglobin level from 15 to 9 g/dL and modifying scaling coefficients in the models simulating heart chamber volumes. Reduced haemoglobin levels decreased the arterial O₂ content, which increased cerebral blood flow rate by more than 50% in heart failure and during CF-LVAD assistance. Reduced haemoglobin levels simulating anaemia had minimal effect on the arterial and atrial blood pressures and ventricular volumes. In contrast, iron deficiency increased end-diastolic left and right ventricular diameters in heart failure from 6.6 cm to 7 cm and 2.9 cm to 3.1 cm and during CF-LVAD support from 6.1 to 6.4 cm and 3.1 to 3.3 cm. The developed numerical model simulates the effects of anaemia in failing heart and during CF-LVAD therapy. It is in good agreement with clinical data and can be utilised to assess CF-LVAD therapy.

中文翻译：

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贫血时心力衰竭和连续流左心室辅助装置支持的计算评估

贫血在接受连续流左心室辅助装置（CF-LVAD）支持的终末期心力衰竭患者中很常见，并且与心力衰竭再入院等不良后果相关。本研究使用计算模拟评估贫血对 CF-LVAD 支持的心力衰竭患者的心脏功能和脑血流的血流动力学影响。使用模拟心脏功能、全身、肺和脑循环、脑血流自动调节机制和血液中气体含量的动态模型来评估贫血和铁缺乏对心力衰竭和CF-LVAD支持期间的影响。CF-LVAD 治疗通过描述 HeartMate 3 的模型进行模拟。通过将血红蛋白水平从 15 g/dL 降低至 9 g/dL 并修改模拟心室容积的模型中的缩放系数来模拟贫血和缺铁。血红蛋白水平降低会降低动脉O ₂含量，从而使心力衰竭和CF-LVAD辅助期间的脑血流量增加50%以上。模拟贫血的血红蛋白水平降低对动脉和心房血压以及心室容积的影响很小。相比之下，缺铁使心力衰竭时左心室和右心室舒张末直径从 6.6 cm 增加到 7 cm，从 2.9 cm 增加到 3.1 cm，在 CF-LVAD 支持期间从 6.1 cm 增加到 6.4 cm，从 3.1 cm 增加到 3.3 cm。开发的数值模型模拟了贫血对心力衰竭和 CF-LVAD 治疗期间的影响。与临床数据吻合良好，可用于评估 CF-LVAD 治疗。