Cardiovascular simulation as clinical decision support in cardiac surgery, cardiology and intensive care

The manifold drug, surgical and device treatments in cardiovascular disease and improved diagnostics imposes a need for patient-specific outcome prediction.

Modeling has the potential to bridge the gap between evidence-based medicine proving treatment effects in groups of patients and patient-specific aspects of the disease state necessitating individualization. The current computerized cardiovascular model runs in real-time and allows testing of treatments within minutes and is therefore a realistic clinical tool, although further validation is needed.

Research group leader

Michael Broomé

Affiliated to research
Anesthesiology
C3 Department of Physiology and Pharmacology

Projects

Analysis and optimization of cardiac loading in complex cardiovascular disease and mechanical circulatory support – clinical studies enforced by computerized cardiovascular physiology simulation.

Research support

  • Swedish Heart Lung Foundation 2019
  • Stockholm City Council ALF/SLL 2017-2018
  • Swedish Research Council 2013-2015

Collaborations

  • Professor Dirk Donker MD PhD, Cardiovascular and Respiratory Physiology (CRPH), Science and Technology, University of Twente, The Netherlands.
    Consultant intensivist/cardiologist Utrecht Medical Center, The Netherlands
  • Associate Professor Clinical Physiology Marcus Carlsson, Lunds University Hospital, Sweden. Clinical Investigator, National Institute of Health (NIH), Bethesda, Maryland, USA.
  • Associate Professor Pediatric Cardiology Petru Liuba, Lunds University Hospital, Sweden
  • Associate Professor Pediatric Cardiology Nina Hakacova, Lunds University Hospital, Sweden

Articles and publications

Right-Left Ventricular Interaction in Left-Sided Heart Failure With and Without Venoarterial Extracorporeal Membrane Oxygenation Support-A Simulation Study.
Donker DW, Sallisalmi M, Broome M.
ASAIO J. 2021;67(3):297-305.

Long term extracorporeal membrane oxygenation bridge to lung transplant after COVID-19.
Magnusson JM, Silverborn M, Broome M, Riise GC, Dellgren G.
Ann Thorac Surg. 2021.

Hydraulic force is a novel mechanism of diastolic function that may contribute to decreased diastolic filling in HFpEF and facilitate filling in HFrEF.
Steding-Ehrenborg K, Hedstrom E, Carlsson M, Maksuti E, Broome M, Ugander M, Magnusson M, Smith JG,  Arheden H.
J Appl Physiol (1985). 2021;130(4):993-1000.

Vårt vetande om medvetandet.
Broome M, Lagercrantz H.
Läkartidningen. 2020;2020(38-39):1174-6.

The hemodynamic effect of different left ventricular unloading techniques during veno-arterial extracorporeal life support: a systematic review and meta-analysis.
Meuwese CL, de Haan M, Zwetsloot PP, Braithwaite S, Ramjankhan F, van der Heijden J, Hermens J, Cremer O, Broome M, Donker DW.
Perfusion. 2020:267659119897478.

Extended use of extra corporeal membrane oxygenation as bridge to lung transplantation in two patients.
Skansebo E, Broome M, Magnusson J, Riise GC, Dellgren G.
J Cardiothorac Surg. 2020;15(1):16.

Differential hypoxemia during venoarterial extracorporeal membrane oxygenation.
Falk L, Sallisalmi M, Lindholm J, Lindfors M, Frenckner B, Broome M, Broman M.
Perfusion. 2019;34(EuroELSO 2019):22-9.

Cardiac remodeling in aortic and mitral valve disease: a simulation study with clinical validation.
Maksuti E, Westerhof BE, Ugander M, Donker DW, Carlsson M, Broomé M
J. Appl. Physiol. 2019 May;126(5):1377-1389

Left ventricular unloading during veno-arterial ECMO: a review of percutaneous and surgical unloading interventions.
Donker DW, Brodie D, Henriques JPS, Broomé M
Perfusion 2019 03;34(2):98-105

Position of draining venous cannula in extracorporeal membrane oxygenation for respiratory and respiratory/circulatory support in adult patients.
Frenckner B, Broman M, Broomé M
Crit Care 2018 06;22(1):163

Left Ventricular Unloading During Veno-Arterial ECMO: A Simulation Study.
Donker DW, Brodie D, Henriques JPS, Broomé M
ASAIO J. 2019 Jan;65(1):11-20

Treatment limitations in the era of ECMO.
Brodie D, Curtis JR, Vincent JL, Bakker J, Brown CE, Creteur J, et al
Lancet Respir Med 2017 10;5(10):769-770

Hydraulic forces contribute to left ventricular diastolic filling.
Maksuti E, Carlsson M, Arheden H, Kovács SJ, Broomé M, Ugander M
Sci Rep 2017 03;7():43505

Venous Cannula Positioning in Arterial Deoxygenation During Veno-Arterial Extracorporeal Membrane Oxygenation-A Simulation Study and Case Report.
Lindfors M, Frenckner B, Sartipy U, Bjällmark A, Broomé M
Artif Organs 2017 Jan;41(1):75-81

Contribution of the Arterial System and the Heart to Blood Pressure during Normal Aging - A Simulation Study.
Maksuti E, Westerhof N, Westerhof BE, Broomé M, Stergiopulos N
PLoS ONE 2016 ;11(6):e0157493

Individualized real-time clinical decision support to monitor cardiac loading during venoarterial ECMO.
Broomé M, Donker DW
J Transl Med 2016 Jan;14():4

Recirculation during veno-venous extra-corporeal membrane oxygenation--a simulation study.
Broman M, Frenckner B, Bjällmark A, Broomé M
Int J Artif Organs 2015 Jan;38(1):23-30

Modelling the heart with the atrioventricular plane as a piston unit.
Maksuti E, Bjällmark A, Broomé M
Med Eng Phys 2015 Jan;37(1):87-92

A factor XIIa inhibitory antibody provides thromboprotection in extracorporeal circulation without increasing bleeding risk.
Larsson M, Rayzman V, Nolte MW, Nickel KF, Björkqvist J, Jämsä A, et al
Sci Transl Med 2014 Feb;6(222):222ra17

Dissertations

Michael Broomé: PhD 2001 Umeå Universitet, Anestesiologi och Intensivvård
“Exogenous Angiotensin II – an experimental study of integrated circulatory effects in heart, splanchnic organs and kidney”
Handledare: Professor Björn Biber

Elira Maksuti: 2016 KI and KTH.
"Biomedical Engineering. Computer simulation of hemodynamics and ultrasound-based elastography for better diagnosis and treatment of cardiovascular diseases"

Magnus Larsson: 2015 KI.
"Pediatric Surgery. ECMO and Trauma"