ArticleEuropean heart journal. Digital health2020
Increased myocardial stiffness more than impaired relaxation function limits cardiac performance during exercise in heart failure with preserved ejection fraction: a virtual patient study.
Article in European heart journal. Digital health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 20 citations in OpenAlex.
- Compliance modulation of a soft robotic atrioventricular model of heart failure with preserved ejection fraction.Nature communications · 2026Article
- Impact of left-heart myopathy on mitral valve stenosis assessment and interventional outcomes: anEuropean heart journal. Digital health · 2026Article
- Inter-atrial block as a predictor of adverse outcomes in patients with HFpEF.ESC heart failure · 2025Article
- Impact of myocardial phenotype on optimal atrioventricular delay settings during biventricular and left bundle branch pacing at rest and during exercise: insights from a virtual patient study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- The mechanistic interaction between mechanical dyssynchrony and filling pressure in cardiac resynchronisation therapy candidates.European heart journal. Cardiovascular Imaging · 2025Article
- Differential Myocardial Responses in Male and Female Rats with Uremic Cardiomyopathy.International journal of molecular sciences · 2025Article
- Identification of digital twins to guide interpretable AI for diagnosis and prognosis in heart failure.NPJ digital medicine · 2025Article
- Accelerated atrial pacing reduces left-heart filling pressure: a combined clinical-computational study.European heart journal · 2024Article
- Management of Left Atrial Tachyrhythms in the Setting of HFpEF with Pulsed-Field Ablation: Treating Fire with Water?Therapeutics · 2024Article
- Mitral regurgitation in heart failure with preserved ejection fraction: The interplay of valve, ventricle, and atrium.European journal of heart failure · 2024Review
- Understanding heterogeneous mechanisms of heart failure with preserved ejection fraction through cardiorenal mathematical modeling.PLoS computational biology · 2023Article
- A Closed-Loop Modeling Framework for Cardiac-to-Coronary Coupling.Frontiers in physiology · 2022Article
- Hemodynamics-driven mathematical model of third heart sound generation.Frontiers in physiology · 2022Article
- The prognostic impact of mechanical atrial dysfunction and atrial fibrillation in heart failure with preserved ejection fraction.European heart journal. Cardiovascular Imaging · 2021Article
- The 1-year anniversary of theEuropean heart journal. Digital health · 2021Article
- Uncertainty Quantification of Regional Cardiac Tissue Properties in Arrhythmogenic Cardiomyopathy Using Adaptive Multiple Importance Sampling.Frontiers in physiology · 2021Article
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Aims: The relative impact of left ventricular (LV) diastolic dysfunction (LVDD) and impaired left atrial (LA) function on cardiovascular haemodynamics in heart failure with preserved ejection fraction (HFpEF) is largely unknown. We performed virtual patient simulations to elucidate the relative effects of these factors on haemodynamics at rest and during exercise. Methods and results: The CircAdapt cardiovascular system model was used to simulate cardiac haemodynamics in wide ranges of impaired LV relaxation function, increased LV passive stiffness, and impaired LA function. Simulations showed that LV ejection fraction (LVEF) was preserved (>50%), despite these changes in LV and LA function. Impairment of LV relaxation function decreased Conclusion: The CircAdapt model enabled realistic simulation of virtual HFpEF patients, covering a wide spectrum of LVDD and related limitations of cardiac exercise performance, all with preserved resting LVEF. Simulations suggest that increased LV passive stiffness, more than impaired relaxation function, reduces exercise tolerance, especially when LA function is impaired. In future studies, the CircAdapt model can serve as a valuable platform for patient-specific simulations to identify the disease substrate(s) underlying the individual HFpEF patient's cardiovascular phenotype.
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