University of Twente Student Theses
Analysis of baroreflex functionality in pregnancy through hemodynamical modeling
Boutkan, Nadine (2024) Analysis of baroreflex functionality in pregnancy through hemodynamical modeling.
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| Abstract: | Pregnancy induces crucial cardiovascular adaptations to the maternal system to accommodate increased metabolic demands for both the mother and fetus. Important adaptations include a decrease in peripheral vascular resistance (VR) and blood pressure (BP) and an increase in plasma volume, cardiac output (CO) and heart rate (HR). Through these changes, optimum circumstances are created for placental blood flow to realize fetal growth. Failure to meet these demands can result in hypertensive disorders including preeclampsia (PE), one of the leading causes of morbidity and mortality of mother and fetus [1, 2]. PE is a disease thought to be driven by dysfunction of the placenta, triggering inflammatory and hypertensive reactions of the mother. However, both in presence and absence of PE, other factors also influence the BP during pregnancy [2]. Currently it is known that the arterial baroreflex, which is responsible for the short-term regulation of BP, is diminished during pregnancy. This reduction is even more pronounced in pregnant women with hypertensive disorders such as PE [3-5]. The underlying mechanism behind a diminished baroreflex in pregnancy remains unclear, particularly since the decrease in baroreflex function is even more prominent in a pathological situation. Therefore, more research is necessary to understand the role of the baroreflex in BP maintenance in pregnancy. To address this knowledge gap, mathematical modeling offers a valuable approach. By simulating cardiovascular changes, models can help clarify the interactions between various physiological processes, including the baroreflex. The Radboudumc is developing a maternal hemodynamic model for this purpose. They have started with a lumped model containing compartments that represent the physiological structures and connectors of the cardiovascular system. Recent work has implemented the renal autoregulation, since this has an important role in maintaining BP and extracellular fluid volume [6]. The model is under constant development where one of the next steps is to implement the baroreflex. Many studies have been performed in modeling the baroreflex within a closed-loop system. For example, Sharifi et al. examined calcium transport within the baroreflex [7], Fernandes et al. studied the afferent pathway's role in action potential propagation [8], and Jezek et al. incorporated lung dynamics as well as the baroreflex into a lumped compartment model [9]. Given the complexity of the cardiovascular system, particularly the baroreflex, each model varies in scope, emphasizing different aspects of the physiology. In this research, we aim to build on these efforts by incorporating mechanisms of the baroreflex that could be altered during pregnancy. Our goal is to enhance the understanding of baroreflex function in pregnancy through the development of a mathematical model that captures its role in BP regulation. |
| Item Type: | Essay (Master) |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine |
| Programme: | Technical Medicine MSc (60033) |
| Link to this item: | https://purl.utwente.nl/essays/104594 |
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