Automated drug delivery system for the management of hemodynamics and cardiac energetic in acute heart failure

We have developed a novel automated drug delivery system for simultaneous control of systemic arterial pressure (AP), cardiac output (CO), and left atrial pressure (P_LA) in acute heart failure. The circulatory equilibrium framework we established previously discloses that AP, CO, and P_LA are determined by equilibrium of the mechanical properties of the circulation, i.e. pumping ability of the left heart, stressed blood volume and systemic arterial resistance. Our system directly controls the three mechanical properties with cardiovascular drugs including inotropes and vasodilators, thereby controlling AP, CO, and P_LA. Furthermore, by precisely controlling bradycardia and LV inotropy, our system enables to improve cardiac energetic efficiency while preserving AP, CO, and P_LA within acceptable ranges. In conclusion, by directly controlling the mechanical properties of the heart and vessel, our automated system realizes comprehensive management of hemodynamics in acute heart failure.