This paper presents an optimal control approach to modeling effects of cardiovascular regulation during head-up tilt (HUT). Many patients who suffer from dizziness or light-headedness are administered a head-up tilt test to explore potential deficits within the autonomic control system, which maintains the cardiovascular system at homeostasis. This system is complex and difficult to study in vivo, and thus we propose to use mathematical modeling to achieve a better understanding of cardiovascular regulation during HUT. In particular, we show the feasibility of using optimal control theory to compute physiological control variables, vascular resistance and cardiac contractility, quantities that cannot be measured directly, but which are useful to assess the state of the cardiovascular system. A non-pulsatile lumped parameter model together with pseudo- and clinical data are utilized in the optimal control problem formulation. Results show that the optimal control approach can predict time-varying quantities regulated by the cardiovascular control system. Our results compare favorable to our previous study using a piecewise linear spline approach, less a priori knowledge is needed, and results were obtained at a significantly lower computational cost.

中文翻译：

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抬头倾斜过程中血压调节的最佳控制方法。

本文提出了一种优化的控制方法，以模拟抬头倾斜（HUT）期间心血管调节的效果。对许多头昏眼花或头昏眼花的患者进行平头倾斜试验，以探索自主控制系统内的潜在缺陷，从而使心血管系统保持稳态。该系统复杂且难以在体内研究，因此我们建议使用数学模型来更好地了解HUT期间的心血管调节。特别是，我们展示了使用最佳控制理论来计算生理控制变量，血管阻力和心脏收缩力，无法直接测量但可用于评估心血管系统状态的量的可行性。最佳控制问题的制定中采用了非脉动集总参数模型以及伪数据和临床数据。结果表明，最佳控制方法可以预测心血管控制系统调节的时变量。我们的结果与采用分段线性样条方法的先前研究相比是有利的，所需的先验知识更少，并且以显着较低的计算成本获得了结果。