Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Pathogenetic mechanisms of decompensation in postinfarction aneurysm of the left ventricle from the perspective of the theory of latent oscillations

Authors: Mamalyga M.L.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2026-23-1-13-22

UDC: 616-005.8:616.124.2-007.64

Link: Clinical Physiology of Blood Circulaiton. 2026; 23 (1): 13-22

Quote as: Mamalyga M.L. Pathogenetic mechanisms of decompensation in postinfarction aneurysm of the left ventricle from the perspective of the theory of latent oscillations. Clinical Physiology of Circulation. 2026; 23 (1): 13–22 (in Russ.). DOI: 10.24022/1814-6910-2026-23-1-13-22

Received / Accepted:  29.12.2025 / 26.01.2026

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Abstract

Objective. To investigate the pathogenetic mechanisms of decompensation in left ventricular (LV) post-infarction aneurysm by analyzing a mathematical model of hidden hemodynamic oscillations in the "LV – post-infarction aneurysm" system.

Material and methods. A modified hemodynamic model of two coupled chambers with nonlinear elasticity was developed to study the formation mechanisms, stability, and clinical significance of hidden oscillatory processes. The model is based on three differential equations describing the dynamics of key state variables.

The mathematical model was developed in R software version 4.5.1. The system of differential equations was solved using the classical 4th-order Runge–Kutta method. The study involved a sequential analysis: the first stage simulated an increase in LV volumes, while the second stage assessed recovery dynamics under compensated and decompensated states. Dynamic assessment of volumetric parameters for the contractile LV and the aneurysm during the recovery period was performed by analyzing changes in end-diastolic volumes over a time interval from 1 to 1200 seconds. Model parameters were defined based on physiological data and imaging data from patients with LV post-infarction aneurysms. To verify the hypothesis, a comparative simulation was conducted for different clinical states: compensated hemodynamics and decompensation under load.

Results. Analysis of the mathematical modeling results revealed fundamental differences in the hemodynamic characteristics of the "LV – aneurysm" system across clinical states. Under compensated hemodynamics, stable volume dynamics with minimal oscillation amplitude were observed, indicating effective adaptation of the cardiovascular system. The volume difference between the functioning myocardium and the aneurysmal sac remained stable. Under decompensation with load, a qualitative change in system dynamics was recorded – a stable mode of hidden self- oscillations emerged. In the decompensated state, the initial aneurysm volume was 30.0% larger, and the rate of change in the volume of LV and aneurysm were 6–7 times higher than those in the compensated state. During the recovery period, volume stabilization was observed. Statistical analysis within the 290–300 s interval revealed significant differences in aneurysm volumes (p < 0.001). At later stages (1190–1200 s), minimal parameter variability was recorded. The mathematical modeling results indicate the determining role of a set of complex nonlinear pathophysiological mechanisms in the formation of post-infarction LV aneurysm.

Conclusion. Based on the results of mathematical modeling of the pathogenesis of hemodynamic disorders, the mechanisms of hidden oscillations and their key role in the "LV – post-infarction aneurysm" system during the transition from a stable state to decompensation were identified. A significant factor influencing the mechanisms of decompensation in patients with post-infarction aneurysm is the prolonged persistence of a pathological hidden oscillation regime. This regime is characterized by a high amplitude of paradoxical pulsation and a slow return to the baseline aneurysm volume, which, along with acute LV overload, determines the severity of the clinical presentation.

About Authors

Maksim L. Mamalyga, Dr. Med. Sci., Leading Researcher, Cardiologist; ORCID

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