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Furthermore, we comparatively evaluate the performance of a number of previously proposed physiologically responsive controllers, including constant speed, constant flow pulsatility index (<jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content>), constant average pressure difference between the aorta and the left atrium, constant average differential pump pressure, constant ratio between mean pump flow and pump flow pulsatility (<jats:italic>ratio<jats:sub>P<\/jats:sub><\/jats:italic><jats:styled-content style=\"fixed-case\"><jats:italic>I<\/jats:italic><\/jats:styled-content>or linear<jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>tarling\u2010like control), as well as constant left atrial pressure<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/aor12370-math-5001.png\" xlink:title=\"urn:x-wiley:0160564X:media:aor12370:aor12370-math-5001\"\/>control, with regard to their ability to increase cardiac output during exercise while maintaining circulatory stability upon<jats:styled-content style=\"fixed-case\">HUT<\/jats:styled-content>. Although native cardiac output increases automatically during exercise, increasing pump speed was able to further improve total cardiac output and reduce elevated filling pressures. At the same time, reduced venous return associated with upright posture was not shown to induce left ventricular (<jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>) suction. Although<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/aor12370-math-5002.png\" xlink:title=\"urn:x-wiley:0160564X:media:aor12370:aor12370-math-5002\"\/>control outperformed other control modes in its ability to increase cardiac output during exercise, it caused a fall in the mean arterial pressure upon<jats:styled-content style=\"fixed-case\">HUT<\/jats:styled-content>, which may cause postural hypotension or patient discomfort. To the contrary, maintaining constant average pressure difference between the aorta and the left atrium demonstrated superior performance in both exercise and<jats:styled-content style=\"fixed-case\">HUT<\/jats:styled-content>scenarios. Due to their strong dependence on the pump operating point,<jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content>and<jats:italic>ratio<jats:sub>PI<\/jats:sub><\/jats:italic>control performed poorly during exercise and<jats:styled-content style=\"fixed-case\">HUT<\/jats:styled-content>. Our simulation results also highlighted the importance of the baroreflex mechanism in determining the response of the<jats:styled-content style=\"fixed-case\">IRBP<\/jats:styled-content>\u2010assisted patients to exercise and postural changes, where desensitized reflex response attenuated the percentage increase in cardiac output during exercise and substantially reduced the arterial pressure upon<jats:styled-content style=\"fixed-case\">HUT<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/aor.12370","type":"journal-article","created":{"date-parts":[[2014,10,27]],"date-time":"2014-10-27T05:35:24Z","timestamp":1414388124000},"source":"Crossref","is-referenced-by-count":17,"title":["Hemodynamic Response to Exercise and Head\u2010Up Tilt of Patients Implanted With a Rotary Blood Pump: A Computational Modeling Study"],"prefix":"10.1111","volume":"39","author":[{"given":"Einly","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering Faculty of Engineering University of Malaya Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert Francis","family":"Salamonsen","sequence":"additional","affiliation":[{"name":"Intensive Care Alfred Hospital Prahran Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7702-3249","authenticated-orcid":false,"given":"Mahdi","family":"Mansouri","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Faculty of Engineering University of Malaya Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Gaddum","sequence":"additional","affiliation":[{"name":"Division of Imaging Sciences and Biomedical Engineering St. Thomas\u2019 Hospital King's College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David Glen","family":"Mason","sequence":"additional","affiliation":[{"name":"ITEE University of Queensland Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel L.","family":"Timms","sequence":"additional","affiliation":[{"name":"Texas Heart Institute Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3583-688X","authenticated-orcid":false,"given":"Michael Charles","family":"Stevens","sequence":"additional","affiliation":[{"name":"Critical Care Research Group The Prince Charles Hospital Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Fraser","sequence":"additional","affiliation":[{"name":"Critical Care Research Group The Prince Charles Hospital Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rini","family":"Akmeliawati","sequence":"additional","affiliation":[{"name":"Mechatronics Engineering International Islamic University Malaysia Gombak Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nigel Hamilton","family":"Lovell","sequence":"additional","affiliation":[{"name":"Graduate School of Biomedical Engineering University of New South Wales Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,10,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2004.04.044"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2005.02.004"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0b013e31817b5b0e"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1594.1999.06426.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1594.2011.01227.x"},{"key":"e_1_2_8_7_1","first-page":"554","article-title":"Central and peripheral blood flow during exercise with a continuous\u2010flow left ventricular assist device: constant versus increasing pump speed: a pilot study","volume":"4","author":"Brassard P","year":"2011","journal-title":"Circulation"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.12070"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.98.12.1178"},{"key":"e_1_2_8_10_1","doi-asserted-by":"crossref","unstructured":"MuthiahK RobsonD WalkerR.Relationship between heart rate and pump flow in patients implanted with continuous flow left ventricular assist devices (LVAD). 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