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Rodero C, Baptiste TMG, Barrows RK, Lewalle A, Niederer SA, Strocchi M. Advancing clinical translation of cardiac biomechanics models: a comprehensive review, applications and future pathways. Front Phys 2023; 11:1306210. [PMID: 38500690 PMCID: PMC7615748 DOI: 10.3389/fphy.2023.1306210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Cardiac mechanics models are developed to represent a high level of detail, including refined anatomies, accurate cell mechanics models, and platforms to link microscale physiology to whole-organ function. However, cardiac biomechanics models still have limited clinical translation. In this review, we provide a picture of cardiac mechanics models, focusing on their clinical translation. We review the main experimental and clinical data used in cardiac models, as well as the steps followed in the literature to generate anatomical meshes ready for simulations. We describe the main models in active and passive mechanics and the different lumped parameter models to represent the circulatory system. Lastly, we provide a summary of the state-of-the-art in terms of ventricular, atrial, and four-chamber cardiac biomechanics models. We discuss the steps that may facilitate clinical translation of the biomechanics models we describe. A well-established software to simulate cardiac biomechanics is lacking, with all available platforms involving different levels of documentation, learning curves, accessibility, and cost. Furthermore, there is no regulatory framework that clearly outlines the verification and validation requirements a model has to satisfy in order to be reliably used in applications. Finally, better integration with increasingly rich clinical and/or experimental datasets as well as machine learning techniques to reduce computational costs might increase model reliability at feasible resources. Cardiac biomechanics models provide excellent opportunities to be integrated into clinical workflows, but more refinement and careful validation against clinical data are needed to improve their credibility. In addition, in each context of use, model complexity must be balanced with the associated high computational cost of running these models.
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Affiliation(s)
- Cristobal Rodero
- Cardiac Electro-Mechanics Research Group (CEMRG), National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Tiffany M. G. Baptiste
- Cardiac Electro-Mechanics Research Group (CEMRG), National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
| | - Rosie K. Barrows
- Cardiac Electro-Mechanics Research Group (CEMRG), National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
| | - Alexandre Lewalle
- Cardiac Electro-Mechanics Research Group (CEMRG), National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Steven A. Niederer
- Cardiac Electro-Mechanics Research Group (CEMRG), National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
- Turing Research and Innovation Cluster in Digital Twins (TRIC: DT), The Alan Turing Institute, London, United Kingdom
| | - Marina Strocchi
- Cardiac Electro-Mechanics Research Group (CEMRG), National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
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Mi J, Zhao Z, Wang H, Tang H. Study of the Relationship between Pulmonary Artery Pressure and Heart Valve Vibration Sound Based on Mock Loop. Bioengineering (Basel) 2023; 10:985. [PMID: 37627870 PMCID: PMC10451642 DOI: 10.3390/bioengineering10080985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
The vibration of the heart valves' closure is an important component of the heart sound and contains important information about the mechanical activity of a heart. Stenosis of the distal pulmonary artery can lead to pulmonary hypertension (PH). Therefore, in this paper, the relationship between the vibration sound of heart valves and the pulmonary artery blood pressure was investigated to contribute to the noninvasive detection of PH. In this paper, a lumped parameter circuit platform of pulmonary circulation was first set to guide the establishment of a mock loop of circulation. By adjusting the distal vascular resistance of the pulmonary artery, six different pulmonary arterial pressure states were achieved. In the experiment, pulmonary artery blood pressure, right ventricular blood pressure, and the vibration sound of the pulmonary valve and tricuspid valve were measured synchronously. Features of the time domain and frequency domain of two valves' vibration sound were extracted. By conducting a significance analysis of the inter-group features, it was found that the amplitude, energy and frequency features of vibration sounds changed significantly. Finally, the continuously varied pulmonary arterial blood pressure and valves' vibration sound were obtained by continuously adjusting the resistance of the distal pulmonary artery. A backward propagation neural network and deep learning model were used, respectively, to estimate the features of pulmonary arterial blood pressure, pulmonary artery systolic blood pressure, the maximum rising rate of pulmonary artery blood pressure and the maximum falling rate of pulmonary artery blood pressure by the vibration sound of the pulmonary and tricuspid valves. The results showed that the pulmonary artery pressure parameters can be well estimated by valve vibration sounds.
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Affiliation(s)
- Jiachen Mi
- School of Biomedical Engineering, Faculty of Medicine, Dalian University of Technology, Dalian 116024, China; (J.M.); (Z.Z.); (H.W.)
- INTESIM (Dalian) Co., Ltd., Dalian 116024, China
| | - Zehang Zhao
- School of Biomedical Engineering, Faculty of Medicine, Dalian University of Technology, Dalian 116024, China; (J.M.); (Z.Z.); (H.W.)
| | - Hongkai Wang
- School of Biomedical Engineering, Faculty of Medicine, Dalian University of Technology, Dalian 116024, China; (J.M.); (Z.Z.); (H.W.)
| | - Hong Tang
- School of Biomedical Engineering, Faculty of Medicine, Dalian University of Technology, Dalian 116024, China; (J.M.); (Z.Z.); (H.W.)
- Liaoning Key Lab of Integrated Circuit and Biomedical Electronic System, Dalian University of Technology, Dalian 116024, China
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Laubscher R, van der Merwe J, Liebenberg J, Herbst P. Dynamic simulation of aortic valve stenosis using a lumped parameter cardiovascular system model with flow regime dependent valve pressure loss characteristics. Med Eng Phys 2022; 106:103838. [DOI: 10.1016/j.medengphy.2022.103838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/20/2022]
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Chen Z, Zhou YP, Liu X, Jiang X, Wu T, Ghista D, Xu XQ, Zhang H, Jing ZC. A Personalized Pulmonary Circulation Model to Non-Invasively Calculate Fractional Flow Reserve for Artery Stenosis Detection. IEEE Trans Biomed Eng 2021; 69:1435-1448. [PMID: 34633925 DOI: 10.1109/tbme.2021.3119188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Fractional Flow Reserve (FFR) is regarded as a fundamental index to assess pulmonary artery stenosis. The application of FFR can increase the accuracy of detection of pulmonary artery stenosis. However, the invasive examination may carry a number of physiological risks for patients. Therefore, we propose a personalized pulmonary circulation model to non- invasively calculate FFR of pulmonary artery stenosis. Method- ology: We employed a personalized pulmonary circulation model to non-invasively calculate FFR using only computed tomography angiogram (CTA) data. This model combined boundary conditions estimation and 3D pulmonary artery morphology reconstruction for CFD simulation. First, we obtained patient-specific boundary conditions by adapting the right ventricle stroke volume and main pulmonary artery pressure feature points (systolic, diastolic, and mean pressure). Secondly, the 3D pulmonary artery morphology was reconstructed by threshold segmentation. The CFD simulation was then performed to obtain pressure distribution in the entire pulmonary artery. Finally, the FFR in pulmonary artery stenoses was calculated as the ratio of distal pressure and proximal pres- sure. RESULTS To validate our model, we compared the calculated FFR with measured FFR by pressure guide wires examination of 8 patients. The FFR calculated by our model showed a good agreement with measured FFR by pressure guide wires exami- nation. The average accuracy rate was 91.41%. CONCLUSION The proposed personalized pulmonary model is capable of reasonably non-invasively calculating FFR with sufficient accuracy. SIGNIFICANCE FFR calculated in our model may contribute to non-invasive detection of pulmonary artery stenosis and to the assessment of invasive interventions.
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Rosalia L, Ozturk C, Van Story D, Horvath MA, Roche ET. Object‐Oriented Lumped‐Parameter Modeling of the Cardiovascular System for Physiological and Pathophysiological Conditions. Adv Theory Simul 2021. [DOI: 10.1002/adts.202000216] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Luca Rosalia
- Institute for Medical Engineering and Science Massachusetts Institute of Technology Cambridge MA 02139 USA
- Harvard‐MIT Program in Health Sciences and Technology Massachusetts Institute of Technology Cambridge MA 02139 USA
| | - Caglar Ozturk
- Institute for Medical Engineering and Science Massachusetts Institute of Technology Cambridge MA 02139 USA
| | - David Van Story
- Institute for Medical Engineering and Science Massachusetts Institute of Technology Cambridge MA 02139 USA
| | - Markus A. Horvath
- Institute for Medical Engineering and Science Massachusetts Institute of Technology Cambridge MA 02139 USA
- Harvard‐MIT Program in Health Sciences and Technology Massachusetts Institute of Technology Cambridge MA 02139 USA
| | - Ellen T. Roche
- Institute for Medical Engineering and Science Massachusetts Institute of Technology Cambridge MA 02139 USA
- Harvard‐MIT Program in Health Sciences and Technology Massachusetts Institute of Technology Cambridge MA 02139 USA
- Department of Mechanical Engineering Massachusetts Institute of Technology Cambridge MA 02139 USA
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