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Bartolo MA, Taylor-LaPole AM, Gandhi D, Johnson A, Li Y, Slack E, Stevens I, Turner ZG, Weigand JD, Puelz C, Husmeier D, Olufsen MS. Computational framework for the generation of one-dimensional vascular models accounting for uncertainty in networks extracted from medical images. J Physiol 2024; 602:3929-3954. [PMID: 39075725 DOI: 10.1113/jp286193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/28/2024] [Indexed: 07/31/2024] Open
Abstract
One-dimensional (1D) cardiovascular models offer a non-invasive method to answer medical questions, including predictions of wave-reflection, shear stress, functional flow reserve, vascular resistance and compliance. This model type can predict patient-specific outcomes by solving 1D fluid dynamics equations in geometric networks extracted from medical images. However, the inherent uncertainty in in vivo imaging introduces variability in network size and vessel dimensions, affecting haemodynamic predictions. Understanding the influence of variation in image-derived properties is essential to assess the fidelity of model predictions. Numerous programs exist to render three-dimensional surfaces and construct vessel centrelines. Still, there is no exact way to generate vascular trees from the centrelines while accounting for uncertainty in data. This study introduces an innovative framework employing statistical change point analysis to generate labelled trees that encode vessel dimensions and their associated uncertainty from medical images. To test this framework, we explore the impact of uncertainty in 1D haemodynamic predictions in a systemic and pulmonary arterial network. Simulations explore haemodynamic variations resulting from changes in vessel dimensions and segmentation; the latter is achieved by analysing multiple segmentations of the same images. Results demonstrate the importance of accurately defining vessel radii and lengths when generating high-fidelity patient-specific haemodynamics models. KEY POINTS: This study introduces novel algorithms for generating labelled directed trees from medical images, focusing on accurate junction node placement and radius extraction using change points to provide haemodynamic predictions with uncertainty within expected measurement error. Geometric features, such as vessel dimension (length and radius) and network size, significantly impact pressure and flow predictions in both pulmonary and aortic arterial networks. Standardizing networks to a consistent number of vessels is crucial for meaningful comparisons and decreases haemodynamic uncertainty. Change points are valuable to understanding structural transitions in vascular data, providing an automated and efficient way to detect shifts in vessel characteristics and ensure reliable extraction of representative vessel radii.
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Affiliation(s)
- Michelle A Bartolo
- Department of Mathematics, North Carolina State University, Raleigh, NC, USA
| | | | - Darsh Gandhi
- Department of Mathematics, North Carolina State University, Raleigh, NC, USA
- Department of Mathematics, University of Texas at Arlington, Arlington, TX, USA
| | - Alexandria Johnson
- Department of Mathematics, North Carolina State University, Raleigh, NC, USA
- Department of Mathematics and Statistics, University of South Florida, Tampa, FL, USA
| | - Yaqi Li
- Department of Mathematics, North Carolina State University, Raleigh, NC, USA
- North Carolina School of Science and Mathematics, Durham, NC, USA
| | - Emma Slack
- Department of Mathematics, North Carolina State University, Raleigh, NC, USA
- Department of Mathematics, Colorado State University, Fort Collins, CO, USA
| | - Isaiah Stevens
- Department of Mathematics, North Carolina State University, Raleigh, NC, USA
| | - Zachary G Turner
- Department of Mathematics, North Carolina State University, Raleigh, NC, USA
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ, USA
| | - Justin D Weigand
- Division of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Charles Puelz
- Division of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Dirk Husmeier
- School of Mathematics and Statistics, University of Glasgow, Glasgow, UK
| | - Mette S Olufsen
- Department of Mathematics, North Carolina State University, Raleigh, NC, USA
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2
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Joy PS, Kumar G, Jermyn R, Van Zyl J, Joseph S, Hsi B, Afzal A, Sauer A, Alam A. Heart Failure Admissions Outcomes in Patients With CardioMEMS. Am J Cardiol 2023; 207:7-9. [PMID: 37717286 DOI: 10.1016/j.amjcard.2023.08.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/19/2023]
Affiliation(s)
| | - Gagan Kumar
- Northeast Georgia Medical Center, Gainesville, Georgia
| | - Rita Jermyn
- St. Francis Hospital & Heart Center, Roslyn, New York
| | | | - Susan Joseph
- The University of Maryland Medical System, Baltimore, Maryland
| | - Brian Hsi
- Baylor University Medical Center, Dallas, Texas
| | - Aasim Afzal
- Baylor University Medical Center, Dallas, Texas
| | - Andrew Sauer
- Saint Luke's Mid America Heart Institute, Kansas City, Missouri
| | - Amit Alam
- New York University, New York City, New York.
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Mastoris I, Gupta K, Sauer AJ. The War Against Heart Failure Hospitalizations: Remote Monitoring and the Case for Expanding Criteria. Cardiol Clin 2023; 41:557-573. [PMID: 37743078 DOI: 10.1016/j.ccl.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Successful remote patient monitoring depends on bidirectional interaction between patients and multidisciplinary clinical teams. Invasive pulmonary artery pressure monitoring has been shown to reduce heart failure (HF) hospitalizations, facilitate guideline-directed medical therapy optimization, and improve quality of life. Cardiac implantable electronic device-based multiparameter monitoring has shown encouraging results in predicting future HF-related events. Potential expanded indications for remote monitoring include guideline-directed medical therapy optimization, application to specific populations, and subclinical detection of HF. Voice analysis, inferior vena cava diameter monitoring, and artificial intelligence-based remote electrocardiogram show potential to gain some merit in remote patient monitoring in HF.
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Affiliation(s)
- Ioannis Mastoris
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Kashvi Gupta
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, 4401 Wornall Road, Kansas City, MO 64111, USA
| | - Andrew J Sauer
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, 4401 Wornall Road, Kansas City, MO 64111, USA.
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Saeyeldin A, Chugh Y, Banerjee S, Alam A. CardioMEMS Device Release Failure Necessitating Percutaneous Retrieval. JOURNAL OF THE SOCIETY FOR CARDIOVASCULAR ANGIOGRAPHY & INTERVENTIONS 2023; 2:100967. [PMID: 39132407 PMCID: PMC11307661 DOI: 10.1016/j.jscai.2023.100967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/07/2023] [Accepted: 03/20/2023] [Indexed: 08/13/2024]
Affiliation(s)
- Ayman Saeyeldin
- Department of Advanced Heart Failure and Transplant Cardiology, Baylor University Medical Center, Dallas, Texas
| | - Yashasvi Chugh
- Department of Interventional Cardiology, Baylor Heart and Vascular Hospital, Dallas, Texas
| | - Subhash Banerjee
- Department of Interventional Cardiology, Baylor Heart and Vascular Hospital, Dallas, Texas
| | - Amit Alam
- Department of Advanced Heart Failure and Transplant Cardiology, Baylor University Medical Center, Dallas, Texas
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5
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Milligan GP, Minniefield N, Raju B, Patel N, Michelis K, Van Zyl J, Cheeran D, Alam A. Effectiveness and Safety Profile of Remote Pulmonary Artery Hemodynamic Monitoring in a “Real-World” Veterans Affairs Healthcare System. Am J Cardiol 2022; 184:56-62. [DOI: 10.1016/j.amjcard.2022.08.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 11/01/2022]
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