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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. FRONTIERS IN PHYSICS 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] [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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Abstract
The treatment of individual patients in cardiology practice increasingly relies on advanced imaging, genetic screening and devices. As the amount of imaging and other diagnostic data increases, paralleled by the greater capacity to personalize treatment, the difficulty of using the full array of measurements of a patient to determine an optimal treatment seems also to be paradoxically increasing. Computational models are progressively addressing this issue by providing a common framework for integrating multiple data sets from individual patients. These models, which are based on physiology and physics rather than on population statistics, enable computational simulations to reveal diagnostic information that would have otherwise remained concealed and to predict treatment outcomes for individual patients. The inherent need for patient-specific models in cardiology is clear and is driving the rapid development of tools and techniques for creating personalized methods to guide pharmaceutical therapy, deployment of devices and surgical interventions.
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Affiliation(s)
- Steven A Niederer
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
| | - Joost Lumens
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, Netherlands
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac, France
| | - Natalia A Trayanova
- Department of Biomedical Engineering and the Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA
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Varela M, Morgan R, Theron A, Dillon-Murphy D, Chubb H, Whitaker J, Henningsson M, Aljabar P, Schaeffter T, Kolbitsch C, Aslanidi OV. Novel MRI Technique Enables Non-Invasive Measurement of Atrial Wall Thickness. IEEE TRANSACTIONS ON MEDICAL IMAGING 2017; 36:1607-1614. [PMID: 28422654 PMCID: PMC5549842 DOI: 10.1109/tmi.2017.2671839] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Knowledge of atrial wall thickness (AWT) has the potential to provide important information for patient stratification and the planning of interventions in atrial arrhythmias. To date, information about AWT has only been acquired in post-mortem or poor-contrast computed tomography (CT) studies, providing limited coverage and highly variable estimates of AWT. We present a novel contrast agent-free MRI sequence for imaging AWT and use it to create personalized AWT maps and a biatrial atlas. A novel black-blood phase-sensitive inversion recovery protocol was used to image ten volunteers and, as proof of concept, two atrial fibrillation patients. Both atria were manually segmented to create subject-specific AWT maps using an average of nearest neighbors approach. These were then registered non-linearly to generate an AWT atlas. AWT was 2.4 ± 0.7 and 2.7 ± 0.7 mm in the left and right atria, respectively, in good agreement with post-mortem and CT data, where available. AWT was 2.6 ± 0.7 mm in the left atrium of a patient without structural heart disease, similar to that of volunteers. In a patient with structural heart disease, the AWT was increased to 3.1 ± 1.3 mm. We successfully designed an MRI protocol to non-invasively measure AWT and create the first whole-atria AWT atlas. The atlas can be used as a reference to study alterations in thickness caused by atrial pathology. The protocol can be used to acquire personalized AWT maps in a clinical setting and assist in the treatment of atrial arrhythmias.
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Trayanova NA, Chang KC. How computer simulations of the human heart can improve anti-arrhythmia therapy. J Physiol 2016; 594:2483-502. [PMID: 26621489 DOI: 10.1113/jp270532] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 11/25/2015] [Indexed: 01/26/2023] Open
Abstract
Over the last decade, the state-of-the-art in cardiac computational modelling has progressed rapidly. The electrophysiological function of the heart can now be simulated with a high degree of detail and accuracy, opening the doors for simulation-guided approaches to anti-arrhythmic drug development and patient-specific therapeutic interventions. In this review, we outline the basic methodology for cardiac modelling, which has been developed and validated over decades of research. In addition, we present several recent examples of how computational models of the human heart have been used to address current clinical problems in cardiac electrophysiology. We will explore the use of simulations to improve anti-arrhythmic pacing and defibrillation interventions; to predict optimal sites for clinical ablation procedures; and to aid in the understanding and selection of arrhythmia risk markers. Together, these studies illustrate how the tremendous advances in cardiac modelling are poised to revolutionize medical treatment and prevention of arrhythmia.
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Affiliation(s)
- Natalia A Trayanova
- Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA.,Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Kelly C Chang
- Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
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Establishment of a database of fetal congenital heart malformations and preliminary investigation of its clinical application. Taiwan J Obstet Gynecol 2015; 54:284-9. [DOI: 10.1016/j.tjog.2015.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2015] [Indexed: 10/23/2022] Open
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Lopez-Perez A, Sebastian R, Ferrero JM. Three-dimensional cardiac computational modelling: methods, features and applications. Biomed Eng Online 2015; 14:35. [PMID: 25928297 PMCID: PMC4424572 DOI: 10.1186/s12938-015-0033-5] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 04/02/2015] [Indexed: 01/19/2023] Open
Abstract
The combination of computational models and biophysical simulations can help to interpret an array of experimental data and contribute to the understanding, diagnosis and treatment of complex diseases such as cardiac arrhythmias. For this reason, three-dimensional (3D) cardiac computational modelling is currently a rising field of research. The advance of medical imaging technology over the last decades has allowed the evolution from generic to patient-specific 3D cardiac models that faithfully represent the anatomy and different cardiac features of a given alive subject. Here we analyse sixty representative 3D cardiac computational models developed and published during the last fifty years, describing their information sources, features, development methods and online availability. This paper also reviews the necessary components to build a 3D computational model of the heart aimed at biophysical simulation, paying especial attention to cardiac electrophysiology (EP), and the existing approaches to incorporate those components. We assess the challenges associated to the different steps of the building process, from the processing of raw clinical or biological data to the final application, including image segmentation, inclusion of substructures and meshing among others. We briefly outline the personalisation approaches that are currently available in 3D cardiac computational modelling. Finally, we present examples of several specific applications, mainly related to cardiac EP simulation and model-based image analysis, showing the potential usefulness of 3D cardiac computational modelling into clinical environments as a tool to aid in the prevention, diagnosis and treatment of cardiac diseases.
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Affiliation(s)
- Alejandro Lopez-Perez
- Centre for Research and Innovation in Bioengineering (Ci2B), Universitat Politècnica de València, València, Spain.
| | - Rafael Sebastian
- Computational Multiscale Physiology Lab (CoMMLab), Universitat de València, València, Spain.
| | - Jose M Ferrero
- Centre for Research and Innovation in Bioengineering (Ci2B), Universitat Politècnica de València, València, Spain.
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Trayanova NA. Mathematical approaches to understanding and imaging atrial fibrillation: significance for mechanisms and management. Circ Res 2014; 114:1516-31. [PMID: 24763468 DOI: 10.1161/circresaha.114.302240] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Atrial fibrillation (AF) is the most common sustained arrhythmia in humans. The mechanisms that govern AF initiation and persistence are highly complex, of dynamic nature, and involve interactions across multiple temporal and spatial scales in the atria. This article aims to review the mathematical modeling and computer simulation approaches to understanding AF mechanisms and aiding in its management. Various atrial modeling approaches are presented, with descriptions of the methodological basis and advancements in both lower-dimensional and realistic geometry models. A review of the most significant mechanistic insights made by atrial simulations is provided. The article showcases the contributions that atrial modeling and simulation have made not only to our understanding of the pathophysiology of atrial arrhythmias, but also to the development of AF management approaches. A summary of the future developments envisioned for the field of atrial simulation and modeling is also presented. The review contends that computational models of the atria assembled with data from clinical imaging modalities that incorporate electrophysiological and structural remodeling could become a first line of screening for new AF therapies and approaches, new diagnostic developments, and new methods for arrhythmia prevention.
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Affiliation(s)
- Natalia A Trayanova
- From the Department of Biomedical Engineering and Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD
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Trayanova NA. Computational cardiology: the heart of the matter. ISRN CARDIOLOGY 2012; 2012:269680. [PMID: 23213566 PMCID: PMC3505657 DOI: 10.5402/2012/269680] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 09/06/2012] [Indexed: 12/19/2022]
Abstract
This paper reviews the newest developments in computational cardiology. It focuses on the contribution of cardiac modeling to the development of new therapies as well as the advancement of existing ones for cardiac arrhythmias and pump dysfunction. Reviewed are cardiac modeling efforts aimed at advancing and optimizing existent therapies for cardiac disease (defibrillation, ablation of ventricular tachycardia, and cardiac resynchronization therapy) and at suggesting novel treatments, including novel molecular targets, as well as efforts to use cardiac models in stratification of patients likely to benefit from a given therapy, and the use of models in diagnostic procedures.
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Affiliation(s)
- Natalia A Trayanova
- Department of Biomedical Engineering and Institute for Computational Medicine, Johns Hopkins University, 3400 North Charles Street, Hackerman Hall Room 216, Baltimore, MD 21218, USA
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Jacquemet V, Kappenberger L, Henriquez CS. Modeling atrial arrhythmias: impact on clinical diagnosis and therapies. IEEE Rev Biomed Eng 2012; 1:94-114. [PMID: 22274901 DOI: 10.1109/rbme.2008.2008242] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Atrial arrhythmias are the most frequent sustained rhythm disorders in humans and often lead to severe complications such as heart failure and stroke. Despite the important insights provided by animal models into the mechanisms of atrial arrhythmias, direct translation of experimental findings to new therapies in patients has not been straightforward. With the advances in computer technology, large-scale electroanatomical computer models of the atria that integrate information from the molecular to organ scale have reached a level of sophistication that they can be used to interpret the outcome of experimental and clinical studies and aid in the rational design of therapies. This paper reviews the state-of-the-art of computer models of the electrical dynamics of the atria and discusses the evolving role of simulation in assisting the clinical diagnosis and treatment of atrial arrhythmias.
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Affiliation(s)
- Vincent Jacquemet
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA.
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Dössel O, Krueger MW, Weber FM, Wilhelms M, Seemann G. Computational modeling of the human atrial anatomy and electrophysiology. Med Biol Eng Comput 2012; 50:773-99. [PMID: 22718317 DOI: 10.1007/s11517-012-0924-6] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 05/21/2012] [Indexed: 01/08/2023]
Abstract
This review article gives a comprehensive survey of the progress made in computational modeling of the human atria during the last 10 years. Modeling the anatomy has emerged from simple "peanut"-like structures to very detailed models including atrial wall and fiber direction. Electrophysiological models started with just two cellular models in 1998. Today, five models exist considering e.g. details of intracellular compartments and atrial heterogeneity. On the pathological side, modeling atrial remodeling and fibrotic tissue are the other important aspects. The bridge to data that are measured in the catheter laboratory and on the body surface (ECG) is under construction. Every measurement can be used either for model personalization or for validation. Potential clinical applications are briefly outlined and future research perspectives are suggested.
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Affiliation(s)
- Olaf Dössel
- Institute of Biomedical Engineering, Karlsruhe Institute of Technology, Karlsruhe, Germany.
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Graf IM, Miri R, Smalling RW, Emelianov S. Clinical benefits of integrating cardiac and vascular models. EXPERT OPINION ON MEDICAL DIAGNOSTICS 2011; 5:501-515. [PMID: 23484748 DOI: 10.1517/17530059.2011.616195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Recent advances in computational methods and medical imaging techniques have enabled non-invasive exploration of cardiovascular pathologies, from cardiac level to complex arterial networks. The potential of cardiac and vascular modeling in guiding and monitoring therapies could be further extended through the integration of the two systems. AREAS COVERED This review includes advances in methods for cardiac electromechanics and vascular flow simulations. The results of a literature search depicting the state of the art in cardiac and vascular modeling are reviewed. The paper goes on to address the benefits and challenges of combined cardiovascular modeling, highlighting the relevance of specific cardiovascular features and implementation. Various alternative approaches and insights on future directions are presented and analyzed with respect to their applicability to clinical practice. EXPERT OPINION The article has emerged from the exploration of currently available cardiac and vascular mathematical tools and their corresponding clinical application. The summarized analysis suggests that future efforts should be aimed at developing more accurate and patient-specific mathematical models integrating cardiac and vascular functions to enhance the knowledge of cardiovascular pathologies.
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Affiliation(s)
- Iulia M Graf
- University of Texas at Austin , Department of Biomedical Engineering , BME Building, Room 4.414, 107 W. Dean Keeton Street, 1 University Station C0800, Austin, TX 78712 , USA +1 512 232 2892 ; +1 512 471 0616 ;
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Pei Q, Liang M, Huang X, Wei Y. Construction of a three-dimensional anatomical database of the human fetal heart. Pediatr Cardiol 2010; 31:234-7. [PMID: 19936582 DOI: 10.1007/s00246-009-9596-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Accepted: 10/31/2009] [Indexed: 11/29/2022]
Abstract
The objective of this study was to establish an anatomical atlas and a three-dimensional model of the fetal heart. To do this, we created a 60-microm cross-sectional image database of the heart of a Chinese male fetus. A 31-week stillborn fetus with no congenital defects was used as the model. All thoracic organs were removed from the thoracic cavity after formalin fixation and then frozen at -25 degrees C for 2 h. Frozen serial sections, 60-microm thick, were prepared and macroshot with a digital camera to obtain image data. Eight hundred seventy-one cross-sectional photos of the fetal heart were made at a resolution of 3888 x 2592 pixels. The atrioventricular cavity, as well as other fine structures, was revealed in the images, showing a clear boundary between the peripheral tissues. This rich database showing the three-dimensional features and anatomy of the fetal heart will be useful for teaching, scientific research, and clinical applications.
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Affiliation(s)
- Qiuyan Pei
- Department of Obstetric Ultrasonography, Peking University People's Hospital, Beijing 100044, China.
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Sarkar C, Abbasi SA. Cellular automata-based forecasting of the impact of accidental fire and toxic dispersion in process industries. JOURNAL OF HAZARDOUS MATERIALS 2006; 137:8-30. [PMID: 16713088 DOI: 10.1016/j.jhazmat.2006.01.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2004] [Revised: 01/12/2006] [Accepted: 01/13/2006] [Indexed: 05/09/2023]
Abstract
The strategies to prevent accidents from occurring in a process industry, or to minimize the harm if an accident does take place, always revolve around forecasting the likely accidents and their impacts. Based on the likely frequency and severity of the accidents, resources are committed towards preventing the accidents. Nearly all techniques of ranking hazardous units, be it the hazard and operability studies, fault tree analysis, hazard indice, etc.--qualitative as well as quantitative--depend essentially on the assessment of the likely frequency and the likely harm accidents in different units may cause. This fact makes it exceedingly important that the forecasting the accidents and their likely impact is done as accurately as possible. In the present study we introduce a new approach to accident forecasting based on the discrete modeling paradigm of cellular automata. In this treatment an accident is modeled as a self-evolving phenomena, the impact of which is strongly influenced by the size, nature, and position of the environmental components which lie in the vicinity of the accident site. The outward propagation of the mass, energy and momentum from the accident epicenter is modeled as a fast diffusion process occurring in discrete space-time coordinates. The quantum of energy and material that would flow into each discrete space element (cell) due to the accidental release is evaluated and the degree of vulnerability posed to the receptors if present in the cell is measured at the end of each time element. This approach is able to effectively take into account the modifications in the flux of energy and material which occur as a result of the heterogeneous environment prevailing between the accident epicenter and the receptor. Consequently, more realistic accident scenarios are generated than possible with the prevailing techniques. The efficacy of the approach has been illustrated with case studies.
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Affiliation(s)
- Chinmoy Sarkar
- Center for Pollution Control and Energy Technology, Pondicherry University, Pondicherry 605 014, India
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Hammer PE, Brooks DH, Triedman JK. Estimation of entrainment response using electrograms from remote sites: validation in animal and computer models of reentrant tachycardia. J Cardiovasc Electrophysiol 2003; 14:52-61. [PMID: 12625610 DOI: 10.1046/j.1540-8167.2003.02105.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Studies suggest that entrainment response (ER) of reentrant tachycardia to overdrive pacing can be estimated using signals from sites other than the paced site. METHODS AND RESULTS A formula for estimation of ER using remote sites against the difference between the postpacing interval (PPI) and tachycardia cycle length (TCL) determined solely from the paced site signal was validated in experimental data and using a simple two-dimensional cellular automata model of reentry. The model also was used to study the behavior and features of entrained surfaces, including the resetting of tachycardia phase by single premature paced stimuli. Experimental results from 1,484 remote sites in 115 pacing sequences showed the average of the median ER estimate error at each pacing site was -2 +/- 5 msec, and the median ER estimate was within 10 msec of PPI-TCL for 94% of pacing sites. From simulation results, ER at the paced site was accurately estimated from >99.8% of 20,764 remote sites during pacing at 24 sites and three paced cycle lengths. Intervals measured from remote electrograms revealed whether the site was activated orthodromically or nonorthodromically during pacing, and results of simulations illustrated that the portion of the surface activated nonorthodromically during pacing increased with distance from the pacing site to the circuit. The phenomenon of nonorthodromic activation of reentrant circuits predicted by modeling was discernible in measurements taken from the animal model of reentrant tachycardia. Results also showed that, for single premature stimuli that penetrated the tachycardia circuit, phase reset of the tachycardia was linearly related to distance between the central obstacle and the paced site. CONCLUSION The ER is a complex but predictable perturbation of the global activation sequence of reentrant tachycardias. This predictability allows calculations of the response from anywhere on the perturbed surface. These findings suggest new techniques for measurement of the ER, which may lend themselves to computer-based methods for accurate and rapid mapping of reentrant circuits.
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Affiliation(s)
- Peter E Hammer
- Department of Cardiology, Children's Hospital, Boston, Massachusetts 02115, USA
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Trelease RB. Anatomical informatics: Millennial perspectives on a newer frontier. THE ANATOMICAL RECORD 2002; 269:224-35. [PMID: 12379939 DOI: 10.1002/ar.10177] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
One of the most ancient of sciences, anatomy has evolved over many centuries. Its methods have progressively encompassed dissection instruments, manual illustration, stains, microscopes, cameras and photography, and digital imaging systems. Like many other more modern scientific disciplines in the late 20th century, anatomy has also benefited from the revolutionary development of digital computers and their automated information management and analytical capabilities. By using newer methods of computer and information sciences, anatomists have made outstanding contributions to science, medicine, and education. In that regard, there is a strong rationale for recognizing anatomical informatics as a proper subdiscipline of anatomy. A high-level survey of the field reveals important anatomical applications of computer sciences methods in imaging, image processing and visualization, virtual reality, modeling and simulation, structural database processing, networking, and artificial intelligence. Within this framework, computational anatomy is a developing field focusing on data-driven mathematical models of bodily structures. Mastering such computer sciences and informatics methods is crucial for new anatomists, who will shape the future in research, clinical knowledge, and teaching.
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Affiliation(s)
- Robert B Trelease
- Division of Integrative Anatomy, Department of Pathology and Laboratory Medicine, UCLA School of Medicine, Los Angeles, CA 90095, USA.
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Tjardes T, Neugebauer E. Sepsis research in the next millennium: concentrate on the software rather than the hardware. Shock 2002; 17:1-8. [PMID: 11795662 DOI: 10.1097/00024382-200201000-00001] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Today the basic principles of septic conditions are understood. Nevertheless, sepsis research has reached a critical point. To integrate our knowledge towards a consistent theory of the disease process and to derive effective therapies, new perspectives for future research that fit the complexity of the problem have to be found. We conducted a review of the literature concerning systemic inflammatory response syndrome (SIRS) and sepsis with particular reference to liver pathophysiology. And compared our findings with characteristic features of complex systems. The complexity of sepsis is broadly recognized. A review of the different aspects of liver inflammation during SIRS and sepsis, i.e. endotoxin challenge, cytokine induced dysfunction, the mechanisms of leukocyte transmigration, and hormonal and neuroendocrine regulatory mechanisms is given. Key aspects of complex systems, including parallelism, locality, emergence, and cross-scale interactions are introduced. We conclude that sepsis research needs new perspectives that allow us to handle the complex interactions occurring during the disease process. We propose to focus research on the interactions between the constituents of the system rather than only describing isolated aspects of the disease process. We also conclude that the ideas and techniques of non-linear systems theory are suitable tools for the analysis of complex and dynamic diseases like SIRS and sepsis.
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