1
|
In silico identification of potential calcium dynamics and sarcomere targets for recovering left ventricular function in rat heart failure with preserved ejection fraction. PLoS Comput Biol 2021; 17:e1009646. [PMID: 34871310 PMCID: PMC8675924 DOI: 10.1371/journal.pcbi.1009646] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/16/2021] [Accepted: 11/16/2021] [Indexed: 01/28/2023] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) is a complex disease associated with multiple co-morbidities, where impaired cardiac mechanics are often the end effect. At the cellular level, cardiac mechanics can be pharmacologically manipulated by altering calcium signalling and the sarcomere. However, the link between cellular level modulations and whole organ pump function is incompletely understood. Our goal is to develop and use a multi-scale computational cardiac mechanics model of the obese ZSF1 HFpEF rat to identify important biomechanical mechanisms that underpin impaired cardiac function and to predict how whole-heart mechanical function can be recovered through altering cellular calcium dynamics and/or cellular contraction. The rat heart was modelled using a 3D biventricular biomechanics model. Biomechanics were described by 16 parameters, corresponding to intracellular calcium transient, sarcomere dynamics, cardiac tissue and hemodynamics properties. The model simulated left ventricular (LV) pressure-volume loops that were described by 14 scalar features. We trained a Gaussian process emulator to map the 16 input parameters to each of the 14 outputs. A global sensitivity analysis was performed, and identified calcium dynamics and thin and thick filament kinetics as key determinants of the organ scale pump function. We employed Bayesian history matching to build a model of the ZSF1 rat heart. Next, we recovered the LV function, described by ejection fraction, peak pressure, maximum rate of pressure rise and isovolumetric relaxation time constant. We found that by manipulating calcium, thin and thick filament properties we can recover 34%, 28% and 24% of the LV function in the ZSF1 rat heart, respectively, and 39% if we manipulate all of them together. We demonstrated how a combination of biophysically based models and their derived emulators can be used to identify potential pharmacological targets. We predicted that cardiac function can be best recovered in ZSF1 rats by desensitising the myofilament and reducing the affinity to intracellular calcium concentration and overall prolonging the sarcomere staying in the active force generating state. We developed a computational model of the ZSF1 rat model of heart failure with preserved ejection fraction. We validated that the model can link simulated pharmacological interventions from cellular to whole heart pump function. Our computational model identified calcium dynamics as the main determinant of left ventricular contractile behaviour. We demonstrated that the highest degree of LV function recovery could be achieved when calcium dynamics is manipulated in conjunction with both thin and thick filament kinetics.
Collapse
|
2
|
Lewalle A, Land S, Merken JJ, Raafs A, Sepúlveda P, Heymans S, Kleinjans J, Niederer SA. Balance of Active, Passive, and Anatomical Cardiac Properties in Doxorubicin-Induced Heart Failure. Biophys J 2019; 117:2337-2348. [PMID: 31447110 PMCID: PMC6990149 DOI: 10.1016/j.bpj.2019.07.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/12/2019] [Accepted: 07/23/2019] [Indexed: 01/31/2023] Open
Abstract
Late-onset heart failure (HF) is a known side effect of doxorubicin chemotherapy. Typically, patients are diagnosed when already at an irreversible stage of HF, which allows few or no treatment options. Identifying the causes of compromised cardiac function in this patient group may improve early patient diagnosis and support treatment selection. To link doxorubicin-induced changes in cardiac cellular and tissue mechanical properties to overall cardiac function, we apply a multiscale biophysical biomechanics model of the heart to measure the plausibility of changes in model parameters representing the passive, active, or anatomical properties of the left ventricle for reproducing measured patient phenotypes. We create representative models of healthy controls (N = 10) and patients with HF induced by (N = 22) or unrelated to (N = 25) doxorubicin therapy. The model predicts that HF in the absence of doxorubicin is characterized by a 2- to 3-fold stiffness increase, decreased tension (0–20%), and ventricular dilation (of order 10–30%). HF due to doxorubicin was similar but showed stronger bias toward reduced active contraction (10–30%) and less dilation (0–20%). We find that changes in active, passive, and anatomical properties all play a role in doxorubicin-induced cardiotoxicity phenotypes. Differences in parameter changes between patient groups are consistent with doxorubicin cardiotoxicity having a greater dependence on reduced cellular contraction and less anatomical remodeling than HF not caused by doxorubicin.
Collapse
Affiliation(s)
- Alexandre Lewalle
- Department of Biomedical Engineering, St Thomas's Hospital, King's College London, London, United Kingdom
| | - Sander Land
- Department of Biomedical Engineering, St Thomas's Hospital, King's College London, London, United Kingdom
| | - Jort J Merken
- Department of Cardiology, Maastricht University, Maastricht, the Netherlands
| | - Anne Raafs
- Department of Cardiology, Maastricht University, Maastricht, the Netherlands
| | - Pilar Sepúlveda
- Regenerative Medicine and Heart Transplantation Unit, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Stéphane Heymans
- Department of Cardiology, Maastricht University, Maastricht, the Netherlands
| | - Jos Kleinjans
- Department of Toxicogenomics, Maastricht University, Maastricht, the Netherlands
| | - Steven A Niederer
- Department of Biomedical Engineering, St Thomas's Hospital, King's College London, London, United Kingdom.
| |
Collapse
|
3
|
Balaban G, Finsberg H, Funke S, Håland TF, Hopp E, Sundnes J, Wall S, Rognes ME. In vivo estimation of elastic heterogeneity in an infarcted human heart. Biomech Model Mechanobiol 2018; 17:1317-1329. [PMID: 29774440 PMCID: PMC6154126 DOI: 10.1007/s10237-018-1028-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 05/05/2018] [Indexed: 11/26/2022]
Abstract
In myocardial infarction, muscle tissue of the heart is damaged as a result of ceased or severely impaired blood flow. Survivors have an increased risk of further complications, possibly leading to heart failure. Material properties play an important role in determining post-infarction outcome. Due to spatial variation in scarring, material properties can be expected to vary throughout the tissue of a heart after an infarction. In this study we propose a data assimilation technique that can efficiently estimate heterogeneous elastic material properties in a personalized model of cardiac mechanics. The proposed data assimilation is tested on a clinical dataset consisting of regional left ventricular strains and in vivo pressures during atrial systole from a human with a myocardial infarction. Good matches to regional strains are obtained, and simulated equi-biaxial tests are carried out to demonstrate regional heterogeneities in stress–strain relationships. A synthetic data test shows a good match of estimated versus ground truth material parameter fields in the presence of no to low levels of noise. This study is the first to apply adjoint-based data assimilation to the important problem of estimating cardiac elastic heterogeneities in 3-D from medical images.
Collapse
Affiliation(s)
- Gabriel Balaban
- Division of Imaging Sciences and Biomedical Engineering, King's College London, St. Thomas Hospital, London, UK.
| | - Henrik Finsberg
- Simula Research Laboratory, Oslo, Norway
- Department of Informatics, University of Oslo, Oslo, Norway
| | | | - Trine F Håland
- Department of Cardiology, Center for Cardiological, Oslo University Hospital, Rikhospitalet, Oslo, Norway
| | - Einar Hopp
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Joakim Sundnes
- Simula Research Laboratory, Oslo, Norway
- Department of Informatics, University of Oslo, Oslo, Norway
| | - Samuel Wall
- Simula Research Laboratory, Oslo, Norway
- Department of Mathematical Science and Technology, Norwegian University of Life Sciences, Ås, Norway
| | | |
Collapse
|
4
|
Land S, Niederer SA. Influence of atrial contraction dynamics on cardiac function. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2018; 34:e2931. [PMID: 28990354 DOI: 10.1002/cnm.2931] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 08/11/2017] [Accepted: 09/25/2017] [Indexed: 06/07/2023]
Abstract
In recent years, there has been a move from monoventricular or biventricular models of the heart, to more complex models that incorporate the electromechanical function in all 4 chambers. However, the biophysical foundation is still underdeveloped, with most work in atrial cellular models having focused on electrophysiological properties. Here, we present a biophysical model of human atrial contraction at body temperature and use it to study the effects of atrial contraction on whole organ function and a study of the effects of remodelling due to atrial fibrillation on atrial and ventricular function.
Collapse
Affiliation(s)
- Sander Land
- King's College London, Department of Biomedical Engineering, St Thomas' Hospital, SE1 7EH, London, UK
| | - Steven Alexander Niederer
- King's College London, Department of Biomedical Engineering, St Thomas' Hospital, SE1 7EH, London, UK
| |
Collapse
|
5
|
Lewalle A, Land S, Carruth E, Frank LR, Lamata P, Omens JH, McCulloch AD, Niederer SA, Smith NP. Decreasing Compensatory Ability of Concentric Ventricular Hypertrophy in Aortic-Banded Rat Hearts. Front Physiol 2018; 9:37. [PMID: 29527171 PMCID: PMC5829063 DOI: 10.3389/fphys.2018.00037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/10/2018] [Indexed: 11/28/2022] Open
Abstract
The cardiac system compensates for variations in physiological and pathophysiological conditions through a dynamic remodeling at the organ, tissue, and intracellular levels in order to maintain function. However, on longer time scales following the onset of ventricular pressure overload, such remodeling may begin to inhibit physiological function and ultimately lead to heart failure. This progression from compensatory to decompensatory behavior is poorly understood, in particular owing to the absence of a unified perspective of the concomitantly remodeling subsystems. To address this issue, the present study investigates the evolution of compensatory mechanisms, in response to overload, by integrating diffusion-tensor MRI, echocardiography, and intracellular and hemodynamic measurements within consistent computational simulations of aortic-banded rat hearts. This approach allows a comparison of the relative leverage of different cardiac properties (geometry, passive mechanical stiffness, fiber configuration, diastolic and peak calcium concentrations, calcium-binding affinity, and aortic impedance) to affect cardiac contraction. Measurements indicate that, following aortic banding, an ejection fraction (EF) of 75% was maintained, relative to control rats, despite significant remodeling of the left-ventricular wall thickness (increasing by ~90% over 4 weeks). Applying our framework, we identified the left-ventricular wall thickness (concentric hypertrophy) and the intracellular calcium dynamics as playing the dominant roles in preserving EF acutely, whereas the significance of hypertrophy decreased subsequently. This trend suggests an increasing reliance on intracellular mechanisms (average increase ~50%), rather than on anatomical features (average decrease ~60%), to achieve compensation of pump function in the early phase of heart failure.
Collapse
Affiliation(s)
- Alexandre Lewalle
- Department of Biomedical Engineering, King's College London, St. Thomas's Hospital, London, United Kingdom
| | - Sander Land
- Department of Biomedical Engineering, King's College London, St. Thomas's Hospital, London, United Kingdom
| | - Eric Carruth
- Department of Bioengineering, University of California, San Diego, San Diego, CA, United States
| | - Lawrence R. Frank
- Radiology Department, University of California, San Diego, San Diego, CA, United States
| | - Pablo Lamata
- Department of Biomedical Engineering, King's College London, St. Thomas's Hospital, London, United Kingdom
| | - Jeffrey H. Omens
- Department of Bioengineering, University of California, San Diego, San Diego, CA, United States
- Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Andrew D. McCulloch
- Department of Bioengineering, University of California, San Diego, San Diego, CA, United States
- Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Steven A. Niederer
- Department of Biomedical Engineering, King's College London, St. Thomas's Hospital, London, United Kingdom
| | - Nicolas P. Smith
- Department of Biomedical Engineering, King's College London, St. Thomas's Hospital, London, United Kingdom
- Faculty of Engineering, University of Auckland, Auckland, New Zealand
- *Correspondence: Nicolas P. Smith
| |
Collapse
|
6
|
Balaban G, Finsberg H, Odland HH, Rognes ME, Ross S, Sundnes J, Wall S. High-resolution data assimilation of cardiac mechanics applied to a dyssynchronous ventricle. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2017; 33:e2863. [PMID: 28039961 DOI: 10.1002/cnm.2863] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/31/2016] [Accepted: 12/28/2016] [Indexed: 06/06/2023]
Abstract
Computational models of cardiac mechanics, personalized to a patient, offer access to mechanical information above and beyond direct medical imaging. Additionally, such models can be used to optimize and plan therapies in-silico, thereby reducing risks and improving patient outcome. Model personalization has traditionally been achieved by data assimilation, which is the tuning or optimization of model parameters to match patient observations. Current data assimilation procedures for cardiac mechanics are limited in their ability to efficiently handle high-dimensional parameters. This restricts parameter spatial resolution, and thereby the ability of a personalized model to account for heterogeneities that are often present in a diseased or injured heart. In this paper, we address this limitation by proposing an adjoint gradient-based data assimilation method that can efficiently handle high-dimensional parameters. We test this procedure on a synthetic data set and provide a clinical example with a dyssynchronous left ventricle with highly irregular motion. Our results show that the method efficiently handles a high-dimensional optimization parameter and produces an excellent agreement for personalized models to both synthetic and clinical data.
Collapse
Affiliation(s)
- Gabriel Balaban
- Simula Research Laboratory, P.O. Box 134 1325 Lysaker, Norway
- Department of Informatics, University of Oslo, P.O. Box 1080, Blindern 0316 Oslo, Norway
- Center for Cardiological Innovation, Songsvannsveien 9, 0372 Oslo, Norway
| | - Henrik Finsberg
- Simula Research Laboratory, P.O. Box 134 1325 Lysaker, Norway
- Department of Informatics, University of Oslo, P.O. Box 1080, Blindern 0316 Oslo, Norway
- Center for Cardiological Innovation, Songsvannsveien 9, 0372 Oslo, Norway
| | - Hans Henrik Odland
- Faculty of Medicine, University of Oslo, P.O. Box 1078 Blindern, 0316 Oslo, Norway
- Department of Pediatrics, Oslo University Hospital, PO Nydalen, Oslo, Norway
| | - Marie E Rognes
- Simula Research Laboratory, P.O. Box 134 1325 Lysaker, Norway
- Department of Mathematics, University of Oslo, P.O Box 1053, Blindern 0316 Oslo, Norway
| | - Stian Ross
- Faculty of Medicine, University of Oslo, P.O. Box 1078 Blindern, 0316 Oslo, Norway
- Center for Cardiological Innovation, Songsvannsveien 9, 0372 Oslo, Norway
| | - Joakim Sundnes
- Simula Research Laboratory, P.O. Box 134 1325 Lysaker, Norway
- Department of Informatics, University of Oslo, P.O. Box 1080, Blindern 0316 Oslo, Norway
- Center for Cardiological Innovation, Songsvannsveien 9, 0372 Oslo, Norway
| | - Samuel Wall
- Simula Research Laboratory, P.O. Box 134 1325 Lysaker, Norway
- Center for Cardiological Innovation, Songsvannsveien 9, 0372 Oslo, Norway
- Department of Mathematical Science and Technology, Norwegian University of Life Sciences, Universitetstunet 3 1430 Ås, Norway
| |
Collapse
|
7
|
Land S, Park-Holohan SJ, Smith NP, Dos Remedios CG, Kentish JC, Niederer SA. A model of cardiac contraction based on novel measurements of tension development in human cardiomyocytes. J Mol Cell Cardiol 2017; 106:68-83. [PMID: 28392437 DOI: 10.1016/j.yjmcc.2017.03.008] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 01/12/2017] [Accepted: 03/31/2017] [Indexed: 11/18/2022]
Abstract
Experimental data from human cardiac myocytes at body temperature is crucial for a quantitative understanding of clinically relevant cardiac function and development of whole-organ computational models. However, such experimental data is currently very limited. Specifically, important measurements to characterize changes in tension development in human cardiomyocytes that occur with perturbations in cell length are not available. To address this deficiency, in this study we present an experimental data set collected from skinned human cardiac myocytes, including the passive and viscoelastic properties of isolated myocytes, the steady-state force calcium relationship at different sarcomere lengths, and changes in tension following a rapid increase or decrease in length, and after constant velocity shortening. This data set is, to our knowledge, the first characterization of length and velocity-dependence of tension generation in human skinned cardiac myocytes at body temperature. We use this data to develop a computational model of contraction and passive viscoelasticity in human myocytes. Our model includes troponin C kinetics, tropomyosin kinetics, a three-state crossbridge model that accounts for the distortion of crossbridges, and the cellular viscoelastic response. Each component is parametrized using our experimental data collected in human cardiomyocytes at body temperature. Furthermore we are able to confirm that properties of length-dependent activation at 37°C are similar to other species, with a shift in calcium sensitivity and increase in maximum tension. We revise our model of tension generation in the skinned isolated myocyte to replicate reported tension traces generated in intact muscle during isometric tension, to provide a model of human tension generation for multi-scale simulations. This process requires changes to calcium sensitivity, cooperativity, and crossbridge transition rates. We apply this model within multi-scale simulations of biventricular cardiac function and further refine the parametrization within the whole organ context, based on obtaining a healthy ejection fraction. This process reveals that crossbridge cycling rates differ between skinned myocytes and intact myocytes.
Collapse
Affiliation(s)
- Sander Land
- Department of Biomedical Engineering, King's College London, UK.
| | - So-Jin Park-Holohan
- Cardiovascular Division, King's College London British Heart Foundation Centre of Research Excellence, UK
| | - Nicolas P Smith
- Department of Engineering Science, University of Auckland, New Zealand
| | | | - Jonathan C Kentish
- Cardiovascular Division, King's College London British Heart Foundation Centre of Research Excellence, UK
| | | |
Collapse
|
8
|
Nasopoulou A, Shetty A, Lee J, Nordsletten D, Rinaldi CA, Lamata P, Niederer S. Improved identifiability of myocardial material parameters by an energy-based cost function. Biomech Model Mechanobiol 2017. [PMID: 28188386 DOI: 10.1007/s10237‐016‐0865‐3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Myocardial stiffness is a valuable clinical biomarker for the monitoring and stratification of heart failure (HF). Cardiac finite element models provide a biomechanical framework for the assessment of stiffness through the determination of the myocardial constitutive model parameters. The reported parameter intercorrelations in popular constitutive relations, however, obstruct the unique estimation of material parameters and limit the reliable translation of this stiffness metric to clinical practice. Focusing on the role of the cost function (CF) in parameter identifiability, we investigate the performance of a set of geometric indices (based on displacements, strains, cavity volume, wall thickness and apicobasal dimension of the ventricle) and a novel CF derived from energy conservation. Our results, with a commonly used transversely isotropic material model (proposed by Guccione et al.), demonstrate that a single geometry-based CF is unable to uniquely constrain the parameter space. The energy-based CF, conversely, isolates one of the parameters and in conjunction with one of the geometric metrics provides a unique estimation of the parameter set. This gives rise to a new methodology for estimating myocardial material parameters based on the combination of deformation and energetics analysis. The accuracy of the pipeline is demonstrated in silico, and its robustness in vivo, in a total of 8 clinical data sets (7 HF and one control). The mean identified parameters of the Guccione material law were [Formula: see text] and [Formula: see text] ([Formula: see text], [Formula: see text], [Formula: see text]) for the HF cases and [Formula: see text] and [Formula: see text] ([Formula: see text], [Formula: see text], [Formula: see text]) for the healthy case.
Collapse
Affiliation(s)
- Anastasia Nasopoulou
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Anoop Shetty
- Cardiovascular Department, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Jack Lee
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - David Nordsletten
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - C Aldo Rinaldi
- Cardiovascular Department, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Pablo Lamata
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
| | - Steven Niederer
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
| |
Collapse
|
9
|
Nasopoulou A, Shetty A, Lee J, Nordsletten D, Rinaldi CA, Lamata P, Niederer S. Improved identifiability of myocardial material parameters by an energy-based cost function. Biomech Model Mechanobiol 2017; 16:971-988. [PMID: 28188386 PMCID: PMC5480093 DOI: 10.1007/s10237-016-0865-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 12/09/2016] [Indexed: 12/16/2022]
Abstract
Myocardial stiffness is a valuable clinical biomarker for the monitoring and stratification of heart failure (HF). Cardiac finite element models provide a biomechanical framework for the assessment of stiffness through the determination of the myocardial constitutive model parameters. The reported parameter intercorrelations in popular constitutive relations, however, obstruct the unique estimation of material parameters and limit the reliable translation of this stiffness metric to clinical practice. Focusing on the role of the cost function (CF) in parameter identifiability, we investigate the performance of a set of geometric indices (based on displacements, strains, cavity volume, wall thickness and apicobasal dimension of the ventricle) and a novel CF derived from energy conservation. Our results, with a commonly used transversely isotropic material model (proposed by Guccione et al.), demonstrate that a single geometry-based CF is unable to uniquely constrain the parameter space. The energy-based CF, conversely, isolates one of the parameters and in conjunction with one of the geometric metrics provides a unique estimation of the parameter set. This gives rise to a new methodology for estimating myocardial material parameters based on the combination of deformation and energetics analysis. The accuracy of the pipeline is demonstrated in silico, and its robustness in vivo, in a total of 8 clinical data sets (7 HF and one control). The mean identified parameters of the Guccione material law were [Formula: see text] and [Formula: see text] ([Formula: see text], [Formula: see text], [Formula: see text]) for the HF cases and [Formula: see text] and [Formula: see text] ([Formula: see text], [Formula: see text], [Formula: see text]) for the healthy case.
Collapse
Affiliation(s)
- Anastasia Nasopoulou
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Anoop Shetty
- Cardiovascular Department, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Jack Lee
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - David Nordsletten
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - C Aldo Rinaldi
- Cardiovascular Department, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Pablo Lamata
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
| | - Steven Niederer
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
| |
Collapse
|
10
|
Niederer SA, Smith NP. Using physiologically based models for clinical translation: predictive modelling, data interpretation or something in-between? J Physiol 2016; 594:6849-6863. [PMID: 27121495 PMCID: PMC5134392 DOI: 10.1113/jp272003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 03/13/2016] [Indexed: 02/02/2023] Open
Abstract
Heart disease continues to be a significant clinical problem in Western society. Predictive models and simulations that integrate physiological understanding with patient information derived from clinical data have huge potential to contribute to improving our understanding of both the progression and treatment of heart disease. In particular they provide the potential to improve patient selection and optimisation of cardiovascular interventions across a range of pathologies. Currently a significant proportion of this potential is still to be realised. In this paper we discuss the opportunities and challenges associated with this realisation. Reviewing the successful elements of model translation for biophysically based models and the emerging supporting technologies, we propose three distinct modes of clinical translation. Finally we outline the challenges ahead that will be fundamental to overcome if the ultimate goal of fully personalised clinical cardiac care is to be achieved.
Collapse
Affiliation(s)
- Steven A. Niederer
- Department of Biomedical Engineering and Imaging SciencesSt Thomas’ HospitalKing's College LondonThe Rayne Institute4th Floor Lambeth WingLondonSE1 7EHUK
| | - Nic P. Smith
- Department of Biomedical Engineering and Imaging SciencesSt Thomas’ HospitalKing's College LondonThe Rayne Institute4th Floor Lambeth WingLondonSE1 7EHUK
- Engineering School Block 1University of AucklandLevel 5, 20 Symonds StreetAuckland101New Zealand
| |
Collapse
|
11
|
Washio T, Yoneda K, Okada JI, Kariya T, Sugiura S, Hisada T. Ventricular fiber optimization utilizing the branching structure. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2016; 32:e02753. [PMID: 26453026 DOI: 10.1002/cnm.2753] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 10/06/2015] [Accepted: 10/07/2015] [Indexed: 05/19/2023]
Abstract
In this paper, we propose an algorithm that optimizes the ventricular fiber structure of the human heart. A number of histological studies and diffusion tensor magnetic resonance imaging analyses have revealed that the myocardial fiber forms a right-handed helix at the endocardium. However, the fiber formation changes its orientation as a function of transmural depth, becoming a left-handed helix at the epicardium. To determine how nature can construct such a structure, which obtains surprising pumping performance, we introduce macroscopic modeling of the branching structure of cardiac myocytes in our finite element ventricular model and utilize this in an optimization process. We put a set of multidirectional fibers around a central fiber orientation at each point of the ventricle walls and simulate heartbeats by generating contraction forces along each of these directions. We examine two optimization processes using the workloads or impulses measured in these directions to update the central fiber orientation. Both processes improve the pumping performance towards an optimal value within several tens of heartbeats, starting from an almost-flat fiber orientation. However, compared with the workload optimization, the impulse optimization produces better agreement with experimental studies on transmural changes of fiber helix angle, streamline patterns of characteristic helical structures, and temporal changes in strain. Furthermore, the impulse optimization is robust under geometrical changes of the heart and tends to homogenize various mechanical factors such as the stretch and stretch rate along the fiber orientation, the contraction force, and energy consumption. Copyright © 2015 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Takumi Washio
- Graduate School of Frontier Sciences, The University of Tokyo, 178-4 Wakashiba, Kashiwa, Chiba, 277-0871, Japan
| | - Kazunori Yoneda
- Next-Generation Healthcare Innovation Center, Fujitsu Ltd, 1-17-25 Shin-kamata, Ohta-ku, Tokyo, 144-8588, Japan
| | - Jun-Ichi Okada
- Graduate School of Frontier Sciences, The University of Tokyo, 178-4 Wakashiba, Kashiwa, Chiba, 277-0871, Japan
| | - Taro Kariya
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Seiryo Sugiura
- Graduate School of Frontier Sciences, The University of Tokyo, 178-4 Wakashiba, Kashiwa, Chiba, 277-0871, Japan
| | - Toshiaki Hisada
- Graduate School of Frontier Sciences, The University of Tokyo, 178-4 Wakashiba, Kashiwa, Chiba, 277-0871, Japan
| |
Collapse
|
12
|
Land S, Gurev V, Arens S, Augustin CM, Baron L, Blake R, Bradley C, Castro S, Crozier A, Favino M, Fastl TE, Fritz T, Gao H, Gizzi A, Griffith BE, Hurtado DE, Krause R, Luo X, Nash MP, Pezzuto S, Plank G, Rossi S, Ruprecht D, Seemann G, Smith NP, Sundnes J, Rice JJ, Trayanova N, Wang D, Jenny Wang Z, Niederer SA. Verification of cardiac mechanics software: benchmark problems and solutions for testing active and passive material behaviour. Proc Math Phys Eng Sci 2015; 471:20150641. [PMID: 26807042 PMCID: PMC4707707 DOI: 10.1098/rspa.2015.0641] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Models of cardiac mechanics are increasingly used to investigate cardiac physiology. These models are characterized by a high level of complexity, including the particular anisotropic material properties of biological tissue and the actively contracting material. A large number of independent simulation codes have been developed, but a consistent way of verifying the accuracy and replicability of simulations is lacking. To aid in the verification of current and future cardiac mechanics solvers, this study provides three benchmark problems for cardiac mechanics. These benchmark problems test the ability to accurately simulate pressure-type forces that depend on the deformed objects geometry, anisotropic and spatially varying material properties similar to those seen in the left ventricle and active contractile forces. The benchmark was solved by 11 different groups to generate consensus solutions, with typical differences in higher-resolution solutions at approximately 0.5%, and consistent results between linear, quadratic and cubic finite elements as well as different approaches to simulating incompressible materials. Online tools and solutions are made available to allow these tests to be effectively used in verification of future cardiac mechanics software.
Collapse
Affiliation(s)
- Sander Land
- Department of Biomedical Engineering, King's College London , London, UK
| | - Viatcheslav Gurev
- Thomas J. Watson Research Center, IBM Research, Yorktown Heights , NY 10598, USA
| | - Sander Arens
- Department of Physics and Astronomy , Ghent University , Ghent, Belgium
| | | | - Lukas Baron
- Institute of Biomedical Engineering, Karlsruhe Institute of Technology , Karlsruhe, Germany
| | - Robert Blake
- Department of Biomedical Engineering and Institute for Computational Medicine , Johns Hopkins University , Baltimore, MD 21218, USA
| | - Chris Bradley
- Auckland Bioengineering Institute, University of Auckland , Auckland, New Zealand
| | - Sebastian Castro
- Department of Structural and Geotechnical Engineering , Pontifica Universidad Católica de Chile , Chile
| | - Andrew Crozier
- Institute of Biophysics, Medical University of Graz , Graz, Austria
| | - Marco Favino
- Center for Computational Medicine in Cardiology , Institute of Computational Science, Università della Svizzera italiana , Lugano, Switzerland
| | - Thomas E Fastl
- Department of Biomedical Engineering, King's College London , London, UK
| | - Thomas Fritz
- Institute of Biomedical Engineering, Karlsruhe Institute of Technology , Karlsruhe, Germany
| | - Hao Gao
- School of Mathematics and Statistics, University of Glasgow , Glasgow, UK
| | - Alessio Gizzi
- Department of Engineering, Nonlinear Physics and Mathematical Modeling Lab , University Campus Bio-Medico of Rome , Rome, Italy
| | - Boyce E Griffith
- Interdisciplinary Applied Mathematics Center , University of North Carolina at Chapel Hill , Chapel Hill, NC, USA
| | - Daniel E Hurtado
- Department of Structural and Geotechnical Engineering , Pontifica Universidad Católica de Chile , Chile
| | - Rolf Krause
- Center for Computational Medicine in Cardiology , Institute of Computational Science, Università della Svizzera italiana , Lugano, Switzerland
| | - Xiaoyu Luo
- School of Mathematics and Statistics, University of Glasgow , Glasgow, UK
| | - Martyn P Nash
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand; Department of Engineering Science, University of Auckland, Auckland, New Zealand
| | - Simone Pezzuto
- Center for Computational Medicine in Cardiology, Institute of Computational Science, Università della Svizzera italiana, Lugano, Switzerland; Simula Research Laboratory, Fornebu, Norway
| | - Gernot Plank
- Institute of Biophysics, Medical University of Graz , Graz, Austria
| | - Simone Rossi
- Civil and Environmental Engineering Department , Duke University , Durham, NC 27708-0287, USA
| | - Daniel Ruprecht
- Center for Computational Medicine in Cardiology , Institute of Computational Science, Università della Svizzera italiana , Lugano, Switzerland
| | - Gunnar Seemann
- Institute of Biomedical Engineering, Karlsruhe Institute of Technology , Karlsruhe, Germany
| | - Nicolas P Smith
- Department of Biomedical Engineering, King's College London, London, UK; Department of Engineering Science, University of Auckland, Auckland, New Zealand
| | | | - J Jeremy Rice
- Thomas J. Watson Research Center, IBM Research, Yorktown Heights , NY 10598, USA
| | - Natalia Trayanova
- Department of Biomedical Engineering and Institute for Computational Medicine , Johns Hopkins University , Baltimore, MD 21218, USA
| | - Dafang Wang
- Department of Biomedical Engineering and Institute for Computational Medicine , Johns Hopkins University , Baltimore, MD 21218, USA
| | - Zhinuo Jenny Wang
- Auckland Bioengineering Institute, University of Auckland , Auckland, New Zealand
| | - Steven A Niederer
- Department of Biomedical Engineering, King's College London , London, UK
| |
Collapse
|