Multi-scale, tailor-made heart simulation can predict the effect of cardiac resynchronization therapy

Okada, Junichi; Washio, Takumi; Nakagawa, Machiko; Watanabe, Masahiro; Kadooka, Yoshimasa; Kariya, Taro; Yamashita, Hiroshi; Yamada, Yoko; Momomura, Shin‐ichi; Nagai, Ryozo; Hisada, Toshiaki; Sugiura, Seiryo

doi:10.1016/j.yjmcc.2017.05.006

Cited by 42 publications

(50 citation statements)

References 43 publications

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“…Researchers participating in the simulations were blinded to the outcome until the simulations were completed. The details of the simulation method were described previously [19,20] and are shown in the supplementary methods provided in Online Resource 1.…”

Section: Simulationmentioning

confidence: 99%

“…To save computational time and cost, we modeled only ventricles, and the time-varying elastance models of atria were connected with an electrical circuit analog of circulation ( Fig. 1a), the parameter values of which were adjusted for each patient [19,20,24] (see supplementary Table 2 in Online Resource 1). Finally, contractility of the ventricles was adjusted to match the EF and non-invasive arterial blood pressure of each patient.…”

Section: Patient-specific Heart Modelmentioning

confidence: 99%

“…Among these, the University of Tokyo heart simulator is a multi-scale, multi-physics heart simulator, in which the function of the heart, including patient-specific mechanics and electrophysiology, is reproduced in a three-dimensional heart model based on the molecular mechanism of the excitation-contraction coupling process [14][15][16][17][18]. Okada et al applied this simulation model to patient-specific CRT simulation to show that the simulated changes in ventricular function, measured by the maximum rate of rise in ventricular pressure (dP/dt max ), correlated well with the clinically observed changes in ejection fraction (EF) in a retrospective study [19]. Because, however, information on the actual pacing site was utilized, this approach cannot be translated to the prediction of non-responders in practice.…”

Section: Introductionmentioning

confidence: 99%

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Patient-specific heart simulation can identify non-responders to cardiac resynchronization therapy

et al. 2020

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To identify non-responders to cardiac resynchronization therapy (CRT), various biomarkers have been proposed, but these attempts have not been successful to date. We tested the clinical applicability of computer simulation of CRT for the identification of non-responders. We used the multi-scale heart simulator "UT-Heart," which can reproduce the electrophysiology and mechanics of the heart based on a molecular model of the excitation-contraction mechanism. Patient-specific heart models were created for eight heart failure patients who were treated with CRT, based on the clinical data recorded before treatment. Using these heart models, bi-ventricular pacing simulations were performed at multiple pacing sites adopted in clinical practice. Improvement in pumping function measured by the relative change of maximum positive derivative of left ventricular pressure (%ΔdP/dt max) was compared with the clinical outcome. The operators of the simulation were blinded to the clinical outcome. In six patients, the relative reduction in end-systolic volume exceeded 15% in the follow-up echocardiogram at 3 months (responders) and the remaining two patients were judged as non-responders. The simulated %ΔdP/dt max at the best lead position could identify responders and non-responders successfully. With further refinement of the model, patient-specific simulation could be a useful tool for identifying non-responders to CRT.

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Section: Simulationmentioning

confidence: 99%

Section: Patient-specific Heart Modelmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patient-specific heart simulation can identify non-responders to cardiac resynchronization therapy

et al. 2020

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“…There is a growing interest in dynamic models of electrical and muscle activity of the heart, which require adequate geometric modeling of the heart [23]. A study was conducted in [8], the purpose of which was to test the ability of simulation models of a particular patient to reproduce the response to cardiac resynchronization therapy (CPT) using the latest heart simulation technology. As a result, it was found that multiscale heart modeling for a particular patient can successfully reproduce the response to CRT.…”

Section: Fig 2 (A) a Drawing Made By Torrent-guasp Illustratingmentioning

confidence: 99%

Simulation of Contractile Heart Function in the Autodesk Maya Environment Based on Muscle Fiber Macro-Structure

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Томчинская³

et al. 2019

GraphiCon'2019 Proceedings. Volume 2

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A dynamic simulation model of the contractile function of the heart is presented. The contractile function simulation is based on the modeling of the muscle fibers' structure according to the Atlas of human anatomy and the use of parameters of their geometric shape as parameters that control the contraction. The basic concepts of the architecture of muscle fibers of the myocardium and the structure of the blood supply to the heart are investigated. An algorithm is developed for local parameterization of the contractile function of the heart, which mimics blood flow and conduction disturbances via special control functions. The algorithm of the simulation model is shown in the example of only the left ventricle of the heart but is embedded in the full three-dimensional model of the ventricular complex of the heart. The simulation model is implemented as a solid-state parameterized model in the Autodesk Maya tool environment, managed by a program in the embedded Python language. The result is compared with the results of the OpenCMISS software in favor of the latter. It is planned to continue work with the implementation of the most advanced concept of the myocardial architecture of Torrent-Guasp together with the networks of electrical excitation and blood supply.

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“…Patient-specific models not only enhance physiological understanding of the diseasespecific processes involved in dyssynchronous HF and its treatment by CRT, but also can assist in personalized diagnostic, prognostic and treatment related support. To date, some feasibility studies containing small number of patients have shown that computer models have the potential to predict acute hemodynamic response to CRT 87,88 . In Chapter 2 we showed that personalized prediction of acute hemodynamic response did not improve by adding more detailed information on the electrical substrate in addition to interventricular dyssynchrony during intrinsic rhythm.…”

Section: Response To Crt: the Role Of Computer Modelingmentioning

confidence: 99%

Pacing the heart

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Multi-scale, tailor-made heart simulation can predict the effect of cardiac resynchronization therapy

Abstract: By integrating the complex pathophysiology of the heart, patient-specific, multi-scale heart simulation could successfully reproduce the response to CRT. With further verification, this technique could be a useful tool in clinical decision making.

Cited by 42 publications

References 43 publications

Patient-specific heart simulation can identify non-responders to cardiac resynchronization therapy

Patient-specific heart simulation can identify non-responders to cardiac resynchronization therapy

Simulation of Contractile Heart Function in the Autodesk Maya Environment Based on Muscle Fiber Macro-Structure

Pacing the heart

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