Towards predictive computer simulations in cardiology: Finite element analysis of personalized heart models
Towards predictive computer simulations in cardiology: Finite element analysis of personalized heart models
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DOI：
10.1002/zamm.201800055
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发表时间：
2018-12-01
影响因子：
2.3
通讯作者：
Kaliske, Michael
中科院分区：
文献类型：
--
作者：
Cansiz, Baris;Sveric, Krunoslav;Kaliske, Michael
这份手稿的目的是证明我们最近在心脏病学中朝着预测性计算机模拟方向发展的数字发展的可行性。与文献中已有的弱耦合和强耦合整体方法不同，我们采用了一种全隐式交错求解方案，它能够通过有限元模拟来研究心脏组织在单域和双域环境中的强兴奋-收缩耦合。在本构水平上，我们采用了最近提出的改进的Hill模型(CMAME 315；434-466,2017)，该模型将心肌视为电粘性材料。所有的时间积分都是通过隐式后向欧拉格式进行计算的，该格式确保无条件稳定。该框架的性能是通过两个临床相关和有趣的例子来演示的。首先，模拟了个性化左心室模型的基本变形特征，如旋转、扭转和纵向缩短，以及生理压力-体积关系。此外，对粘弹性解和弹性解的结果进行了比较。在第二个例子中，我们模拟了一个具有不同步的连续跳动的虚拟双心室模型，并模拟了两种不同的心脏再同步治疗尝试，以提高心输出量。在模拟过程中记录相应的心电图和左心室容量-时间关系，并与健康病例进行比较。
The goal of this manuscript is to demonstrate the feasibility of our recent numerical developments towards predictive computer simulations in cardiology. In contrast to existing weakly coupled and strongly coupled monolithic approaches in the literature, we utilize a fully implicit staggered solution scheme that enables to study the strong excitation-contraction coupling of the heart tissue in the monodomain and the bidomain setting through finite element simulations. On the constitutive level, we employ the recently proposed modified Hill model (CMAME 315; 434-466, 2017) that treats the myocardium as an electro-visco-active material. All the time integrations are evaluated via an implicit backward Euler scheme that ensures unconditional stability. The performance of the framework is demonstrated by means of two clinically relevant and interesting examples. Firstly, basic deformation characteristics of a personalized left ventricle model such as rotation, twist and longitudinal shortening are simulated along with a physiological pressure-volume relation. In addition, the results of the viscoelastic and elastic solutions are compared. In the second example, we simulate a continuously beating virtual biventricle model having dyssynchrony and imitate two different cardiac resynchronization therapy attempts in order to improve the cardiac output. The corresponding electrocardiograms and left ventricle volume-time relations are recorded during the simulation and compared to the healthy case.