Precision medicine in human heart modeling : Perspectives, challenges, and opportunities.
Precision medicine in human heart modeling : Perspectives, challenges, and opportunities.
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人类心脏建模中的精准医学：前景，挑战和机遇。
DOI：
10.1007/s10237-021-01421-z
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发表时间：
2021-06
影响因子：
3.5
通讯作者：
Kuhl E
中科院分区：
文献类型：
--
作者：
Peirlinck M;Costabal FS;Yao J;Guccione JM;Tripathy S;Wang Y;Ozturk D;Segars P;Morrison TM;Levine S;Kuhl E
精准医疗是医疗保健领域的一个新前沿，它使用科学方法为每个人的个体基因、解剖学、生理学和生活方式定制医疗。在心血管健康领域，精准医疗已成为一种有前途的范例，可以提供具有成本效益的解决方案，提高生活质量并降低死亡率。然而，人类心脏建模在精准医学中的确切作用尚未得到充分探索。在这里，我们讨论了个性化人类心脏模拟的挑战和机遇，从诊断到设备设计，治疗计划和预后。为了实现个性化，我们绘制了过去三十年来解剖，物理和构成人类心脏模型的历史。我们说明了最近的人类心脏电生理学，心脏力学和流体动力学建模，并强调这些模型的药物开发，起搏电极导线故障，心力衰竭，心室辅助装置，边缘到边缘修复和瓣环成形术的临床相关应用。从转化医学的角度来看，我们提供了虚拟成像试验的临床视角和医疗器械创新的监管视角。我们表明，人类心脏建模中的精准医学并不一定需要完全个性化的，高分辨率的整个心脏模型和整个个性化的病史。相反，我们主张通过使用机器学习在患者队列的临床数据和病史之间进行变形，从基于人群的库中创建具有几何，生物，物理和临床信息的个性化模型。我们预计，这一观点将塑造将人类心脏模拟引入精准医学的道路，最终目标是促进临床决策，指导治疗计划和加速设备设计。
Precision medicine is a new frontier in healthcare that uses scientific methods to customize medical treatment to the individual genes, anatomy, physiology, and lifestyle of each person. In cardiovascular health, precision medicine has emerged as a promising paradigm to enable cost-effective solutions that improve quality of life and reduce mortality rates. However, the exact role in precision medicine for human heart modeling has not yet been fully explored. Here, we discuss the challenges and opportunities for personalized human heart simulations, from diagnosis to device design, treatment planning, and prognosis. With a view toward personalization, we map out the history of anatomic, physical, and constitutive human heart models throughout the past three decades. We illustrate recent human heart modeling in electrophysiology, cardiac mechanics, and fluid dynamics and highlight clinically relevant applications of these models for drug development, pacing lead failure, heart failure, ventricular assist devices, edge-to-edge repair, and annuloplasty. With a view toward translational medicine, we provide a clinical perspective on virtual imaging trials and a regulatory perspective on medical device innovation. We show that precision medicine in human heart modeling does not necessarily require a fully personalized, high-resolution whole heart model with an entire personalized medical history. Instead, we advocate for creating personalized models out of population-based libraries with geometric, biological, physical, and clinical information by morphing between clinical data and medical histories from cohorts of patients using machine learning. We anticipate that this perspective will shape the path toward introducing human heart simulations into precision medicine with the ultimate goals to facilitate clinical decision making, guide treatment planning, and accelerate device design.
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影响因子：
3.8
作者：
Amini, Rouzbeh;Eckert, Chad E.;Koomalsingh, Kevin;McGarvey, Jeremy;Minakawa, Masahito;Gorman, Joseph H.;Gorman, Robert C.;Sacks, Michael S.
通讯作者：
Sacks, Michael S.
影响因子：
3.8
作者：
Bayer, J. D.;Blake, R. C.;Plank, G.;Trayanova, N. A.
通讯作者：
Trayanova, N. A.
影响因子：
--
作者：
Aksenov, Andrey A.
通讯作者：
Aksenov, Andrey A.
影响因子：
1.9
作者：
Ambrosi, D.;Arioli, G.;Quarteroni, A.
通讯作者：
Quarteroni, A.
影响因子：
4.1
作者：
Baillargeon, Brian;Rebelo, Nuno;Fox, David D.;Taylor, Robert L.;Kuhl, Ellen
通讯作者：
Kuhl, Ellen