Towards Patient-specific Simulations and Treatment Methods in Cardiology: Develop-ment of a Comprehensive Numerical Framework for Left Ventricle Remodelling

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According to the statistics of the World Health Organization, in 2015, an average of one death every 2 seconds came into existence due to cardiovascular diseases (CVDs), which was 31% of all global deaths. Over the last decades, a significant progress has been achieved in interdisciplinary research between clinicians and engineers, who deal with numerical modelling, to understand the working mechanisms of the heart and reduce mortality and economic consequences of CVDs.In particular, left ventricle (LV) remodelling is a frequently encountered pathological case in cardiology departments. The existence of unique properties and conditions of each patient complicates to identify the disease severity and its optimum treatment strategy. Besides, current cardiac analysing methods have limitations and a deeper insight into LV remodelling is needful. In this context, computational approaches might provide a promising investigation capability that is virtual, i.e. non-invasive, relatively cheap and fast, and assist cardiologists to choose the most appropriate treatment method for a specific patient. Inspired by this idea, the Institute for Structural Analysis and the Department of Cardiology, TU Dresden, will perform an interdisciplinary research cooperation that combines medical and engineering competences with the objective to provide advanced precise computer analysis of LV remodelling particularly under pathological conditions. In this regard, several novelties will be established. One of the significant innovative developments will be a finite element (FE) based methodology that will analyse clinical data obtained from cardiac magnetic resonance imaging and 3D echocardiography with an engineering perspective providing a pointwise distribution of values, unlike averaged segment values as in medical assessment softwares, and geometrical shape analysis of the LV. Such an innovative approach would facilitate to define more robust markers identifying the disease severity and prognosticate disease progression in clinical routine. Furthermore, analysis of the clinical data through this methodology will guide us to develop an extensive constitutive law for LV remodelling. Unlike existing material models for LV remodelling in the literature, several important characteristics will be unified in one rheology. For this purpose, the remodelling aspects such as volumetric growth, fibrosis synthesis and fibre orientation change will be embedded into the modified Hill model, which was proposed to describe the electro-visco-active response of the myocardium. Another essential feature of the research program will be the implementation of an FE based fluid-structure interaction algorithm in order to mimic the presence of blood within the LV, which will eventually improve the realism of computer simulations. Finally, we aim to perform comprehensive FE analyses of generic and personalized LV geometries in order to validate the developed numerical framework.