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

心脏病学中针对患者的模拟和治疗方法：左心室重塑综合数值框架的开发

• 批准号: 428761409
• 负责人: Professor Dr.-Ing. Michael Kaliske
• 金额: --
• 依托单位: Institut für Statik und Dynamik der Tragwerke
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2019
• 资助国家: 德国
• 起止时间: 2018-12-31 至 2023-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/428761409?language=en
• 关键词: Towards; Patient; specific; Simulations; Treatment

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.

据世界卫生组织统计，2015年，全球平均每2秒就有1人死于心血管疾病（CVD），占全球死亡人数的31%。在过去的几十年里，临床医生和工程师之间的跨学科研究取得了重大进展，他们处理数值模拟，以了解心脏的工作机制，降低心血管疾病的死亡率和经济后果。特别是左心室（LV）重塑是心脏科常见的病理情况。每个患者的独特性质和状况的存在使确定疾病严重程度及其最佳治疗策略变得复杂。此外，目前的心脏分析方法有局限性，需要更深入地了解左室重构。在这种情况下，计算方法可以提供一种有前途的调查能力，即虚拟的，即非侵入性的，相对便宜和快速的，并协助心脏病专家选择最合适的治疗方法为特定的患者。在这一想法的启发下，德累斯顿工业大学结构分析研究所和心脏病学系将进行跨学科的研究合作，将医学和工程能力相结合，目标是提供先进的精确的计算机分析，特别是在病理条件下的左心室重塑。在这方面，将确立若干新的做法。其中一个重要的创新发展将是基于有限元（FE）的方法，该方法将分析从心脏磁共振成像和3D超声心动图中获得的临床数据，并从工程角度提供逐点分布的值，与医学评估软件中的平均段值不同，以及LV的几何形状分析。这种创新的方法将有助于在临床常规中定义识别疾病严重程度和快速疾病进展的更稳健的标志物。此外，通过这种方法学的临床数据分析将指导我们开发一个广泛的LV重构的本构律。与文献中LV重塑的现有材料模型不同，几个重要特征将统一在一个流变学中。为此，重构方面，如体积生长，纤维化的合成和纤维取向的变化将被嵌入到修改后的希尔模型，这是提出来描述的电-粘-活性反应的心肌。该研究计划的另一个重要特征是实施基于有限元的流体-结构相互作用算法，以模拟LV内血液的存在，这最终将提高计算机模拟的真实性。最后，我们的目标是进行全面的有限元分析的通用和个性化的LV几何形状，以验证开发的数值框架。