Computer Simulations and Medical Imaging Towards Healing Damaged Hearts.

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Our heart is a remarkable pump that beats every second of our lives to provide oxygen-rich blood to our body. However, certain diseases, such as heart attack, can initiate a dangerous and vicious cycle that can impede the pumping function of the heart, generally known as a heart failure. This disease affects 3-5% of adult population but is particularly fatal in older adults, with 50% dying within 5 years of diagnosis, which costs the Canadian economy $2.8 Billion each year. Although heart failure is a complex disease, and involves many cellular and molecular mechanisms, the global alterations are linked to changes in biomechanical conditions, such as fluid and structural stresses. Unfortunately, routine medical images, such as CTA or MRI, are unable to provide these stresses. Hence, most clinical decisions are based on anatomical and population-averaged biomarkers. The lack of patient-tailored approaches, optimized with engineering design, ultimately lead to suboptimal interventions and long-term complications. In the proposed research, we will investigate the role that biomechanical stresses play in heart failure, and develop computational and experimental methods to provide patient-tailored treatment options. Towards these goals, we will pursue three initiatives. First, we will develop novel computational simulation methods that integrate physical equations into medical images to estimate biomechanical stresses, which will ultimately allow us to virtually perform interventions to optimize treatment planning. Second initiative will focus on validation of the simulation methods. In this initiative, we will develop realistic 3D printed hearts, and attach these to a hydraulic pump. By experimentally simulating flow through these 3D printed hearts, we will obtain velocity, pressures and other quantities to compare against computational simulation methods. The experimental platform will open up opportunities to perform pre-surgical training and also test novel medical devices (e.g. heart valves) before implanting in patients. The third initiative will explore how distinct biomechanical stresses alter heart function. First, we will induce heart failure in mice and study the changes in heart function using ultrasound system. Second, we will fabricate a system to house freshly harvested mice hearts, and impose distinct biomechanical stresses through a pump. These methods will allow us to explore how variation in biomechanical stresses (e.g. turbulent vs smooth) alter heart tissue structure. Biomechanical stresses are thought to play a key role in heart disease and failure; however, Canadian and global health industry lacks patient-tailored methodologies that can estimate these stresses and utilize them in clinical decision-making. The proposed basic engineering research will provide engineers and doctors with patient-tailored approaches to better diagnose and treat, and ultimately improve outcomes of heart failure patients.