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.

根据世界卫生组织的统计数据，2015年，由于心血管疾病（CVD），平均每2秒出现一次死亡，占全球所有死亡的31％。在过去的几十年中，临床医生和工程师之间的跨学科研究取得了重大进展，他们处理数值建模，了解心脏的工作机制并减少CVDS的死亡率和经济后果。尤其是左心室（LV）改造是一种经常遇到的病理学病例。每个患者的独特特性和条件的存在变得复杂，以确定疾病的严重程度及其最佳治疗策略。此外，当前的心脏分析方法具有局限性，并且需要更深入地了解LV重塑。在这种情况下，计算方法可能会提供有希望的调查能力，即虚拟的，即非侵入性，相对便宜且快速，并协助心脏病专家为特定患者选择最合适的治疗方法。受这个想法的启发，结构分析研究所和心脏病学院Tu Dresden将进行跨学科研究合作，将医学和工程能力与目标相结合，以提供对LV重塑的高级精确计算机分析，尤其是在病理条件下。在这方面，将建立几个新颖性。重要的创新发展之一将是基于有限的元素（FE）方法，该方法将分析从心脏磁共振成像和3D超声心动图获得的临床数据，具有工程学的透视图，可提供值的值分布，与医学评估软件和GEEMERTIAL SLAGE SLAGE SLEAME CLAINGIAD SEGRATED值不同，以及LV的GEEMERTICALICAL SLAGERANES分析。这种创新的方法将有助于定义更强大的标记物，以识别疾病的严重程度和预后疾病在临床常规中的进展。此外，通过这种方法对临床数据的分析将指导我们为LV重塑开发广泛的本构定律。与文献中LV重塑的现有材料模型不同，几个重要特征将在一个流变学中统一。为此，将诸如体积生长，纤维化合成和纤维方向变化等重塑方面嵌入了修饰的山坡模型中，该模型提出了描述心肌的电 - 维斯科活性反应。研究计划的另一个基本特征将是实施基于FE的流体结构相互作用算法，以模仿LV中的血液的存在，这最终将改善计算机模拟的现实主义。最后，我们旨在对通用和个性化LV几何形状进行全面的FE分析，以验证开发的数值框架。