scholarly journals Effects of Fibrosis Morphology on Reentrant Ventricular Tachycardia Inducibility and Simulation Fidelity in Patient-Derived Models

2014 ◽  
Vol 8s1 ◽  
pp. CMC.S15712 ◽  
Author(s):  
Jordan Ringenberg ◽  
Makarand Deo ◽  
David Filgueiras-Rama ◽  
Gonzalo Pizarro ◽  
Borja Ibañez ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Computational Models ◽  
Border Zone ◽  
Patient Specific ◽  
Narrow Channels ◽  
Simulation Fidelity ◽  
Strong Indicator ◽  
Significant Step ◽  
Magnetic Resonance Imaging Mri

Myocardial fibrosis detected via delayed-enhanced magnetic resonance imaging (MRI) has been shown to be a strong indicator for ventricular tachycardia (VT) inducibility. However, little is known regarding how inducibility is affected by the details of the fibrosis extent, morphology, and border zone configuration. The objective of this article is to systematically study the arrhythmogenic effects of fibrosis geometry and extent, specifically on VT inducibility and maintenance. We present a set of methods for constructing patient-specific computational models of human ventricles using in vivo MRI data for patients suffering from hypertension, hypercholesterolemia, and chronic myocardial infarction. Additional synthesized models with morphologically varied extents of fibrosis and gray zone (GZ) distribution were derived to study the alterations in the arrhythmia induction and reentry patterns. Detailed electrophysiological simulations demonstrated that (1) VT morphology was highly dependent on the extent of fibrosis, which acts as a structural substrate, (2) reentry tended to be anchored to the fibrosis edges and showed transmural conduction of activations through narrow channels formed within fibrosis, and (3) increasing the extent of GZ within fibrosis tended to destabilize the structural reentry sites and aggravate the VT as compared to fibrotic regions of the same size and shape but with lower or no GZ. The approach and findings represent a significant step toward patient-specific cardiac modeling as a reliable tool for VT prediction and management of the patient. Sensitivities to approximation nuances in the modeling of structural pathology by image-based reconstruction techniques are also implicated.

scholarly journals Validating Patient-Specific Finite Element Models of Direct Electrocortical Stimulation

2021 ◽  
Vol 15 ◽  
Author(s):  
Chantel M. Charlebois ◽  
David J. Caldwell ◽  
Sumientra M. Rampersad ◽  
Andrew P. Janson ◽  
Jeffrey G. Ojemann ◽  
...  
Keyword(s):  
Computational Models ◽  
Projection Methods ◽  
Patient Specific ◽  
Clinical Effects ◽  
Cortical Surface ◽  
Brain Shift ◽  
Model Errors ◽  
Computer Interfaces ◽  
Electrode Localization

Direct electrocortical stimulation (DECS) with electrocorticography electrodes is an established therapy for epilepsy and an emerging application for stroke rehabilitation and brain-computer interfaces. However, the electrophysiological mechanisms that result in a therapeutic effect remain unclear. Patient-specific computational models are promising tools to predict the voltages in the brain and better understand the neural and clinical response to DECS, but the accuracy of such models has not been directly validated in humans. A key hurdle to modeling DECS is accurately locating the electrodes on the cortical surface due to brain shift after electrode implantation. Despite the inherent uncertainty introduced by brain shift, the effects of electrode localization parameters have not been investigated. The goal of this study was to validate patient-specific computational models of DECS against in vivo voltage recordings obtained during DECS and quantify the effects of electrode localization parameters on simulated voltages on the cortical surface. We measured intracranial voltages in six epilepsy patients during DECS and investigated the following electrode localization parameters: principal axis, Hermes, and Dykstra electrode projection methods combined with 0, 1, and 2 mm of cerebral spinal fluid (CSF) below the electrodes. Greater CSF depth between the electrode and cortical surface increased model errors and decreased predicted voltage accuracy. The electrode localization parameters that best estimated the recorded voltages across six patients with varying amounts of brain shift were the Hermes projection method and a CSF depth of 0 mm (r = 0.92 and linear regression slope = 1.21). These results are the first to quantify the effects of electrode localization parameters with in vivo intracranial recordings and may serve as the basis for future studies investigating the neuronal and clinical effects of DECS for epilepsy, stroke, and other emerging closed-loop applications.

scholarly journals Patient-Specific Aortic Phantom With Tunable Compliance

2019 ◽  
Vol 2 (4) ◽  
Author(s):  
Antonio Gallarello ◽  
Andrea Palombi ◽  
Giacomo Annio ◽  
Shervanthi Homer-Vanniasinkam ◽  
Elena De Momi ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Computational Models ◽  
Three Dimensional ◽  
Complex Interventions ◽  
Patient Specific ◽  
Arch Model ◽  
Magnetic Resonance Imaging Mri ◽  
Variable Wall ◽  
Silicone Model

Abstract Validation of computational models using in vitro phantoms is a nontrivial task, especially in the replication of the mechanical properties of the vessel walls, which varies with age and pathophysiological state. In this paper, we present a novel aortic phantom reconstructed from patient-specific data with variable wall compliance that can be tuned without recreating the phantom. The three-dimensional (3D) geometry of an aortic arch was retrieved from a computed tomography angiography scan. A rubber-like silicone phantom was manufactured and connected to a compliance chamber in order to tune its compliance. A lumped resistance was also coupled with the system. The compliance of the aortic arch model was validated using the Young's modulus and characterized further with respect to clinically relevant indicators. The silicone model demonstrates that compliance can be finely tuned with this system under pulsatile flow conditions. The phantom replicated values of compliance in the physiological range. Both, the pressure curves and the asymmetrical behavior of the expansion, are in agreement with the literature. This novel design approach allows obtaining for the first time a phantom with tunable compliance. Vascular phantoms designed and developed with the methodology proposed in this paper have high potential to be used in diverse conditions. Applications include training of physicians, pre-operative trials for complex interventions, testing of medical devices for cardiovascular diseases (CVDs), and comparative Magnetic-resonance-imaging (MRI)-based computational studies.

Impact of Patient-Specific In Vivo Vessel Material Properties on Carotid Atherosclerotic Plaque Stress/Strain Calculations

2019 ◽  
Vol 16 (03) ◽  
pp. 1842002 ◽  
Author(s):  
Qingyu Wang ◽  
Dalin Tang ◽  
Gador Canton ◽  
Thomas S. Hatsukami ◽  
Kristen L. Billiar ◽  
...  
Keyword(s):  
Material Properties ◽  
Carotid Plaque ◽  
Computational Models ◽  
Patient Specific ◽  
Stress And Strain ◽  
Carotid Atherosclerotic Plaque ◽  
Plaque Vulnerability ◽  
Material Models ◽  
Vessel Material

Patient-specific vessel material properties are in general lacking in image-based computational models. Carotid plaque stress and strain conditions with in vivo material and old material models were investigated (8 patients, 16 plaques). Plaque models using patient-specific in vivo vessel material properties showed significant differences from models using old material properties from the literature on stress and strain calculations. These differences demonstrated that models using in vivo material properties could improve the accuracy of stress and strain calculations which could potentially lead to more accurate plaque vulnerability assessment.

scholarly journals Evaluation of a modified Cheatham-Platinum stent for the treatment of aortic coarctation by finite element modelling

2018 ◽  
Vol 7 ◽  
pp. 204800401877395 ◽  
Author(s):  
Barbara EU Burkhardt ◽  
Nicholas Byrne ◽  
Marí Nieves Velasco Forte ◽  
Francesco Iannaccone ◽  
Matthieu De Beule ◽  
...  
Keyword(s):  
Finite Element ◽  
Aortic Coarctation ◽  
Computational Models ◽  
Three Dimensional ◽  
Computational Modelling ◽  
Patient Specific ◽  
Stent Design ◽  
Initial Length ◽  
Element Analysis

Objectives Stent implantation for the treatment of aortic coarctation has become a standard approach for the management of older children and adults. Criteria for optimal stent design and construction remain undefined. This study used computational modelling to compare the performance of two generations of the Cheatham-Platinum stent (NuMED, Hopkinton, NY, USA) deployed in aortic coarctation using finite element analysis. Design Three-dimensional models of both stents, reverse engineered from microCT scans, were implanted in the aortic model of one representative patient. They were virtually expanded in the vessel with a 16 mm balloon and a pressure of 2 atm. Results The conventional stent foreshortened to 96.5% of its initial length, whereas the new stent to 99.2% of its initial length. Diameters in 15 slices across the conventional stent were 11.6–15 mm (median 14.2 mm) and slightly higher across the new stent: 10.7–15.3 mm (median 14.5 mm) (p= 0.021). Apposition to the vessel wall was similar: conventional stent 31.1% and new stent 28.6% of total stent area. Conclusions The new design Cheatham-Platinum stent showed similar deployment results compared to the conventional design. The new stent design showed slightly higher expansion, using the same delivery balloon. Patient-specific computational models can be used for virtual implantation of new aortic stents and promise to inform subsequent in vivo trials.

Fluid-Solid Interaction Simulation of Flow and Stress Pattern in Thoracoabdominal Aneurysms: A Patient Specific Study

2006 ◽  
Author(s):  
Alessandro Borghi ◽  
Nigel B. Wood ◽  
Raad H. Mohiaddin ◽  
X. Yun Xu
Keyword(s):  
Wall Stress ◽  
Aortic Aneurysms ◽  
Maximum Diameter ◽  
Patient Specific ◽  
Specific Flow ◽  
Hyperelastic Materials ◽  
Abdominal Aortic ◽  
Magnetic Resonance Imaging Mri ◽  
Fluid Solid Interaction

Thoracoabdominal aneurysm (TA) is a pathology that involves the enlargement of the aortic diameter in the inferior descending thoracic aorta and has risk factors including aortic dissection, aortitis or connective tissue disorders (Webb, T. H. and Williams, G. M. 1999). Abnormal flow patterns and stress on the diseased aortic wall are thought to play an important role in the development of this pathology and the internal wall stress has proved to be more reliable as a predictor of rupture than the maximum diameter for abdominal aortic aneurysms (Fillinger, M. F., et al. 2003). In the present study, two patients with TAs of different maximum diameters were scanned using magnetic resonance imaging (MRI) techniques. Realistic models of the aneurysms were reconstructed from the in vivo MRI data acquired from the patients, and subject-specific flow conditions were applied as boundary conditions. The wall and thrombus were modeled as hyperelastic materials and their properties were derived from the literature. Fully coupled fluid-solid interaction simulations were performed for both cases using ADINA 8.2. Results were obtained for both the flow and wall stress patterns within the aneurysms. The results show that the wall stress distribution and its magnitude are strongly dependent on the 3-D shape of the aneurysm and the distribution of thrombus.

scholarly journals Days Gained: A Simulation-Based, Response Metric in the Assessment of Glioblastoma

2018 ◽  
Author(s):  
Gustavo De Leon ◽  
Kyle W. Singleton ◽  
Kristin R. Swanson
Keyword(s):  
Computational Models ◽  
Therapeutic Response ◽  
Growth Dynamics ◽  
Response To Therapy ◽  
Patient Specific ◽  
Tumor Lesion ◽  
Simulation Based ◽  
Magnetic Resonance Imaging Mri ◽  
Insight Into ◽  
Time Point

AbstractWe show the application of a minimally based, patient-specific mathematical model in the evaluation of glioblastoma response to therapy. Days Gained uses computational models of glioblastoma growth dynamics derived from clinically acquired magnetic resonance imaging (MRI) to compare the post-treatment tumor lesion to the expected untreated tumor lesion at the same time point. It accounts for the inter-patient variability in growth dynamics and response to therapy. This allows for the accurate assessment of therapeutic response and provides insight into overall survival as it relates to treatment response.

scholarly journals An automate pipeline for generating fiber orientation and region annotation in patient specific atrial models

2021 ◽  
Vol 7 (2) ◽  
pp. 136-139
Author(s):  
Tianbao Zheng ◽  
Luca Azzolin ◽  
Jorge Sánchez ◽  
Olaf Dössel ◽  
Axel Loewe
Keyword(s):  
Fiber Orientation ◽  
Specific Model ◽  
Human Interaction ◽  
Patient Specific ◽  
Potential Source ◽  
Automate Pipeline ◽  
Automated Pipeline ◽  
Magnetic Resonance Imaging Mri ◽  
Source Of Error

Abstract Modeling the 'digital twin' of a patient's heart has gained traction in the last years and helps to understand the pathogenic mechanisms of cardiovascular disease to pave the way for personalized therapies. Although a 3D patient-specific model (PSM) can be obtained from computed tomography (CT) or magnetic resonance imaging (MRI), the fiber orientation of cardiac muscle, which significantly affects the electrophysiological and mechanical characteristics of the heart, can hardly be obtained in vivo. Several approaches have been suggested to solve this problem. However, most of them require a considerable amount of human interaction, which is both time-consuming and a potential source of error. In this work, a highly automated pipeline based on a Laplace- Dirichlet-rule-based method (LDRBM) for annotating fibers and anatomical regions in both atria is introduced. The calculated fiber arrangement was regionally compared with anatomical observations from literature and faithfully reproduced clinical and experimental data.

Determination of Human Carotid Atherosclerotic Plaque Material Properties Non-Invasively Using In Vivo Cine and 3D Magnetic Resonance Imaging and Image-Based Modeling Techniques

2011 ◽  
Author(s):  
Haofei Liu ◽  
Gador Canton ◽  
Chun Yuan ◽  
Marina Ferguson ◽  
Chun Yang ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Atherosclerotic Plaque ◽  
Material Properties ◽  
Computational Models ◽  
Plaque Rupture ◽  
Patient Specific ◽  
Material Strength ◽  
Modeling Techniques ◽  
Human Carotid

Atherosclerotic plaque rupture is believed to be associated with high critical stress exceeding plaque cap material strength. In vivo magnetic resonance image (MRI)-based computational models have been introduced to calculate critical plaque stress and assess plaque vulnerability [1–5]. However, accuracy of computational stress predictions is heavily dependent on the data used by the models. Patient-specific plaque material properties are desirable for accurate stress predictions but are not currently available. In this paper, non-invasive in vivo Cine and 3D multicontrast MRI data and modeling techniques were combined to obtain patient-specific plaque material properties to improve model prediction accuracies. A 2D human carotid plaque model was used to demonstrate impact of material stiffness on computational stress predictions.

Validation of Computational Knee Models Using a Dynamic Knee Simulator

2008 ◽  
Author(s):  
Trent M. Guess ◽  
Mohammad Kia ◽  
Katherine Weimer ◽  
Kevin Dodd ◽  
Lorin Maletsky
Keyword(s):  
Computational Models ◽  
Patient Specific ◽  
Specific Reference ◽  
Knee Biomechanics ◽  
Computational Simulations ◽  
Body Model ◽  
Knee Simulator ◽  
Multi Body ◽  
Models And Modeling

Computational models of the knee provide valuable information on knee biomechanics, but validation of these models is challenging as in-vivo parameters such as muscle forces and tissue loading cannot be measured. Machines that simulate the dynamic loading and motion of physiological activities on cadaver knees can provide a means for validating computational knee models and modeling methods. In this approach, all forces applied to cadaver knees are known and can be replicated in computational simulations. The resulting experimental and computational kinematics can then be compared. Presented here is the development and use of a modeling platform comprised of a multi-body computational model of a cadaver knee and dynamic knee simulator and experimental measurements from the cadaver knee loaded in the machine. This modeling platform has been used to study: 1) patient specific reference lengths versus literature obtained reference lengths [1], 2) inclusion of ligament and tendon wrapping [2] and, 3) the development of a multi-body model of the meniscus [3].

scholarly journals Analyzing the Role of Repolarization Gradients in Post-infarct Ventricular Tachycardia Dynamics Using Patient-Specific Computational Heart Models

2021 ◽  
Vol 12 ◽  
Author(s):  
Eric Sung ◽  
Adityo Prakosa ◽  
Natalia A. Trayanova
Keyword(s):  
Ventricular Tachycardia ◽  
Cardiac Magnetic Resonance ◽  
Conduction Block ◽  
Magnetic Resonance Images ◽  
Border Zone ◽  
Patient Specific ◽  
Rapid Pacing ◽  
Infarct Border Zone ◽  
Infarct Border

Aims: Disease-induced repolarization heterogeneity in infarcted myocardium contributes to VT arrhythmogenesis but how apicobasal and transmural (AB-TM) repolarization gradients additionally affect post-infarct VT dynamics is unknown. The goal of this study is to assess how AB-TM repolarization gradients impact post-infarct VT dynamics using patient-specific heart models.Method: 3D late gadolinium-enhanced cardiac magnetic resonance images were acquired from seven post-infarct patients. Models representing the patient-specific scar and infarct border zone distributions were reconstructed without (baseline) and with repolarization gradients along both the AB-TM axes. AB only and TM only models were created to assess the effects of each ventricular gradient on VT dynamics. VTs were induced in all models via rapid pacing.Results: Ten baseline VTs were induced. VT inducibility in AB-TM models was not significantly different from baseline (p>0.05). Reentry pathways in AB-TM models were different than baseline pathways due to alterations in the location of conduction block (p<0.05). VT exit sites in AB-TM models were different than baseline VT exit sites (p<0.05). VT inducibility of AB only and TM only models were not significantly different than that of baseline (p>0.05) or AB-TM models (p>0.05). Reentry pathways and VT exit sites in AB only and TM only models were different than in baseline (p<0.05). Lastly, repolarization gradients uncovered multiple VT morphologies with different reentrant pathways and exit sites within the same structural, conducting channels.Conclusion: VT inducibility was not impacted by the addition of AB-TM repolarization gradients, but the VT reentrant pathway and exit sites were greatly affected due to modulation of conduction block. Thus, during ablation procedures, physiological and pharmacological factors that impact the ventricular repolarization gradient might need to be considered when targeting the VTs.

Sign in / Sign up

Export Citation Format

Share Document