Abstract
Computer models of cardiac electro-mechanics (EM) show promise as an effective means for the quantitative analysis of clinical data and, potentially, for predicting therapeutic responses. To realize such advanced applications methodological key challenges must be addressed. Enhanced computational efficiency and robustness is crucial to facilitate, within tractable time frames, model personalization, the simulation of prolonged observation periods under a broad range of conditions, and physiological completeness encompassing therapy-relevant mechanisms is needed to endow models with predictive capabilities beyond the mere replication of observations.Here, we introduce a universal feature-complete cardiac EM modeling framework that builds on a flexible method for coupling a 3D model of bi-ventricular EM to the physiologically comprehensive 0D CircAdapt model representing atrial mechanics and closed-loop circulation. A detailed mathematical description is given and efficiency, robustness, and accuracy of numerical scheme and solver implementation are evaluated. After parameterization and stabilization of the coupled 3D–0D model to a limit cycle under baseline conditions, the model’s ability to replicate physiological behaviors is demonstrated, by simulating the transient response to alterations in loading conditions and contractility, as induced by experimental protocols used for assessing systolic and diastolic ventricular properties. Mechanistic completeness and computational efficiency of this novel model render advanced applications geared towards predicting acute outcomes of EM therapies feasible.
Highlights
Cardiovascular diseases (CVDs) are the primary cause of mortality and morbidity in industrialized nations, posing a significant burden on health care systems worldwide [1, 2, 3]
We introduce the set of cavities C = {LV, right ventricular (RV), LA, RA}, with the left ventricle (LV), the left atrium (LA), the right ventricle (RV), and the right atrium (RA); the set of cavities CPDE ⊆ C that are modeled as a 3D PDE model; and the set of cavities CODE = C \ CPDE that are modeled as a 0D ordinary differential equations (ODEs) model
This study reports on a flexible monolithic 3D solid - 0D fluid coupling method for integrated models of cardiac EM and cardiovascular hemodynamics
Summary
Cardiovascular diseases (CVDs) are the primary cause of mortality and morbidity in industrialized nations, posing a significant burden on health care systems worldwide [1, 2, 3]. Despite continuous diagnostic and therapeutic advances, their optimal treatment remains a challenge [4]. This is due to the complex multiphysics nature of cardiovascular function – the Preprint submitted to Computer Methods in Applied Mechanics and Engineering heart is an electrically controlled mechanical pump driving blood through the circulatory system. Advanced clinical modalities provide a wealth of disparate data, but effective tools allowing their comprehensive quantitative analysis are lacking. Computer models able to capture mechanistic relations between clinical observations quantitatively show promise to fill this void. In recent single physics cardiac electrophysiology (EP) studies, the added value of models in improving therapy stratification [5] and planning [6, 7] has been demonstrated already
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