Title
Patient-specific electromechanical models of the heart for the prediction of pacing acute effects in CRT: a preliminary clinical validation.
Abstract
Cardiac resynchronisation therapy (CRT) is an effective treatment for patients with congestive heart failure and a wide QRS complex. However, up to 30% of patients are non-responders to therapy in terms of exercise capacity or left ventricular reverse remodelling. A number of controversies still remain surrounding patient selection, targeted lead implantation and optimisation of this important treatment. The development of biophysical models to predict the response to CRT represents a potential strategy to address these issues. In this article, we present how the personalisation of an electromechanical model of the myocardium can predict the acute haemodynamic changes associated with CRT. In order to introduce such an approach as a clinical application, we needed to design models that can be individualised from images and electrophysiological mapping of the left ventricle. In this paper the personalisation of the anatomy, the electrophysiology, the kinematics and the mechanics are described. The acute effects of pacing on pressure development were predicted with the in silico model for several pacing conditions on two patients, achieving good agreement with invasive haemodynamic measurements: the mean error on dP/dtmax is 47.5±35mmHgs−1, less than 5% error. These promising results demonstrate the potential of physiological models personalised from images and electrophysiology signals to improve patient selection and plan CRT.
Year
DOI
Venue
2012
10.1016/j.media.2011.07.003
Medical Image Analysis
Keywords
Field
DocType
Cardiac modelling,Resynchronisation therapy,Biophysical models,Medical imaging,Parameter estimation
Hemodynamics,Heart failure,Medical imaging,Internal medicine,Cardiology,Ventricle,Medicine,Haemodynamic measurements,Wide QRS complex
Journal
Volume
Issue
ISSN
16
1
1361-8415
Citations 
PageRank 
References 
52
3.31
25
Authors
18
Name
Order
Citations
PageRank
Maxime Sermesant11111122.97
Radomir Chabiniok2779.71
Phani Chinchapatnam318618.55
Tommaso Mansi445445.94
Florence Billet51017.10
Philippe Moireau69510.11
Jean-Marc Peyrat737527.30
Weng Kee Wong8858.54
J Relan9889.28
Kawal S. Rhode1075978.72
Matthew Ginks111179.76
Pier Lambiase1213613.12
Herve Delingette131300136.45
Michel Sorine1414620.31
C. Aldo Rinaldi1522821.98
Dominique Chapelle1611515.37
Reza Razavi1792994.25
Nicholas Ayache18108041654.36