CASyM winter school of Systems Medicine took place between March 29th and April 1st 2017 in Ljubljana, Slovenia and is entitled »The 3rd SysBioMed hands-on tutorial: Systems Medicine Approaches in Personalized Medicine«
Edward Vigmond1, Gernot Plank2, Joost Lumens3, Frits Prinzen3, Philippe Ritter4
1University of Bordeaux, 2Medical University of GRaz, 3University of Masstricht, 4CHU Bordeaux
Heart failure patients often have comprised conduction systems which leads to improper activation of the heart and, subsequently, reduced cardiac output. Cardiac resynchronization therapy (CRT) attempts to correct for this by using two pacing leads, one in the right ventricle and one on the left, to better activate the heart. However, 30% of patients receiving this therapy do not respond optimally or at all. By choosing better lead locations and stimulus timings, one may be better able to activate the ventricles to improve performance. The heart is an electrically activated mechanical pump producing fluid flow which depends on the circulatory load. Thus, there is an interaction of systems across scales and physics which must be considered. The PUSHCART project aims to improve CRT repsonse by incorporating clinical data into personalized computer models of the cardiovascular system to better predict system response to pacing strategies. A highly detailed finite electromechanical model of the heart will be coupled to the CircApadt circulatory model.Clinical data to incorporate includes MRI images, late gadolineum enhanced MRI, ECG, intracavitiy pressure-volume measurements, and echocardiography. The model will be validated on invasive animal data before retrospective and prospective studies in humans.
Figure 1:Electromechanical model and the fitting required.Electrical model showing activation through the His-Purkinje system (left). Cellular Calcium release leads to contraction (middle figure) and fluid flow (right figure). Clinical data is incorporated to personalize the model.
2006 - University of Ljubljana, Faculty of Medicine, Center for Functional Genomics and Bio-chips.