title: Patient-specific modeling of dyssynchronous heart failure: a case study.
abstract: The development and clinical use of patient-specific models of the heart is now a feasible goal. Models have the potential to aid in diagnosis and support decision-making in clinical cardiology. Several groups are now working on developing multi-scale models of the heart for understanding therapeutic mechanisms and better predicting clinical outcomes of interventions such as cardiac resynchronization therapy. Here we describe the methodology for generating a patient-specific model of the failing heart with a myocardial infarct and left ventricular bundle branch block. We discuss some of the remaining challenges in developing reliable patient-specific models of cardiac electromechanical activity, and identify some of the main areas for focusing future research efforts. Key challenges include: efficiently generating accurate patient-specific geometric meshes and mapping regional myofiber architecture to them; modeling electrical activation patterns based on cellular alterations in human heart failure, and estimating regional tissue conductivities based on clinically available electrocardiographic recordings; estimating unloaded ventricular reference geometry and material properties for biomechanical simulations; and parameterizing systemic models of circulatory dynamics from available hemodynamic measurements.
authors.affiliation: Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA. jaguadosierra@ucsd.edu
authors.forename: Jazmin
authors.initials: J
authors.lastname: Aguado-Sierra
authors.forename: Adarsh
authors.initials: A
authors.lastname: Krishnamurthy
authors.forename: Christopher
authors.initials: C
authors.lastname: Villongco
authors.forename: Joyce
authors.initials: J
authors.lastname: Chuang
authors.forename: Elliot
authors.initials: E
authors.lastname: Howard
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Gonzales
authors.forename: Jeff
authors.initials: J
authors.lastname: Omens
authors.forename: David E
authors.initials: DE
authors.lastname: Krummen
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Narayan
authors.forename: Roy C P
authors.initials: RC
authors.lastname: Kerckhoffs
authors.forename: Andrew D
authors.initials: AD
authors.lastname: McCulloch
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D055724:Electrophysiological Phenomena; D006333:Heart Failure / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008953:Models, Anatomic; D008954:Models, Biological; D009119:Muscle Contraction; D009203:Myocardial Infarction / Q000150:complications; D057285:Precision Medicine