title: Towards Personalized Cardiology: Multi-Scale Modeling of the Failing Heart.
abstract: BACKGROUND
  Despite modern pharmacotherapy and advanced implantable cardiac devices, overall prognosis and quality of life of HF patients remain poor. This is in part due to insufficient patient stratification and lack of individualized therapy planning, resulting in less effective treatments and a significant number of non-responders.
  
  
  RESULTS
  State-of-the-art clinical phenotyping was acquired, including magnetic resonance imaging (MRI) and biomarker assessment. An individualized, multi-scale model of heart function covering cardiac anatomy, electrophysiology, biomechanics and hemodynamics was estimated using a robust framework. The model was computed on n=46 HF patients, showing for the first time that advanced multi-scale models can be fitted consistently on large cohorts. Novel multi-scale parameters derived from the model of all cases were analyzed and compared against clinical parameters, cardiac imaging, lab tests and survival scores to evaluate the explicative power of the model and its potential for better patient stratification. Model validation was pursued by comparing clinical parameters that were not used in the fitting process against model parameters.
  
  
  CONCLUSIONS
  This paper illustrates how advanced multi-scale models can complement cardiovascular imaging and how they could be applied in patient care. Based on obtained results, it becomes conceivable that, after thorough validation, such heart failure models could be applied for patient management and therapy planning in the future, as we illustrate in one patient of our cohort who received CRT-D implantation.
authors.affiliation: Department of Medicine III, University of Heidelberg, Heidelberg, Germany; DZHK (German Centre for Cardiovascular Research), Heidelberg, Germany.
authors.forename: Elham
authors.initials: E
authors.lastname: Kayvanpour
authors.affiliation: Siemens Corporation, Corporate Technology, Imaging and Computer Vision, Princeton, New Jersey, United States of America.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Mansi
authors.affiliation: Department of Medicine III, University of Heidelberg, Heidelberg, Germany; DZHK (German Centre for Cardiovascular Research), Heidelberg, Germany.
authors.forename: Farbod
authors.initials: F
authors.lastname: Sedaghat-Hamedani
authors.affiliation: Department of Medicine III, University of Heidelberg, Heidelberg, Germany; DZHK (German Centre for Cardiovascular Research), Heidelberg, Germany.
authors.forename: Ali
authors.initials: A
authors.lastname: Amr
authors.affiliation: Siemens Corporation, Corporate Technology, Imaging and Computer Vision, Princeton, New Jersey, United States of America.
authors.forename: Dominik
authors.initials: D
authors.lastname: Neumann
authors.affiliation: Siemens Corporation, Corporate Technology, Imaging and Computer Vision, Princeton, New Jersey, United States of America.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Georgescu
authors.affiliation: Siemens Corporation, Corporate Technology, Imaging and Computer Vision, Princeton, New Jersey, United States of America.
authors.forename: Philipp
authors.initials: P
authors.lastname: Seegerer
authors.affiliation: Siemens Corporation, Corporate Technology, Imaging and Computer Vision, Princeton, New Jersey, United States of America.
authors.forename: Ali
authors.initials: A
authors.lastname: Kamen
authors.affiliation: Department of Medicine III, University of Heidelberg, Heidelberg, Germany; DZHK (German Centre for Cardiovascular Research), Heidelberg, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Haas
authors.affiliation: Department of Medicine III, University of Heidelberg, Heidelberg, Germany; DZHK (German Centre for Cardiovascular Research), Heidelberg, Germany.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Frese
authors.affiliation: Department of Medicine III, University of Heidelberg, Heidelberg, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Irawati
authors.affiliation: Siemens AG, Corporate Technology, Erlangen, Germany.
authors.forename: Emil
authors.initials: E
authors.lastname: Wirsz
authors.affiliation: Siemens Corporation, Corporate Technology, Sensor Technologies, Princeton, New Jersey, United States of America.
authors.forename: Vanessa
authors.initials: V
authors.lastname: King
authors.affiliation: Department of Medicine III, University of Heidelberg, Heidelberg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Buss
authors.affiliation: Department of Medicine III, University of Heidelberg, Heidelberg, Germany.
authors.forename: Derliz
authors.initials: D
authors.lastname: Mereles
authors.affiliation: Department of Medicine III, University of Heidelberg, Heidelberg, Germany.
authors.forename: Edgar
authors.initials: E
authors.lastname: Zitron
authors.affiliation: Biomarker Discovery Center Heidelberg, Heidelberg, Germany; Department of Human Genetics, Saarland University, Homburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Keller
authors.affiliation: Department of Medicine III, University of Heidelberg, Heidelberg, Germany; DZHK (German Centre for Cardiovascular Research), Heidelberg, Germany; Klaus Tschira Institute for Computational Cardiology, Heidelberg, Germany.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.affiliation: Siemens Corporation, Corporate Technology, Imaging and Computer Vision, Princeton, New Jersey, United States of America.
authors.forename: Dorin
authors.initials: D
authors.lastname: Comaniciu
authors.affiliation: Department of Medicine III, University of Heidelberg, Heidelberg, Germany; DZHK (German Centre for Cardiovascular Research), Heidelberg, Germany; Klaus Tschira Institute for Computational Cardiology, Heidelberg, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Meder
mesh_terms: D006333:Heart Failure / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D057285:Precision Medicine