title: Multi-scale Modeling of the Cardiovascular System: Disease Development, Progression, and Clinical Intervention.
abstract: Cardiovascular diseases (CVDs) are the leading cause of death in the western world. With the current development of clinical diagnostics to more accurately measure the extent and specifics of CVDs, a laudable goal is a better understanding of the structure-function relation in the cardiovascular system. Much of this fundamental understanding comes from the development and study of models that integrate biology, medicine, imaging, and biomechanics. Information from these models provides guidance for developing diagnostics, and implementation of these diagnostics to the clinical setting, in turn, provides data for refining the models. In this review, we introduce multi-scale and multi-physical models for understanding disease development, progression, and designing clinical interventions. We begin with multi-scale models of cardiac electrophysiology and mechanics for diagnosis, clinical decision support, personalized and precision medicine in cardiology with examples in arrhythmia and heart failure. We then introduce computational models of vasculature mechanics and associated mechanical forces for understanding vascular disease progression, designing clinical interventions, and elucidating mechanisms that underlie diverse vascular conditions. We conclude with a discussion of barriers that must be overcome to provide enhanced insights, predictions, and decisions in pre-clinical and clinical applications.
authors.affiliation: Departments of Mechanical Engineering and Biomedical Engineering, Boston University, Boston, MA, USA. yanhang@bu.edu.
authors.forename: Yanhang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Victor H
authors.initials: VH
authors.lastname: Barocas
authors.affiliation: Department of Surgery, University of Florida, Gainesville, FL, USA.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Berceli
authors.affiliation: Department of Pharmacology, University of California, Davis, CA, USA.
authors.forename: Colleen E
authors.initials: CE
authors.lastname: Clancy
authors.affiliation: Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Eckmann
authors.affiliation: Center for Computational Surgery, Methodist Hospital Research Institute, Houston, TX, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Garbey
authors.affiliation: California Medical Innovations Institute, San Diego, CA, USA.
authors.forename: Ghassan S
authors.initials: GS
authors.lastname: Kassab
authors.affiliation: Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD, USA.
authors.forename: Donna R
authors.initials: DR
authors.lastname: Lochner
authors.affiliation: Departments of Bioengineering and Medicine, University of California, San Diego, CA, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: McCulloch
authors.affiliation: Departments of Mechanical & Aerospace Engineering and Biomedical Engineering, University of Florida, Gainesville, FL, USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Tran-Son-Tay
authors.affiliation: Department of Biomedical Engineering and Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Natalia A
authors.initials: NA
authors.lastname: Trayanova
mesh_terms: D002318:Cardiovascular Diseases / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008955:Models, Cardiovascular; D066230:Patient-Specific Modeling; D057285:Precision Medicine
keywords: Cardiac mechanics; Cardiovascular fluid mechanics; Constitutive model; Electrophysiological modeling; Extracellular matrix; Mechanical forces; Multi-scale modeling; Pathway network analysis; Vascular mechanics