title: Personalized Computer Simulation of Diastolic Function in Heart Failure.
abstract: The search for a parameter representing left ventricular relaxation from non-invasive and invasive diagnostic tools has been extensive, since heart failure (HF) with preserved ejection fraction (HF-pEF) is a global health problem. We explore here the feasibility using patient-specific cardiac computer modeling to capture diastolic parameters in patients suffering from different degrees of systolic HF. Fifty eight patients with idiopathic dilated cardiomyopathy have undergone thorough clinical evaluation, including cardiac magnetic resonance imaging (MRI), heart catheterization, echocardiography, and cardiac biomarker assessment. A previously-introduced framework for creating multi-scale patient-specific cardiac models has been applied on all these patients. Novel parameters, such as global stiffness factor and maximum left ventricular active stress, representing cardiac active and passive tissue properties have been computed for all patients. Invasive pressure measurements from heart catheterization were then used to evaluate ventricular relaxation using the time constant of isovolumic relaxation Tau (τ). Parameters from heart catheterization and the multi-scale model have been evaluated and compared to patient clinical presentation. The model parameter global stiffness factor, representing diastolic passive tissue properties, is correlated significantly across the patient population with τ. This study shows that multi-modal cardiac models can successfully capture diastolic (dys) function, a prerequisite for future clinical trials on HF-pEF.
authors.affiliation: Institute for Cardiomyopathies, Department of Medicine III, University of Heidelberg, 69120 Heidelberg, Germany; German Centre for Cardiovascular Research (DZHK), Heidelberg/Mannheim, Germany.
authors.forename: Ali
authors.initials: A
authors.lastname: Amr
authors.affiliation: Institute for Cardiomyopathies, Department of Medicine III, University of Heidelberg, 69120 Heidelberg, Germany; German Centre for Cardiovascular Research (DZHK), Heidelberg/Mannheim, Germany.
authors.forename: Elham
authors.initials: E
authors.lastname: Kayvanpour
authors.affiliation: Institute for Cardiomyopathies, Department of Medicine III, University of Heidelberg, 69120 Heidelberg, Germany; German Centre for Cardiovascular Research (DZHK), Heidelberg/Mannheim, Germany.
authors.forename: Farbod
authors.initials: F
authors.lastname: Sedaghat-Hamedani
authors.affiliation: Siemens Healthcare, Medical Imaging Technologies, Princeton, NJ 08540, USA.
authors.forename: Tiziano
authors.initials: T
authors.lastname: Passerini
authors.affiliation: Siemens Healthcare, Medical Imaging Technologies, Princeton, NJ 08540, USA.
authors.forename: Viorel
authors.initials: V
authors.lastname: Mihalef
authors.affiliation: Institute for Cardiomyopathies, Department of Medicine III, University of Heidelberg, 69120 Heidelberg, Germany.
authors.forename: Alan
authors.initials: A
authors.lastname: Lai
authors.affiliation: Siemens Healthcare, Medical Imaging Technologies, Princeton, NJ 08540, USA.
authors.forename: Dominik
authors.initials: D
authors.lastname: Neumann
authors.affiliation: Siemens Healthcare, Medical Imaging Technologies, Princeton, NJ 08540, USA.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Georgescu
authors.affiliation: Institute for Cardiomyopathies, Department of Medicine III, University of Heidelberg, 69120 Heidelberg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Buss
authors.affiliation: Institute for Cardiomyopathies, Department of Medicine III, University of Heidelberg, 69120 Heidelberg, Germany.
authors.forename: Derliz
authors.initials: D
authors.lastname: Mereles
authors.affiliation: Institute for Cardiomyopathies, Department of Medicine III, University of Heidelberg, 69120 Heidelberg, Germany.
authors.forename: Edgar
authors.initials: E
authors.lastname: Zitron
authors.affiliation: Siemens Healthcare, Strategy and Innovation, 91052 Erlangen, Germany.
authors.forename: Andreas E
authors.initials: AE
authors.lastname: Posch
authors.affiliation: Siemens Healthcare, Strategy and Innovation, 91052 Erlangen, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Würstle
authors.affiliation: Siemens Healthcare, Medical Imaging Technologies, Princeton, NJ 08540, USA.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Mansi
authors.affiliation: Institute for Cardiomyopathies, Department of Medicine III, University of Heidelberg, 69120 Heidelberg, Germany; German Centre for Cardiovascular Research (DZHK), Heidelberg/Mannheim, Germany.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.affiliation: Institute for Cardiomyopathies, Department of Medicine III, University of Heidelberg, 69120 Heidelberg, Germany; German Centre for Cardiovascular Research (DZHK), Heidelberg/Mannheim, Germany. Electronic address: Benjamin.Meder@med.uni-heidelberg.de.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Meder
mesh_terms: D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D001794:Blood Pressure; D006328:Cardiac Catheterization; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism; D003198:Computer Simulation; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000378:metabolism / Q000503:physiopathology*; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011498:Protein Precursors / Q000032:analysis
chemical_list: D015415:Biomarkers; C099254:N-terminal proatrial natriuretic peptide; D011498:Protein Precursors; D009320:Atrial Natriuretic Factor
keywords: Computer-based 3D model; Diastolic function; Dilated cardiomyopathy; Myocardial stiffness; Personalized medicine; Tau