Page 33 - Artificial Intelligence for Computational Modeling of the Heart

P. 33

Multi-scale models of the heart

for patient-speciﬁc simulations

Viorel Mihalef, Tiziano Passerini, Tommaso Mansi
Siemens Healthineers, Princeton, NJ, United States

Modeling heart function consists in translating the main mech-
anisms that govern heart function into mathematical laws and
computational algorithms. Multi-scale models describe the inter-
actions at different time scales (from nanoseconds to minutes to
years), spatial scales (from nanometers to centimeters), and func-
tional scales (from molecular pathways to circulatory system).
Such models can therefore pave the way to predictive medicine
by computing advanced measurements, planning therapies in-
silico before the intervention, evaluating the effects of molecular
changes on the global cardiac function. Scientiﬁc and techno-
logical development of such models are enabling comprehensive
and detailed understanding of heart physiology. At the same time,
clinical translation requires a clear clinical focus on selecting the
models, controlling the underlying assumptions and simpliﬁca-
tions, and ensuring their usefulness to address real-world clini-
cal problems while being integrated into the day-to-day workﬂow.
This chapter introduces the typical components of a multi-scale
heart model that includes personalized anatomy, electrophysi-
ology, biomechanics, valves, hemodynamics, and common ap-
proaches to parameter estimation from routinely available clinical
data.

1.1 Models of cardiac anatomy

Let us ﬁrst review the major anatomical elements to consider
for cardiac modeling. The reader is invited to refer to specialized
literature such as [42] for a more detailed description of cardiac
anatomy and function. The very ﬁrst step in modeling heart func-
tion consists in deﬁning a realistic model of its anatomy, which in-
cludes shape, tissue types (also called substrate) and tissue micro-
architecture. At a high level, the heart can be described as a system
of four blood-ﬁlled chambers separated by valves (Fig. 1.1). Func-
tionally and anatomically the heart can be divided into the atria

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