Understanding the mechanisms amenable to CRT response: from pre-operative multimodal image data to patient-specific computational models

Med Biol Eng Comput. 2013 Nov;51(11):1235-50. doi: 10.1007/s11517-013-1044-7. Epub 2013 Feb 21.

Abstract

This manuscript describes our recent developments towards better understanding of the mechanisms amenable to cardiac resynchronization therapy response. We report the results from a full multimodal dataset corresponding to eight patients from the euHeart project. The datasets include echocardiography, MRI and electrophysiological studies. We investigate two aspects. The first one focuses on pre-operative multimodal image data. From 2D echocardiography and 3D tagged MRI images, we compute atlas based dyssynchrony indices. We complement these indices with presence and extent of scar tissue and correlate them with CRT response. The second one focuses on computational models. We use pre-operative imaging to generate a patient-specific computational model. We show results of a fully automatic personalized electromechanical simulation. By case-per-case discussion of the results, we highlight the potential and key issues of this multimodal pipeline for the understanding of the mechanisms of CRT response and a better patient selection.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Aged
  • Cardiac Resynchronization Therapy*
  • Computer Simulation
  • Electrocardiography*
  • Humans
  • Imaging, Three-Dimensional*
  • Magnetic Resonance Imaging*
  • Middle Aged
  • Models, Cardiovascular*
  • Patient Selection
  • Precision Medicine*