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research article

A comprehensive and biophysically detailed computational model of the whole human heart electromechanics

Fedele, Marco
•
Piersanti, Roberto
•
Regazzoni, Francesco
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March 21, 2023
Computer Methods In Applied Mechanics And Engineering

While ventricular electromechanics is extensively studied in both physiological and pathological conditions, four-chamber heart models have only been addressed recently; most of these works however neglect atrial contraction. Indeed, as atria are characterized by a complex anatomy and a physiology that is strongly influenced by the ventricular function, developing computational models able to capture the physiological atrial function and atrioventricular interaction is very challenging. In this paper, we propose a biophysically detailed electromechanical model of the whole human heart that considers both atrial and ventricular contraction. Our model includes: (i) an anatomically accurate whole-heart geometry; (ii) a comprehensive myocardial fiber architecture; (iii) a biophysically detailed microscale model for the active force generation; (iv) a 0D closed-loop model of the circulatory system, fully-coupled with the mechanical model of the heart; (v) the fundamental interactions among the different core models, such as the mechano-electric feedback or the fibers-stretch and fibers-stretch-rate feedbacks; (vi) specific constitutive laws and model parameters for each cardiac region. Concerning the numerical discretization, we propose an efficient segregated-intergrid-staggered scheme that includes a computationally efficient strategy to handle the non-conductive regions. We also propose extending recent stabilization techniques - regarding the circulation and the fibers-stretch-rate feedback - to the whole heart, demonstrating their cruciality for obtaining a stable formulation in a four-chamber scenario. We are able to reproduce the healthy cardiac function for all the heart chambers, in terms of pressure-volume loops, time evolution of pressures, volumes and fluxes, and three-dimensional cardiac deformation, with volumetric indexes within reference ranges for cardiovascular magnetic resonance. We also show the importance of considering atrial contraction, fibers-stretch-rate feedback and the proposed stabilization techniques, by comparing the results obtained with and without these features in the model. In particular, we show that the fibers-stretch-rate feedback, often neglected due to the numerical challenges that it entails, plays a fundamental role in the regulation of the blood flux ejected by ventricles. The proposed model represents the state-of-the-art electromechanical model of the iHEART ERC project - an Integrated Heart Model for the Simulation of the Cardiac Function - and is a fundamental step toward the building of physics-based digital twins of the human heart.(c) 2023 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

  • Details
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Type
research article
DOI
10.1016/j.cma.2023.115983
Web of Science ID

WOS:000958994200001

Author(s)
Fedele, Marco
Piersanti, Roberto
Regazzoni, Francesco
Salvador, Matteo
Africa, Pasquale Claudio
Bucelli, Michele
Zingaro, Alberto
Dede, Luca
Quarteroni, Alfio  
Date Issued

2023-03-21

Publisher

ELSEVIER SCIENCE SA

Published in
Computer Methods In Applied Mechanics And Engineering
Volume

410

Article Number

115983

Subjects

Engineering, Multidisciplinary

•

Mathematics, Interdisciplinary Applications

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Mechanics

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Engineering

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Mathematics

•

Mechanics

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multiphysics and multiscale modeling

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whole-heart modeling

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cardiac electromechanics

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computational cardiology

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high performance computing

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cardiac digital twin

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left atrial reservoir

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booster pump function

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cardiac electrophysiology

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active contraction

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numerical-method

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blood-flow

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simulations

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myocardium

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activation

•

size

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

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Available on Infoscience
April 24, 2023
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/197055
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