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research article

The role of computational methods in cardiovascular medicine: a narrative review

Fumagalli, Ivan
•
Pagani, Stefano
•
Vergara, Christian
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January 1, 2024
Translational Pediatrics

Background and Objective: Computational models of the cardiovascular system allow for a detailed and quantitative investigation of both physiological and pathological conditions, thanks to their ability to combine clinical-possibly patient-specific-data with physical knowledge of the processes underlying the heart function. These models have been increasingly employed in clinical practice to understand pathological mechanisms and their progression, design medical devices, support clinicians in improving therapies. Hinging upon a long-year experience in cardiovascular modeling, we have recently constructed a computational multi-physics and multi-scale integrated model of the heart for the investigation of its physiological function, the analysis of pathological conditions, and to support clinicians in both diagnosis and treatment planning. This narrative review aims to systematically discuss the role that such model had in addressing specific clinical questions, and how further impact of computational models on clinical practice are envisaged. Methods: We developed computational models of the physical processes encompassed by the heart function myocardial perfusion) and of their inherently strong coupling. To solve the equations of such models, we devised advanced numerical methods, implemented in a flexible and highly efficient software library. We also developed computational procedures for clinical data post-processing-like the reconstruction of the heart geometry and motion from diagnostic images-and for their integration into computational models. Key Content and Findings: Our integrated computational model of the heart function provides noninvasive measures of indicators characterizing the heart function and dysfunctions, and sheds light on its underlying processes and their coupling. Moreover, thanks to the close collaboration with several clinical partners, we addressed specific clinical questions on pathological conditions, such as arrhythmias, ventricular dyssynchrony, hypertrophic cardiomyopathy, degeneration of prosthetic valves, and the way coronavirus disease 2019 (COVID-19) infection may affect the cardiac function. In multiple cases, we were also able to provide quantitative indications for treatment. Conclusions: Computational models provide a quantitative and detailed tool to support clinicians in patient care, which can enhance the assessment of cardiac diseases, the prediction of the development of pathological conditions, and the planning of treatments and follow-up tests.

  • Details
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Type
research article
DOI
10.21037/tp-23-184
Web of Science ID

WOS:001186669200002

Author(s)
Fumagalli, Ivan
Pagani, Stefano
Vergara, Christian
Dede', Luca
Adebo, Dilachew A.
Del Greco, Maurizio
Frontera, Antonio
Luciani, Giovanni Battista
Pontone, Gianluca
Scrofani, Roberto
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Date Issued

2024-01-01

Publisher

Ame Publishing Company

Published in
Translational Pediatrics
Volume

13

Issue

1

Start page

146

End page

163

Subjects

Life Sciences & Biomedicine

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Computational Cardiology

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Image-Based Reconstruction Procedures

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Multi-Physics

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Ablation

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Cardiac Valve Diseases

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
CIB  
FunderGrant Number

Italian Ministry of University and Research (MIUR) within the PRIN

2017AXL54F

Project Dipartimento di Eccellenza

INdAM-GNCS

CUP E53C22001930001

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Available on Infoscience
April 17, 2024
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/207237
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