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

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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.

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Notes

  1. Early inward motion/contraction of the septum, followed by lateral wall contraction. This latter contraction pulls the relaxed septum and thereby stretches it (see animations in supplementary material).

  2. http://tetgen.berlios.de.

  3. http://www.hpfem.jku.at/netgen.

  4. Early inward motion/contraction of the septum, followed by lateral wall contraction. This latter contraction pulls the relaxed septum and thereby stretches it (see animations in supplementary material).

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Acknowledgments

This work was partially funded by the Spanish Ministry of Innovation and Science (CEN-20091044, TIN2009-14536-C02-01 and TIN2011-28067), and the European Commission Seventh Framework Programme (FP7-ICT-2007-2-224495).

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Authors and Affiliations

  1. CISTIB, Universitat Pompeu Fabra, Barcelona, Spain

    C. Tobon-Gomez, N. Duchateau, O. Camara, M. De Craene, A. Pashaei, M. Steghofer & A. F. Frangi

  2. CIBER-BBN, Barcelona, Spain

    C. Tobon-Gomez, N. Duchateau, O. Camara, M. De Craene, A. Pashaei, M. Steghofer & A. F. Frangi

  3. PhySense, Universitat Pompeu Fabra, Barcelona, Spain

    C. Tobon-Gomez & O. Camara

  4. Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain

    N. Duchateau

  5. Philips Research, Medisys, Suresnes, France

    M. De Craene

  6. Department of Mechanical Engineering, University of Sheffield, Sheffield, UK

    A. F. Frangi

  7. Computational Multi-Scale Physiology Lab, Universitat de Valencia, Valencia, Spain

    R. Sebastian

  8. INRIA Méditerranée, Asclepios Project, Sophia Antipolis, France

    S. Marchesseau, J. Relan, H. Delingette, M. Sermesant & N. Ayache

  9. INSERM, U1099, 35000, Rennes, France

    E. Donal, M. Garreau, A. Hernandez & C. Leclercq

  10. Université de Rennes 1, LTSI, 35000, Rennes, France

    E. Donal, M. Garreau, A. Hernandez & C. Leclercq

  11. CHU Rennes, Service de Cardiologie et Maladies Vasculaires, 35000, Rennes, France

    E. Donal & C. Leclercq

  12. Department of Computer Science, University of Oxford, Oxford, UK

    P. Lamata & N. P. Smith

  13. Division of Imaging Sciences and Biomedical Engineering, King’s College London, London, UK

    P. Lamata, S. Duckett, K. S. Rhode, R. Razavi & N. P. Smith

Authors
  1. C. Tobon-Gomez
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  2. N. Duchateau
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  3. R. Sebastian
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  4. S. Marchesseau
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  5. O. Camara
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  6. E. Donal
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  7. M. De Craene
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  8. A. Pashaei
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  9. J. Relan
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  10. M. Steghofer
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  11. P. Lamata
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  12. H. Delingette
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  13. S. Duckett
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  14. M. Garreau
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  15. A. Hernandez
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  16. K. S. Rhode
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  17. M. Sermesant
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  18. N. Ayache
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  19. C. Leclercq
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  20. R. Razavi
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  21. N. P. Smith
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  22. A. F. Frangi
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Correspondence to C. Tobon-Gomez.

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Tobon-Gomez, C., Duchateau, N., Sebastian, R. et al. Understanding the mechanisms amenable to CRT response: from pre-operative multimodal image data to patient-specific computational models. Med Biol Eng Comput 51, 1235–1250 (2013). https://doi.org/10.1007/s11517-013-1044-7

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  • DOI: https://doi.org/10.1007/s11517-013-1044-7

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