Dongdong Deng1, Hermenegild J Arevalo1, Adityo Prakosa1, David J Callans2, Natalia A Trayanova3. 1. Department of Biomedical Engineering, Institute for Computational Medicine, Johns Hopkins University, 3400 North Charles Street, Hackerman 216, Baltimore, MD 21218, USA. 2. Division of Cardiovascular Medicine, Electrophysiology Section, University of Pennsylvania, 3400 Spruce St, 9 Founders Pavillion, Philadelphia, PA 19104. 3. Department of Biomedical Engineering, Institute for Computational Medicine, Johns Hopkins University, 3400 North Charles Street, Hackerman 216, Baltimore, MD 21218, USA ntrayanova@jhu.edu.
Abstract
AIM: To predict arrhythmia susceptibility in myocardial infarction (MI) patients with left ventricular ejection fraction (LVEF) >35% using a personalized virtual heart simulation approach. METHODS AND RESULTS: A total of four contrast enhanced magnetic resonance imaging (MRI) datasets of patient hearts with MI and average LVEF of 44.0 ± 2.6% were used in this study. Because of the preserved LVEF, the patients were not indicated for implantable cardioverter defibrillator (ICD) insertion. One patient had spontaneous ventricular tachycardia (VT) prior to the MRI scan; the others had no arrhythmic events. Simulations of arrhythmia susceptibility were blind to clinical outcome. Models were constructed from patient MRI images segmented to identify myocardium, grey zone, and scar based on pixel intensity. Grey zone was modelled as having altered electrophysiology. Programmed electrical stimulation (PES) was performed to assess VT inducibility from 19 bi-ventricular sites in each heart model. Simulations successfully predicted arrhythmia risk in all four patients. For the patient with arrhythmic event, in-silico PES resulted in VT induction. Simulations correctly predicted that VT was non-inducible for the three patients with no recorded VT events. CONCLUSIONS: Results demonstrate that the personalized virtual heart simulation approach may provide a novel risk stratification modality to non-invasively and effectively identify patients with LVEF >35% who could benefit from ICD implantation. Published on behalf of the European Society of Cardiology. All rights reserved.
AIM: To predict arrhythmia susceptibility in myocardial infarction (MI) patients with left ventricular ejection fraction (LVEF) >35% using a personalized virtual heart simulation approach. METHODS AND RESULTS: A total of four contrast enhanced magnetic resonance imaging (MRI) datasets of patient hearts with MI and average LVEF of 44.0 ± 2.6% were used in this study. Because of the preserved LVEF, the patients were not indicated for implantable cardioverter defibrillator (ICD) insertion. One patient had spontaneous ventricular tachycardia (VT) prior to the MRI scan; the others had no arrhythmic events. Simulations of arrhythmia susceptibility were blind to clinical outcome. Models were constructed from patient MRI images segmented to identify myocardium, grey zone, and scar based on pixel intensity. Grey zone was modelled as having altered electrophysiology. Programmed electrical stimulation (PES) was performed to assess VT inducibility from 19 bi-ventricular sites in each heart model. Simulations successfully predicted arrhythmia risk in all four patients. For the patient with arrhythmic event, in-silico PES resulted in VT induction. Simulations correctly predicted that VT was non-inducible for the three patients with no recorded VT events. CONCLUSIONS: Results demonstrate that the personalized virtual heart simulation approach may provide a novel risk stratification modality to non-invasively and effectively identify patients with LVEF >35% who could benefit from ICD implantation. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Manuel D Cerqueira; Neil J Weissman; Vasken Dilsizian; Alice K Jacobs; Sanjiv Kaul; Warren K Laskey; Dudley J Pennell; John A Rumberger; Thomas Ryan; Mario S Verani Journal: Circulation Date: 2002-01-29 Impact factor: 29.690
Authors: Andrew E Epstein; John P DiMarco; Kenneth A Ellenbogen; N A Mark Estes; Roger A Freedman; Leonard S Gettes; A Marc Gillinov; Gabriel Gregoratos; Stephen C Hammill; David L Hayes; Mark A Hlatky; L Kristin Newby; Richard L Page; Mark H Schoenfeld; Michael J Silka; Lynne Warner Stevenson; Michael O Sweeney; Sidney C Smith; Alice K Jacobs; Cynthia D Adams; Jeffrey L Anderson; Christopher E Buller; Mark A Creager; Steven M Ettinger; David P Faxon; Jonathan L Halperin; Loren F Hiratzka; Sharon A Hunt; Harlan M Krumholz; Frederick G Kushner; Bruce W Lytle; Rick A Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel; Lynn G Tarkington; Clyde W Yancy Journal: Circulation Date: 2008-05-15 Impact factor: 29.690
Authors: Matthew R Reynolds; David J Cohen; Aaron D Kugelmass; Phillip P Brown; Edmund R Becker; Steven D Culler; April W Simon Journal: J Am Coll Cardiol Date: 2006-05-30 Impact factor: 24.094
Authors: Ana C Alba; Thomas Agoritsas; Milosz Jankowski; Delphine Courvoisier; Stephen D Walter; Gordon H Guyatt; Heather J Ross Journal: Circ Heart Fail Date: 2013-07-25 Impact factor: 8.790
Authors: Gernot Plank; Lufang Zhou; Joseph L Greenstein; Sonia Cortassa; Raimond L Winslow; Brian O'Rourke; Natalia A Trayanova Journal: Philos Trans A Math Phys Eng Sci Date: 2008-09-28 Impact factor: 4.226
Authors: Jonathan Chrispin; Esra Gucuk Ipek; Sohail Zahid; Adityo Prakosa; Mohammadali Habibi; David Spragg; Joseph E Marine; Hiroshi Ashikaga; John Rickard; Natalia A Trayanova; Stefan L Zimmerman; Vadim Zipunnikov; Ronald D Berger; Hugh Calkins; Saman Nazarian Journal: Heart Rhythm Date: 2015-11-10 Impact factor: 6.343
Authors: Alan Cheng; Darshan Dalal; Barbara Butcher; Sanaz Norgard; Yiyi Zhang; Timm Dickfeld; Zayd A Eldadah; Kenneth A Ellenbogen; Eliseo Guallar; Gordon F Tomaselli Journal: J Am Heart Assoc Date: 2013-02-22 Impact factor: 5.501
Authors: Mark J Cartoski; Plamen P Nikolov; Adityo Prakosa; Patrick M Boyle; Philip J Spevak; Natalia A Trayanova Journal: Pediatr Cardiol Date: 2019-03-06 Impact factor: 1.655
Authors: Konstantinos N Aronis; Rheeda L Ali; Jonathan Chrispin; Natalia A Trayanova; Adityo Prakosa; Hiroshi Ashikaga; Ronald D Berger; Joe B Hakim; Jialiu Liang; Harikrishna Tandri; Fei Teng Journal: Circ Arrhythm Electrophysiol Date: 2020-03-19
Authors: Julie K Shade; Mark J Cartoski; Plamen Nikolov; Adityo Prakosa; Ashish Doshi; Edem Binka; Laura Olivieri; Patrick M Boyle; Philip J Spevak; Natalia A Trayanova Journal: Heart Rhythm Date: 2019-10-04 Impact factor: 6.343
Authors: Jens Cosedis Nielsen; Yenn-Jiang Lin; Marcio Jansen de Oliveira Figueiredo; Alireza Sepehri Shamloo; Alberto Alfie; Serge Boveda; Nikolaos Dagres; Dario Di Toro; Lee L Eckhardt; Kenneth Ellenbogen; Carina Hardy; Takanori Ikeda; Aparna Jaswal; Elizabeth Kaufman; Andrew Krahn; Kengo Kusano; Valentina Kutyifa; Han S Lim; Gregory Y H Lip; Santiago Nava-Townsend; Hui-Nam Pak; Gerardo Rodríguez Diez; William Sauer; Anil Saxena; Jesper Hastrup Svendsen; Diego Vanegas; Marmar Vaseghi; Arthur Wilde; T Jared Bunch; Alfred E Buxton; Gonzalo Calvimontes; Tze-Fan Chao; Lars Eckardt; Heidi Estner; Anne M Gillis; Rodrigo Isa; Josef Kautzner; Philippe Maury; Joshua D Moss; Gi-Byung Nam; Brian Olshansky; Luis Fernando Pava Molano; Mauricio Pimentel; Mukund Prabhu; Wendy S Tzou; Philipp Sommer; Janice Swampillai; Alejandro Vidal; Thomas Deneke; Gerhard Hindricks; Christophe Leclercq Journal: Europace Date: 2020-08-01 Impact factor: 5.214