Advances in computational modelling for personalised medicine after myocardial infarction

Mangion, K., Gao, H. , Husmeier, D. , Luo, X. and Berry, C. (2017) Advances in computational modelling for personalised medicine after myocardial infarction. Heart, (doi:10.1136/heartjnl-2017-311449) (PMID:29127185) (Early Online Publication)

150638.pdf - Accepted Version



Myocardial infarction (MI) is a leading cause of premature morbidity and mortality worldwide. Determining which patients will experience heart failure and sudden cardiac death after an acute MI is notoriously difficult for clinicians. The extent of heart damage after an acute MI is informed by cardiac imaging, typically using echocardiography or sometimes, cardiac magnetic resonance (CMR). These scans provide complex data sets that are only partially exploited by clinicians in daily practice, implying potential for improved risk assessment. Computational modelling of left ventricular (LV) function can bridge the gap towards personalised medicine using cardiac imaging in patients with post-MI. Several novel biomechanical parameters have theoretical prognostic value and may be useful to reflect the biomechanical effects of novel preventive therapy for adverse remodelling post-MI. These parameters include myocardial contractility (regional and global), stiffness and stress. Further, the parameters can be delineated spatially to correspond with infarct pathology and the remote zone. While these parameters hold promise, there are challenges for translating MI modelling into clinical practice, including model uncertainty, validation and verification, as well as time-efficient processing. More research is needed to (1) simplify imaging with CMR in patients with post-MI, while preserving diagnostic accuracy and patient tolerance (2) to assess and validate novel biomechanical parameters against established prognostic biomarkers, such as LV ejection fraction and infarct size. Accessible software packages with minimal user interaction are also needed. Translating benefits to patients will be achieved through a multidisciplinary approach including clinicians, mathematicians, statisticians and industry partners.

Item Type:Articles
Status:Early Online Publication
Glasgow Author(s) Enlighten ID:Berry, Professor Colin and Gao, Dr Hao and Luo, Professor Xiaoyu and Mangion, Dr Kenneth and Husmeier, Professor Dirk
Authors: Mangion, K., Gao, H., Husmeier, D., Luo, X., and Berry, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Science and Engineering > School of Mathematics and Statistics > Mathematics
College of Science and Engineering > School of Mathematics and Statistics > Statistics
Journal Name:Heart
Publisher:BMJ Publishing Group
ISSN (Online):1468-201X
Published Online:10 November 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in Heart 2017
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
544551Validation and significance of myocardial haemorrhage revealed by "bright blood" T2-weighted MRI in heart attack survivors: a prospective cohort study.Colin BerryBritish Heart Foundation (BHF)PG/11/2/28474RI CARDIOVASCULAR & MEDICAL SCIENCES
662681"First steps towards modelling myocardial infarction (a computed MI Physiome): A case-control study of novel biomechanical parameters in acute MI survivors with left ventricular dysfunction."Colin BerryBritish Heart Foundation (BHF)PG/14/64/31043RI CARDIOVASCULAR & MEDICAL SCIENCES
699321Myocardial strain measurements in survivors of acute ST-elevation myocardial infarction: implementation and prognostic significance of novel magnetic resonance imaging methods.Colin BerryBritish Heart Foundation (BHF)FS/15/54/31639RI CARDIOVASCULAR & MEDICAL SCIENCES
694461EPSRC Centre for Multiscale soft tissue mechanics with application to heart & cancerRaymond OgdenEngineering and Physical Sciences Research Council (EPSRC)EP/N014642/1M&S - MATHEMATICS
689601The first fully coupled mitral valve - left ventricle computational modelXiaoyu LuoLeverhulme Trust (LEVERHUL)RF-2015-510M&S - MATHEMATICS