Integrating anatomy and electrophysiology in the healthy human heart: Insights from biventricular statistical shape analysis using universal coordinates.

Journal: Computers in biology and medicine
Published Date:

Abstract

A cardiac digital twin is a virtual replica of a patient-specific heart, mimicking its anatomy and physiology. A crucial step of building a cardiac digital twin is anatomical twinning, where the computational mesh of the digital twin is tailored to the patient-specific cardiac anatomy. In a number of studies, the effect of anatomical variation on clinically relevant functional measurements like electrocardiograms (ECGs) is investigated, using computational simulations. While such a simulation environment provides researchers with a carefully controlled ground truth, the impact of anatomical differences on functional measurements in real-world patients remains understudied. In this study, we develop a biventricular statistical shape model and use it to quantify the effect of biventricular anatomy on ECG-derived and demographic features, providing novel insights for the development of digital twins of cardiac electrophysiology. To this end, a dataset comprising high-resolution cardiac CT scans from 271 healthy individuals, including athletes, is utilized. Furthermore, a novel, universal, ventricular coordinate-based method is developed to establish lightweight shape correspondence. The performance of the shape model is rigorously established, focusing on its dimensionality reduction capabilities and the training data requirements. The most important variability in healthy ventricles captured by the model is their size, followed by their elongation. These anatomical factors are found to significantly correlate with ECG-derived and demographic features. Additionally, a comprehensive synthetic cohort is made available, featuring ready-to-use biventricular meshes with fiber structures and anatomical region annotations. These meshes are well-suited for electrophysiological simulations.

Authors

  • Lore Van Santvliet
    STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering (ESAT), KU Leuven, Kasteelpark Arenberg 10, Leuven, 3001, Belgium. Electronic address: lore.vansantvliet@kuleuven.be.
  • Elena Zappon
    Division of Medical Physics and Biophysics, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria; BioTechMed-Graz, Graz, Austria.
  • Matthias A F Gsell
    Division of Medical Physics and Biophysics, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria.
  • Franz Thaler
    Institute of Computer Graphics and Vision, Graz University of Technology, Graz, Austria.
  • Maarten Blondeel
    Department of Cardiology, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium; Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, Leuven, 3000, Belgium.
  • Steven Dymarkowski
    Division of Radiology, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium.
  • Guido Claessen
    Division of Cardiology, Hartcentrum, Jessa Ziekenhuis, Stadsomvaart 11, Hasselt, 3500, Belgium; Department of Medicine and Life Sciences, University of Hasselt, Stadsomvaart 11, Hasselt, 3500, Belgium.
  • Rik Willems
    KU Leuven, Department of Electrical Engineering (ESAT), STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, Leuven, Belgium; UZ Leuven, Leuven, Belgium. Electronic address: rik.willems@kuleuven.be.
  • Martin Urschler
    a Ludwig Boltzmann Institute for Clinical Forensic Imaging , Graz , Austria .
  • Bert Vandenberk
  • Gernot Plank
    Medical University of Graz, Graz 8036, Austria.
  • Maarten De Vos
    STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics-Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium. maarten.devos@kuleuven.be.