Feature Article Cardiovascular Simulations Can Revolutionize Point of Care Diagnosis of Cardiovascular Disease! Introducing CardioFAN: A Novel Platform for Arterial Network Simulations by Yashar Seyed Vahedein, RIT Engineering PhD Candidate
Cardiovascular diseases remain the number one factor for loss of life among humans in the 21st century. According to American Heart Association, every 39 seconds 1 American dies from heart disease or stroke, and the direct and indirect costs for treatment are estimated to total more than $316 billion in US and $863 billion globally. However, there is still hope! Modern medicine and disease diagnostics are evolving drastically. Nowadays, disease diagnosis not only requires experience-based knowledge of the medical practitioner, it also utilizes the accurately engineered biomedical devices and test procedures to monitor health, predict abnormalities and treat the patients. This has led to a new era for accurately engineered biomedical devices and patient-specific diagnostics and testing. Some of the common types of cardiovascular diseases are arterial aneurysm, arterial narrowing (stenosis), and hypertension. Historically invasive clinical tests were used to diagnose these problems. For instance, for aneurysms, if your doctor is concerned that you have one in your brain, you may get a CT scan or an invasive test called an angiogram. During this process, the doctors inject dye into an artery in an arm or leg, which then travels to your brain. An image of your brain is then taken. The dye will intensify the picture contrast in CT image and make it easier for your doctor to see potential problems. In case of a patient with stenosis, one of the arteries around the heart (i.e. coronary arteries) might have become narrowed. The diagnostic process is even more invasive here. The doctor inserts a long and narrow tube, called catheter, into your arteries or veins to reach the coronary arteries in order to measure local vital signals (blood pressure, cardiac output, etc.). The signals are used to assess if the person needs further treatment. Merits of replacing these clinical methods by more accessible and less invasive techniques or using them as a last resort is clear; the patients with cardiovascular problems are constantly suffering from the painful testing procedures and the high costs for each of these tests.
Clinical catheter insertion (left) and cardiovascular simulation based pressure measurements (center + right). In Laboratory of Applied Nonlinear Mechanics (LANMech), we are trying to close the gap between the clinical tests and in-situ patient care by utilizing biomechanical and biofluidics simulations, allowing us to optimize the design of sophisticated devices and novel algorithms for diagnostics purposes. The aim is to provide novel algorithms for noninvasively monitoring patient’s cardiovascular health and analyze their physiological signals, such as blood pressure and cardiac output to detect possible abnormalities or changes. These algorithms need to be patientspecific, thereby we also need to have a process to easily calibrate them for each patient. This way each individual patient can continuously monitor their cardiovascular health, and in case of seeing abnormal behavior, the patient 18 | The ROCHESTER ENGINEER OCTOBER 2019
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