At the size of an adult fist and the power to pump an average 7 thousand liters of blood every day continuously throughout its life span, the heart prowess goes beyond imagination. In a normal state, it beats around 70 to 75 times per minute. Heartbeat rate changes of course according to an effort’s demand. But what is truly unbelievable, like a Marvel superhero, this intricate machinery can continue beating even if disconnected from the body! Well, only for few minutes, but still…
What is less of a surprise is that a synchronized heartbeat is key to the heart’s healthy functioning. When this isn’t the case, heart failure may be a deadly long-term outcome. Before the game is over, the use of small electrical shocks with the help of a pacemaker – tiny electrode placed surgically beforehand – may regularize the beating rhythm. Unfortunately, around 40% of the patients do not respond to this treatment, and their lack of response is poorly understood. It is at this stage that our research work comes into play.
With computational and mathematical tools, medical images are translated into 3D virtual hearts that can be stimulated electrically in order to study computationally how the organ behaves and responds to the electrical waves. It is important to point out that there are several heart anatomies – bearing slight differences – which bring another layer of complexity in building such research models. Nevertheless, this approach is not invasive and pose fewer ethical problems when compared to experimental studies. In order for the treatment to be more efficient, the goal of my study is to be able to understand where the electrical shock should be applied – that is, where a pacemaker should be placed surgically – for a particular heart anatomy. Hopefully, in the near future, the 40% non-response rate will drop considerably when the models are accurate enough to serve as guidance.
Besides heart failure being caused by a non-harmonized heart rhythm, it may also occur from the thickening of the heart’s wall due to hypertension, a very widespread disease we’ve all heard about. It is a condition in which the blood pressure is high and the heart has to pump more strongly to get the blood into circulation. Before the heart becomes completely thickened and it is too late in the course of the disease to intervene, warning signs exists in the changes of the shape of the heart. Capturing these shape subtle changes can be difficult using conventional measurements of ultrasound images. Finding a good way to recognize the early changes – my current work – may be useful in selecting individuals that can benefit from a better choice in medical treatments.
Despite the fact these two research lines deal with the same organ, could they be complimentary? Yes! One day when the first heart models of a healthy anatomy are practical and learnings are robust, the modelization of hypertensive hearts may eventually follow.
Keep your heartbeat in shape by staying away from salty food. It allows you to read such a 2-minute article ‘almost’ effortlessly while beating around 140 times. Such a marvelous little pump!
I am Cristobal Rodero, and I am a PhD candidate in Prof. Steve Niederer’s and Pablo Lamata groups at the Biomedical Engineering Departmentat the King’s College in London. And Filip Loncaric is a PhD student working at Prof. Marta Sitges Carreño’s group in the Cardiovascular Institute at Hospital Clínic de Barcelona. Both research projects are funded by a European Marie Curie grant – ITN ‘Personalized in-silico Cardiology (PIC)’.