Alison L. Marsden

Luca Pegolotti, Martin R. Pfaller, Natalia L. Rubio et al.

Reduced-order models based on physics are a popular choice in cardiovascular modeling due to their efficiency, but they may experience reduced accuracy when working with anatomies that contain numerous junctions or pathological conditions. We develop one-dimensional reduced-order models that simulate blood flow dynamics using a graph neural network trained on three-dimensional hemodynamic simulation data. Given the initial condition of the system, the network iteratively predicts the pressure and flow rate at the vessel centerline nodes. Our numerical results demonstrate the accuracy and generalizability of our method in physiological geometries comprising a variety of anatomies and boundary conditions. Our findings demonstrate that our approach can achieve errors below 2% and 3% for pressure and flow rate, respectively, provided there is adequate training data. As a result, our method exhibits superior performance compared to physics-based one-dimensional models, while maintaining high efficiency at inference time.

Ju Liu, Alison L. Marsden, Zhen Tao

We develop a mixed formulation for incompressible hyper-elastodynamics based on a continuum modeling framework recently developed and smooth generalizations of the Taylor-Hood element based on non-uniform rational B-splines (NURBS). This continuum formulation draws a link between computational fluid dynamics and computational solid dynamics. This link inspires an energy stability estimate for the spatial discretization, which favorably distinguishes the formulation from the conventional mixed formulations for finite elasticity. The inf-sup condition is utilized to provide a bound for the pressure field. The generalized-$α$ method is applied for temporal discretization, and a nested block preconditioner is invoked for the solution procedure. The inf-sup stability for different pairs of NURBS elements is elucidated through numerical assessment. The convergence rate of the proposed formulation with various combinations of mixed elements is examined by the manufactured solution method. The numerical scheme is also examined under compressive and tensile loads for isotropic and anisotropic hyperelastic materials. Finally, a suite of dynamic problems is numerically studied to corroborate the stability and conservation properties.

Bohan J. Li, Nicholas C. Dorn, Andras Lasso et al.

Stenting is among the most common transcatheter interventions for congenital heart disease (CHD). Patient-specific computational fluid dynamics (CFD) simulations can predict hemodynamic outcomes of intervention scenarios but require post-operative vascular geometries that reflect stent-induced shape changes, which existing tools either model inadequately or require extensive time or manual effort to generate. We present SDFStent, a signed distance function (SDF) based mesh deformation method for virtual stenting that operates in real time, maintains mesh integrity, and preserves junction geometry. The stent is modeled as a pipe surface composed of piecewise-capsule SDFs joined by a smooth-minimum operator. Mesh vertices near the expanding SDF surface are displaced along the SDF gradient with a compactly supported fall-off function and an alpha blending mask. SDFStent was benchmarked against three existing approaches and validated on three tetralogy of Fallot (ToF) patients and three coarctation of the aorta (CoA) patients using rigid-wall steady-state CFD simulations against clinical catheterization measurements. Against a prescribed diameter of 6.0 mm, the method produced a mean stented diameter of 5.92 $\pm$ 0.08 mm in 1.5 s, over 100$\times$ faster than the best stenting-specific comparator. All output meshes were watertight and self-intersection-free. CFD-simulated post-operative pressure drops agreed with clinical measurements within 4 mmHg (mean error 2 mmHg). SDFStent produces simulation-ready post-stent models that match prescribed stent dimensions at interactive speeds, from pre-operative anatomy and catheterization data alone. The implementation is open-source and available in 3D Slicer. Its scriptable architecture enables automated generation of large synthetic cohorts for data-driven surrogate modeling.

Natalia L. Rubio, Eric F. Darve, Alison L. Marsden · stanford

Physics-based 0D reduced-order models provide computationally lightweight predictions of cardiovascular flows, resolving bulk hemodynamics in fractions of a second that would take days to solve using traditional 3D finite-element techniques. However, the accuracy of 0D models is limited as a result of the dramatic simplifications made in their derivations. In this work, we use 0D parameters learned from high-fidelity 3D data to improve 0D model accuracy without sacrificing its low computational cost or interpretability. We use the resistor-quadratic resistor-inductor (RRI) model to predict pressure drops over 0D vessels and bifurcations, where the resistances and inductance (0D parameters) are predicted from the bifurcation or vessel geometry using neural networks trained on high-fidelity 3D simulations. We validate the hybrid physics-based data-driven framework in three types of patient-specific vasculature - aortic, aortofemoral, and pulmonary anatomies. Use of learned 0D parameters reduces error by at least 50% compared to baseline 0D parameters across all anatomical cohorts. The improvements are especially marked for the more complex pulmonary anatomies, where 0D models with learned parameters reduced error from 30% to 7%. Exclusion of the quadratic resistor in the RRI model improved convergence compared to using the full RRI model. The resulting hybrid model presents a means of real-time (personal laptop runtime of <2 seconds for the most complex pulmonary anatomies), interpretable, and accurate cardiovascular flow modeling, enabling digital twins that support clinical decision-making as well as cardiovascular science and engineering research.

Matteo Salvador, Alison L. Marsden

Scientific Machine Learning (ML) is gaining momentum as a cost-effective alternative to physics-based numerical solvers in many engineering applications. In fact, scientific ML is currently being used to build accurate and efficient surrogate models starting from high-fidelity numerical simulations, effectively encoding the parameterized temporal dynamics underlying Ordinary Differential Equations (ODEs), or even the spatio-temporal behavior underlying Partial Differential Equations (PDEs), in appropriately designed neural networks. We propose an extension of Latent Dynamics Networks (LDNets), namely Liquid Fourier LDNets (LFLDNets), to create parameterized space-time surrogate models for multiscale and multiphysics sets of highly nonlinear differential equations on complex geometries. LFLDNets employ a neurologically-inspired, sparse, liquid neural network for temporal dynamics, relaxing the requirement of a numerical solver for time advancement and leading to superior performance in terms of tunable parameters, accuracy, efficiency and learned trajectories with respect to neural ODEs based on feedforward fully-connected neural networks. Furthermore, in our implementation of LFLDNets, we use a Fourier embedding with a tunable kernel in the reconstruction network to learn high-frequency functions better and faster than using space coordinates directly as input. We challenge LFLDNets in the framework of computational cardiology and evaluate their capabilities on two 3-dimensional test cases arising from multiscale cardiac electrophysiology and cardiovascular hemodynamics. This paper illustrates the capability to run Artificial Intelligence-based numerical simulations on single or multiple GPUs in a matter of minutes and represents a significant step forward in the development of physics-informed digital twins.

Bozhi Sun, Seda Tierney, Jeffrey A. Feinstein et al.

Scheduling echocardiographic exams in a hospital presents significant challenges due to non-deterministic factors (e.g., patient no-shows, patient arrival times, diverse exam durations, etc.) and asymmetric resource constraints between fetal and non-fetal patient streams. To address these challenges, we first conducted extensive pre-processing on one week of operational data from the Echo Laboratory at Stanford University's Lucile Packard Children's Hospital, to estimate patient no-show probabilities and derive empirical distributions of arrival times and exam durations. Based on these inputs, we developed a discrete-event stochastic simulation model using SimPy, and integrate it with the open source Gymnasium Python library. As a baseline for policy optimization, we developed a comparative framework to evaluate on-the-fly versus reservation-based allocation strategies, in which different proportions of resources are reserved in advance. Considering a hospital configuration with a 1:6 ratio of fetal to non-fetal rooms and a 4:2 ratio of fetal to non-fetal sonographers, we show that on-the-fly allocation generally yields better performance, more effectively adapting to patient variability and resource constraints. Building on this foundation, we apply reinforcement learning (RL) to derive an approximated optimal dynamic allocation policy. This RL-based policy is benchmarked against the best-performing rule-based strategies, allowing us to quantify their differences and provide actionable insights for improving echo lab efficiency through intelligent, data-driven resource management.

Chloe H. Choi, Alison L. Marsden, Daniele E. Schiavazzi

Boundary condition tuning is a fundamental step in patient-specific cardiovascular modeling. Despite an increase in offline training cost, recent methods in data-driven variational inference can efficiently estimate the joint posterior distribution of boundary conditions, with amortization of training efforts over clinical targets. However, even the most modern approaches fall short in two important scenarios: open-loop models with known mean flow and assumed waveform shapes, and anatomies affected by vascular lesions where segmentation influences the reachability of pressure or flow split targets. In both cases, boundary conditions cannot be tuned in isolation. We introduce a general amortized inference framework based on probabilistic flow that treats clinical targets, inflow features, and point cloud embeddings of patient-specific anatomies as either conditioning variables or quantities to be jointly estimated. We demonstrate the approach on two patient-specific models: an aorto-iliac bifurcation with varying stenosis locations and severity, and a coronary arterial tree.

Chloe H. Choi, Andrea Zanoni, Daniele E. Schiavazzi et al.

Solving inverse problems in cardiovascular modeling is particularly challenging due to the high computational cost of running high-fidelity simulations. In this work, we focus on Bayesian parameter estimation and explore different methods to reduce the computational cost of sampling from the posterior distribution by leveraging low-fidelity approximations. A common approach is to construct a surrogate model for the high-fidelity simulation itself. Another is to build a surrogate for the discrepancy between high- and low-fidelity models. This discrepancy, which is often easier to approximate, is modeled with either a fully connected neural network or a nonlinear dimensionality reduction technique that enables surrogate construction in a lower-dimensional space. A third possible approach is to treat the discrepancy between the high-fidelity and surrogate models as random noise and estimate its distribution using normalizing flows. This allows us to incorporate the approximation error into the Bayesian inverse problem by modifying the likelihood function. We validate five different methods which are variations of the above on analytical test cases by comparing them to posterior distributions derived solely from high-fidelity models, assessing both accuracy and computational cost. Finally, we demonstrate our approaches on two cardiovascular examples of increasing complexity: a lumped-parameter Windkessel model and a patient-specific three-dimensional anatomy.

Natalia L. Rubio, Eric F. Darve, Alison L. Marsden

Three-dimensional (3D) finite-element simulations of cardiovascular flows provide high-fidelity predictions to support cardiovascular medicine, but their high computational cost limits clinical practicality. Reduced-order models (ROMs) offer computationally efficient alternatives but suffer reduced accuracy, particularly at vessel bifurcations where complex flow physics are inadequately captured by standard Poiseuille flow assumptions. We present an enhanced numerical framework that integrates machine learning-predicted bifurcation coefficients into zero-dimensional (0D) hemodynamic ROMs to improve accuracy while maintaining computational efficiency. We develop a resistor-resistor-inductor (RRI) model that uses neural networks to predict pressure-flow relationships from bifurcation geometry, incorporating linear and quadratic resistances along with inductive effects. The method employs non-dimensionalization to reduce training data requirements and apriori flow split prediction for improved bifurcation characterization. We incorporate the RRI model into a 0D model using an optimization-based solution strategy. We validate the approach in isolated bifurcations and vascular trees, across Reynolds numbers from 0 to 5,500, defining ROM accuracy by comparison to 3D finite element simulation. Results demonstrate substantial accuracy improvements: averaged across all trees and Reynolds numbers, the RRI method reduces inlet pressure errors from 54 mmHg (45%) for standard 0D models to 25 mmHg (17%), while a simplified resistor-inductor (RI) variant achieves 31 mmHg (26%) error. The enhanced 0D models show particular effectiveness at high Reynolds numbers and in extensive vascular networks. This hybrid numerical approach enables accurate, real-time hemodynamic modeling for clinical decision support, uncertainty quantification, and digital twins in cardiovascular biomedical engineering.

Riccardo Tenderini, Luca Pegolotti, Fanwei Kong et al.

This work introduces AD-SVFD, a deep learning model for the deformable registration of vascular shapes to a pre-defined reference and for the generation of synthetic anatomies. AD-SVFD operates by representing each geometry as a weighted point cloud and models ambient space deformations as solutions at unit time of ODEs, whose time-independent right-hand sides are expressed through artificial neural networks. The model parameters are optimized by minimizing the Chamfer Distance between the deformed and reference point clouds, while backward integration of the ODE defines the inverse transformation. A distinctive feature of AD-SVFD is its auto-decoder structure, that enables generalization across shape cohorts and favors efficient weight sharing. In particular, each anatomy is associated with a low-dimensional code that acts as a self-conditioning field and that is jointly optimized with the network parameters during training. At inference, only the latent codes are fine-tuned, substantially reducing computational overheads. Furthermore, the use of implicit shape representations enables generative applications: new anatomies can be synthesized by suitably sampling from the latent space and applying the corresponding inverse transformations to the reference geometry. Numerical experiments, conducted on healthy aortic anatomies, showcase the high-quality results of AD-SVFD, which yields extremely accurate approximations at competitive computational costs.

Ju Liu, Alison L. Marsden

We develop a robust and efficient iterative method for hyper-elastodynamics based on a novel continuum formulation recently developed. The numerical scheme is constructed based on the variational multiscale formulation and the generalized-$α$ method. Within the nonlinear solution procedure, a block factorization is performed for the consistent tangent matrix to decouple the kinematics from the balance laws. Within the linear solution procedure, another block factorization is performed to decouple the mass balance equation from the linear momentum balance equations. A nested block preconditioning technique is proposed to combine the Schur complement reduction approach with the fully coupled approach. This preconditioning technique, together with the Krylov subspace method, constitutes a novel iterative method for solving hyper-elastodynamics. We demonstrate the efficacy of the proposed preconditioning technique by comparing with the SIMPLE preconditioner and the one-level domain decomposition preconditioner. Two representative examples are studied: the compression of an isotropic hyperelastic cube and the tensile test of a fully-incompressible anisotropic hyperelastic arterial wall model. The robustness with respect to material properties and the parallel performance of the preconditioner are examined.