Alessandro Veneziani

Huanhuan Yang, Alessandro Veneziani

Clinical oriented applications of computational electrocardiology require efficient and reliable identification of patient-specific parameters of mathematical models based on available measures. In particular, the estimation of cardiac conductivities in models of potential propagation is crucial, since they have major quantitative impact on the solution. Available estimates of cardiac conductivities are significantly diverse in the literature and the definition of experimental/mathematical estimation techniques is an open problem with important practical implications in clinics. We have recently proposed a methodology based on a variational procedure, where the reliability is confirmed by numerical experiments. In this paper we explore model-order-reduction techniques to fit the estimation procedure into timelines of clinical interest. Specifically we consider the Monodomain model and resort to Proper Orthogonal Decomposition (POD) techniques to take advantage of an off-line step when solving iteratively the electrocardiological forward model online. In addition, we perform the Discrete Empirical Interpolation Method (DEIM) to tackle the nonlinearity of the model. While standard POD techniques usually fail in this kind of problems, due to the wave-front propagation dynamics, an educated novel sampling of the parameter space based on the concept of Domain of Effectiveness introduced here dramatically reduces the computational cost of the inverse solver by at least 95%.

Luca Bertagna, Simone Deparis, Luca Formaggia et al.

LifeV is a library for the finite element (FE) solution of partial differential equations in one, two, and three dimensions. It is written in C++ and designed to run on diverse parallel architectures, including cloud and high performance computing facilities. In spite of its academic research nature, meaning a library for the development and testing of new methods, one distinguishing feature of LifeV is its use on real world problems and it is intended to provide a tool for many engineering applications. It has been actually used in computational hemodynamics, including cardiac mechanics and fluid-structure interaction problems, in porous media, ice sheets dynamics for both forward and inverse problems. In this paper we give a short overview of the features of LifeV and its coding paradigms on simple problems. The main focus is on the parallel environment which is mainly driven by domain decomposition methods and based on external libraries such as MPI, the Trilinos project, HDF5 and ParMetis. Dedicated to the memory of Fausto Saleri.

Shady E. Ahmed, Omer San, Adil Rasheed et al.

We propose a new physics guided machine learning (PGML) paradigm that leverages the variational multiscale (VMS) framework and available data to dramatically increase the accuracy of reduced order models (ROMs) at a modest computational cost. The hierarchical structure of the ROM basis and the VMS framework enable a natural separation of the resolved and unresolved ROM spatial scales. Modern PGML algorithms are used to construct novel models for the interaction among the resolved and unresolved ROM scales. Specifically, the new framework builds ROM operators that are closest to the true interaction terms in the VMS framework. Finally, machine learning is used to reduce the projection error and further increase the ROM accuracy. Our numerical experiments for a two-dimensional vorticity transport problem show that the novel PGML-VMS-ROM paradigm maintains the low computational cost of current ROMs, while significantly increasing the ROM accuracy.

Alessandro Veneziani, Annalisa Quaini, Marco Tezzele et al.

The combination of data and models, enhanced by AI methodologies, leads to the paradigm called Digital Twins. This concept is expected to bring unprecedented support to personalized medicine. The combination of mathematical and numerical models with diagnostic devices that provide patient-specific knowledge in a bidirectional framework can be a formidable decision support for clinicians. In this paper, we consider some mathematical aspects of constructing a Digital Twin to prevent and treat Coronary Artery Disease. The keywords for the bidirectional communication between twins in our system are (i) Data Assimilation and (ii) Probabilistic Graphic Models. In particular, a quantity of paramount interest in the evaluation and prognosis of Coronary Artery Disease is the Wall Shear Stress, i.e., the tangential component of normal stress on the arterial wall. By considering steps for the personalization and the synthesis of Wall Shear Stress estimation, we propose a mathematical roadmap for constructing a Digital Twin system that could help prevent infarcts, one of the most lethal diseases in the world.

Ferdinando Auricchio, Michele Conti, Adrian Lefieux et al.

The introduction of computational models in cardiovascular sciences has been progressively bringing new and unique tools for the investigation of the physiopathology. Together with the dramatic improvement of imaging and measuring devices on one side, and of computational architectures on the other one, mathematical and numerical models have provided a new, clearly noninvasive, approach for understanding not only basic mechanisms but also patient-specific conditions, and for supporting the design and the development of new therapeutic options. The terminology in silico is, nowadays, commonly accepted for indicating this new source of knowledge added to traditional in vitro and in vivo investigations. The advantages of in silico methodologies are basically the low cost in terms of infrastructures and facilities, the reduced invasiveness and, in general, the intrinsic predictive capabilities based on the use of mathematical models. The disadvantages are generally identified in the distance between the real cases and their virtual counterpart required by the conceptual modeling that can be detrimental for the reliability of numerical simulations.

Boyi Yang, Marina Piccinelli, Gaetano Esposito et al.

As experts continue to debate the optimal surgery practice for coronary disease - percutaneous coronary intervention (PCI) or coronary aortic bypass graft (CABG) - computational tools may provide a quantitative assessment of each option. Computational fluid dynamics (CFD) has been used to assess the interplay between hemodynamics and stent struts; it is of particular interest in Bioresorbable Vascular Stents (BVS), since their thicker struts may result in impacted flow patterns and possible pathological consequences. Many proofs of concept are presented in the literature; however, a practical method for extracting patient-specific stented coronary artery geometries from images over a large number of patients remains an open problem. This work provides a possible pipeline for the reconstruction of the BVS. Using Optical Coherence Tomographies (OCT) and Invasive Coronary Angiographies (ICA), we can reconstruct the 3D geometry of deployed BVS in vivo. We illustrate the stent reconstruction process: (i) automatic strut detection, (ii) identification of stent components, (iii) 3D registration of stent curvature, and (iv) final stent volume reconstruction. The methodology is designed for use on clinical OCT images, as opposed to approaches that relied on a small number of virtually deployed stents. The proposed reconstruction process is validated with a virtual phantom stent, providing quantitative assessment of the methodology, and with selected clinical cases, confirming feasibility. Using multimodality image analysis, we obtain reliable reconstructions within a reasonable timeframe. This work is the first step toward a fully automated reconstruction and simulation procedure aiming at an extensive quantitative analysis of the impact of BVS struts on hemodynamics via CFD in clinical trials, going beyond the proof-of-concept stage.