Cardiovascular Research: Past, Present and Future

Fiedler, Lorna R.

doi:10.17140/hroj-2-112

Cited by 3 publications

(3 citation statements)

References 59 publications

(52 reference statements)

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“…Despite the explosive growth of CVD research since the 1970s, advances in clinical practice and treatments appear to have come to a halt, and finding alternative strategies has become imperative (Fiedler 2015). Novel approaches to the problems are required and the combination of engineering with cardiology is providing unprecedented opportunities both for the comprehension of the heart physiology and for the design and testing of new procedures and devices.…”

Section: Introductionmentioning

confidence: 99%

Electro-fluid-mechanics of the heart

Verzicco

2022

J. Fluid Mech.

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This article presents an overview of the dynamics of the human heart and the main goal is the discussion of its fluid mechanic features. We will see, however, that the flow in the heart can not be fully described without considering its electrophysiology and elastomechanics as well as the interaction with the systemic and pulmonary circulations with which it is strongly connected. Biologically, the human heart is similar to that of all warm-blooded mammals and it satisfies the same allometric laws. Since the Paleolithic Age, however, humans have improved their living conditions, have modified the environment to satisfy their needs and, more recently, have developed advanced medical knowledge which has allowed triple the number of heartbeats with respect to other mammals. In the last century, effective diagnostic tools, reliable surgical procedures and prosthetic devices have been developed and refined leading to substantial progress in cardiology and heart surgery with routine clinical practice which nowadays cures many disorders, once lethal. Pulse duplicators have been built to reproduce the pulsatile flow and ‘blood analogues’, have been realized. Heart phantoms, can attain deformations similar to the real heart although the active contraction and the tissue anisotropy still can not be replicated. Numerical models have also become a viable alternative for cardiovascular research: they do not suffer from limitations of material properties and device technologies, thus making possible the realization of truly digital twins. Unfortunately, a high-fidelity model for the whole heart consists of a system of coupled, nonlinear partial differential equations with a number of degrees of freedom of the order of a billion and computational costs become the bottleneck. An additional challenge comes from the inherent human variability and the uncertainty of the heart parameters whose statistical assessment requires a campaign of simulations rather than a single deterministic calculation; reduced and surrogate models can be employed to alleviate the huge computational burden and all possibilities are currently being pursued. In the era of big data and artificial intelligence, cardiovascular research is also advancing by exploiting the latest technologies: equation-based augmented reality, virtual surgery and computational prediction of disease progression are just a few examples among many that will become standard practice in the forthcoming years.

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Section: Introductionmentioning

confidence: 99%

Electro-fluid-mechanics of the heart

Verzicco

2022

J. Fluid Mech.

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“…This section presents a summary of the historical development of cardiac anatomy and function over the last 5000 years and is based on the following review articles [14][15][16][17]. Introduction sels attached to the top of the organ.…”

Section: A Brief History Of Cardiac Anatomymentioning

confidence: 99%

Multiscale X-ray Structural Analysis of Cardiac Cells and Tissues

Reichardt¹

2022

Göttingen Series in X-Ray Physics

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List of publications Danksagung Curriculum Vitaeday. Considering an average volume of 70 ml to 80 ml per beat, more than 7 000 liters of blood are pumped through the body each day. The synchronized contraction of the excitable cardiac tissue cells is controlled by the conduction system, which initiates an electric signal in the sinoatrial node and coordinates the propagation of the action potential through the heart. The continuous function of the heart during its entire lifetime is essential for the proper maintenance of all vital organs. Small dysfunctions or abnormalities can cause drastic changes and effects in the human organism. Therefore, it is very important to understand the cardiac structure from the molecular level up to the scale of the entire organ, as well as its function within the body.The primary aim of this thesis is to develop imaging protocols to probe the entire cy- Cardiac structure and (dys)functionCardiovascular diseases (CVDs) are the main cause of death worldwide with a rising incidence. While CVDs were responsible for less than 10% of the deaths worldwide by the beginning of the 20th century, the number of CVD-related deaths increased to over 30% by 2016 [6-8]. This corresponds to 17.9 million global deaths due to CVDs in one year. The major share of these death (85%) is attributed to heart attacks and from the ancient Egyptians [17]. (B) Drawing of the cardiac anatomy by Aristotle [15]. (C) Sketch of the heart by Leonardo da Vinci [15]. (D) Cardiac model by Richard Lower [18]. (E) Text book figure of Henry Gray's anatomy [16]. (F) Concept of a "Triebwerk" by Ludolf Krehl [18]. (G) Jane Sands Robb's model of the heart [18]. (H) Cardiac fiber model of Alfred Benninghoff and Kurt Goerttler [18]. (I) Model of the helical ventricular band by Francisco Torrent-Guasp [18]. Anatomie des Menschen"), Xavier Bichat ("Anatomie Generale") and Henry Gray and Henry Vandyke Carter ("Grays Anatomy"). Nevertheless, due to ongoing research and new discoveries the textbooks had to be updated constantly. In October 2020, the 42th edition of "Grays Anatomy" was released. Concerning the cardiac anatomy, most of the open questions were related to the cardiac function and structural changes caused by CVDs. For example, in 1891 Ludolf Krehl introduced the idea of a circumferential Historically, the observation of the heart structure started by documenting visual impressions gained from evisceration of animals or autopsies. With progress in the manufacture of optics and the invention of the microscope in the 17th century, it was possible to investigate structures in the micrometer range [48]. During this time, Marcello Malpighi was the first who identified small capillaries in the lungs of bats and established the process of oxygen uptake [49]. This procedure, later called histology (from Greek: histos, tissue and logos, study), revealed its full potential during the 19th Recently, this invention was further developed by a combination of STED and single molecule localization microscopy such as stochastic optical...

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“…27,28 Computational tools also provide an unprecedented resource that should be fully utilised. 1 Finally, an important point to consider is simply that targeting opening of the mPTP alone is not sufficient to prevent progression to heart failure in some settings, discussed below.…”

Section: Clinical Trials: Lost In Translationmentioning

confidence: 99%

Pharmacological Agents in the Clinic: Trial and Error

Fiedler¹

2015

Heart Res Open J

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Following an explosion of molecular and cellular research in the last 50 years, the study of specific molecular targets in the context of heart failure has generated much excitement. With the incidence of heart failure rising worldwide, new pharmacological agents are eagerly anticipated as a key tool with the potential for significant impact. In this regard, the results of the keenly awaited Does Cyclosporine Improve Clinical Outcome in ST Elevation Myocardial Infarction Patients (CIRCUS) trial have just been made available. Despite a substantial programme of supporting experimental and preclinical evidence however, the results have proved negative. This is of great disappointment to the clinical and scientific community. Here, this is discussed in the context of previous studies and future directions explored. TARGETING MYOCARDIAL REPERFUSION INJURY TO MITIGATE HEART FAILURE Molecular treatment regimens were first introduced into standard clinical practice in the 1980's but have not changed substantially since. 1 Myocardial infarction is one of the most widespread causes of secondary events, heart failure and death 2,3 and patients with ST-segment Elevation Myocardial Infarction (STEMI) are a particularly high risk group. The extent of cell death in infarction i.e. infarct size, is suggested to be a major determinant in the likelihood of survival. 4-6 Since myocardial reperfusion injury contributes greatly to the final infarct size, treatments that mitigate this have garnered significant interest.

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Cardiovascular Research: Past, Present and Future

Cited by 3 publications

References 59 publications

Electro-fluid-mechanics of the heart

Electro-fluid-mechanics of the heart

Multiscale X-ray Structural Analysis of Cardiac Cells and Tissues

Pharmacological Agents in the Clinic: Trial and Error

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