euHeart - Matters of the Heart

Acronym of the case:

euHeart

Web address of the case:

http://www.euheart.eu/

Country of the case:

Belgium , France , Germany , Netherlands , Spain , United Kingdom

Posting Date:

16 April 2010

Last Edited Date:

19 April 2010

Author:

Ecabert Olivier (Philips Research)

Virtual Physiological Human | Modelling of physiolgical processes | Medical image processing and analysis

Type of initiative

Project or service

Case Abstract

The euHeart consortium, combining 16 industrial, clinical and academic partners, aims to develop advanced computer models of the human heart that can be personalized to patient-specific conditions using clinical data from various sources, such as imaging, measurements of blood flow, blood pressure, and electrocardiography (ECGs). These computer models integrate the behaviour of the heart and the aorta at molecular, cellular, tissue and organ-level. They also incorporate clinical knowledge about how cardiovascular disease disturbs the correct functioning of the heart at these levels. As a result, it may be possible to develop simulation tools that doctors can use to predict the outcome of different types of therapy, and since the models are personalized to individual patients, the therapy can be equally personalized.

The euHeart consortium is also working on the integration of the multi-disciplinary achievements into prototype systems for use in clinical settings. The validation studies carried out on cohorts of patients at clinical sites will facilitate the collection of evidence of clinical benefit and the quantification of potential impact.

Description of the case

Domain

eHealth

Topic

Computer assisted surgery | ICT for disease prevention and health promotion | Medical Imaging

Sector

Education, Science and Research | Healthcare

Date

June 2008 to May 2012

Target Users

Health professionals

Target Users Description

Cardiologists
Electrophysiologists

Scope

International

Language(s)

English

Policy Context and Legal Framework

The pathophysiology of the heart represents a highly relevant and epidemiologically significant contributor to loss of quality and quantity of life within Europe, where each year cardiovascular diseases (CVD) causes over 4.35 million deaths including nearly half of all non-accidental deaths. This epidemic, currently western, is now also spreading to developing nations with CVD predicted to become the most common cause of death in these countries by this year.

CVD is most commonly a consequence of atherosclerosis, manifesting itself in diseases such as coronary artery disease, congestive heart failure, and cardiac arrhythmias. These diseases have a significant impact on the EU economy with an estimated cost of EUR 169 billion a year. The loss of quality and quantity of life producing this significant financial burden is spread across community sectors with approximately 62% of costs due to direct health care costs, 21% due to productivity losses and 17% due to the informal care of people with CVD. Thus the early detection and prediction of the progression of CVD are key requirements towards improved treatment, a reduction in mortality and morbidity, and of course to reduce healthcare costs within the European economy.

Project Size and Implementation

Type of initiative

Not applicable/not available

Overall Implementation approach

Partnerships between administration and/or private sector and/or non-profit sector

Technology choice

Proprietary technology | Standards-based technology | Mainly (or only) open standards | Open source software

Funding source

Public funding EU

Project size

Implementation: €15-49,000

Implementation and Management Approach

Context: Numerous diagnostic techniques are available to assess the presence and severity of Cardiovascular disease (CVD), ranging from electrocardiography through imaging techniques (e.g. magnetic resonance imaging) to invasive tests. These techniques have been continuously refined, and can now derive exact and quantitative data. However, in current clinical practice data from different modalities are not optimally combined. Results from different tests may even be contradictory, as they measure different aspects of disease, which vary considerable even in healthy people.

euHeart aims to improve diagnosis, planning and treatment of CVD by using new computing tools and modelling approaches to generate patient-specific models of the heart and the aorta in clinical environments.

euHeart develops and uses multi-scale models linking molecular, sub-cellular and cellular functions to whole organ performance, via physiological function. These models provide a consistent, biophysically-based framework for the integration of the fragmented and inhomogeneous data currently available, which can be efficiently used to improve the outcome of CVD treatments. In addition, these models help understand the complex and multi-factorial disease mechanisms which play a key role in the pathology of disease.

Clinical focus: euHeart will collect evidence of clinical benefit to quantify the potential impact of multi-scale modelling for a number of CVD and associated therapies which are significant in terms of both healthcare spent and quality of life in Europe:
- Heart failure through cardiac resynchronization therapy (CRT);
- Heart failure through congenital cardiac surgery and left ventricular assist devices;
- Cardiac rhythm disorder through radiofrequency ablation;
- Coronary artery disease through revascularization using coronary stents and pharmacologic therapies;
- Diagnosis and treatment of valvular and aortic diseases.

Each of the selected clinical applications provides a complementary focus for the resulting integrated models of cardiac fluid-electro-mechanical function.

Validation: model validation is carried out in clinical environments on cohorts of patients using dedicated prototypes. In addition, one multicenter pilot trial, including approximately 120 patients, will be performed to demonstrate the clinical benefit in determining the optimal lead placement and pacing sequence in CRT, a treatment that improves the coordination of the heartâ€™s contraction.

Management: the euHeart project is organised around two axes. The horizontal axis comprises technical work packages which exploit economy of scale of the consortium through development of generic technical solutions and horizontal integration of efforts. These technical work packages will deliver their developments to the application work packages which carry the vertical integration around the five clinical applications mentioned above to evaluate clinical benefit of multi-scale modelling.

Technology solution

The development of clinical prototypes requires the integration of numerous multi-disciplinary tools which are developed leveraging the complementary expertise available within the euHeart consortium. More specifically, the focus is on the following activities:

To develop, exchange and integrate multi-physics and multi-scale models of the heart and aorta in normal and pathological conditions using the international encoding standards CellML and FieldML. Recently, euHeartDB, a web-enabled database for sharing and reusing anatomical models of the heart has been released;
To develop and apply strategies for model personalisation, i.e. to make computer models reflect the condition of a specific patient using anatomical and functional information. Effective personalisation is a crucial component to enable personalisation of care;
To develop and validate automated methods for the consistent interpretation of multi-modal clinical images, a prerequisite to enable translation into clinical environments;
To develop tools for the fusion and visualization of the clinical data and physiological information into the same spatial and temporal domains;
To develop environments for the optimization of surgical interventions and tuning of devices for better treatment delivery and clinical outcome.

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