An Italian research aims to create a virtual heart that integrates all the functions of the heart muscle to understand it better. A revolution for medicine
When medicine marries mathematics, the results can be surprising; and if this marriage gives a clearer vision of the marvelous complexity of the human heart, its fruits will also be linked by each beat, by each stroke that nourishes life.
With this in mind, on December 1, 2017, the iHEART project began, an acronym for “Integrated Heart”. For the first time in the world, we will study and work to create a virtual mathematical model that integrates all the processes of cardiac function. A true virtual heart. At the head of the ambitious five-year project at the Politecnico di Milano is the world-renowned mathematician Alfio Quarteroni, professor at the ‘Ecole Polytechnique Fédérale de Lausanne and the Polytechnic of Milan, as well as president of the spin-off of the Milan Polytechnic, Moxoff .
Quarteroni is the winner of an advanced grant of 2,350,000 euros awarded by the European Research Council (ERC), the first organization in the European Union dedicated to supporting scientific research based on the excellence of the researcher and the innovative strength of his idea . Quarteroni had already won an ERC Grant in 2008 and two ERC Proof of Concept, a sign of how much his applied mathematics studies are of extreme importance not only for the scientific community, but for society in general.
The underlying data of the Quarteroni project
The objective of iHEART is to describe the behavior of the human heart with complex equations. The motivation of the project is based on the fact that “a very high percentage of natural deaths in Western countries is due to cardiovascular diseases: 45% of natural deaths are cardiac,” explains Quarteroni. “The social impact is enormous: it is estimated that the cost related to cardiovascular diseases for the European Community is approximately 200 billion dollars a year, of which 55% is due to the direct costs of health, 5% it is due to productivity losses, 22% refers to informal care, that is, people who receive treatment not in hospitals but in the home or in para-hospital structures. ”
In summary, cardiovascular diseases are a real problem for contemporary society. According to the data provided by the thirteenth health report published by the Consortium of Applied Economic Research in Health of the University of Rome Tor Vergata, deaths from cardiovascular diseases in Italy in 2015 amounted to 80.6%. A high average, which is also found in other countries: in Greece (84.4%), in Germany (82.3%), in Sweden (80.7%), in the United Kingdom (79.6%), in Spain (76.7%) or France (75.2%), just to name a few.
If you could create a virtual heart model that would simulate all functions and cardiac dysfunctions, the advantages in terms of prevention and support for doctors would be enormous. An important and very complicated dream, that of Quarteroni: to produce results that can be used for each person, for each heart, in real time.
A “virtual heart” made of mathematics
Here, then, is that in this model mathematics becomes a matter of heart. “It is believed that a very high percentage of these problems is not congenital in nature, but is acquired and, therefore, can be prevented,” Quarteroni said. “Mathematics makes it possible to represent all the cardiac function and, therefore, to create a kind of virtual heart composed only of mathematics, thanks to very complex equations, we can create the conditions for a better understanding of the problems and, therefore, for better prevention. ”
The hope is that, thanks to the study of Quarteroni and his team, you will be able to know in detail the different components that determine the heartbeat second by second: “The first is the electrical component, if we have a pulsating heart it is because in every second of our life there is a spontaneous electrical impulse that is generated, a spark that produces an electric field that then propagates in our myocardium, so there are equations that describe this behavior “.
It is thanks to this electrical component that all the fibers of the heart contract and dilate, giving rise to the mechanical component: the deformation of the walls of the heart due to contraction and dilation.
More formulas describe the part of fluid dynamics, that is, the dynamics of blood: “When the rhythms and heart contracts and pushes blood (oxygenated, editor’s note) that is contained in the left ventricle to the aorta, and from there to all the other arteries, to feed all our cells All these interconnected processes are described by equations linked to each other, and therefore represented by a single mathematical problem, terribly complex, but which incorporates these aspects and integrates them together. “The integrated heart model, in fact. It would be the first complete representation of a virtual heart: to date, in fact, only partial diagrams of cardiac functions have been obtained.
Doctors and mathematicians together for the primacy of all Italians
To achieve this model, we need a fundamental element: collaboration with the doctors. A mixture of relationships that could really lead to a revolution in the field of medicine, and that at the time of our grandparents did not even dream. Then, the stereotype according to which mathematics and medicine are two different fields falls. “It becomes essential a close collaboration with doctors,” notes Quarteroni. “All hearts are different from each other, so that we have a better understanding of the problems and, therefore, to develop better and more personalized models, we need to acquire data.” Data that can only be collected by analyzing the hearts of patients, obtained through medical technology. “The first phase of our exploration consists in creating a geometric model of the heart. We are talking about the cardiac structure: first we have to describe it. Then, when we have all this information a priori, we can use equations to start our model and make it work in that specific heart. These equations are extremely complex: there is no mathematician in the world who can think of solving them; consequently, it must be done with a powerful calculator. Before arriving at the computer, however, we have to translate these equations into an algorithm, approximating them in a scientific way, so that they are simplified equations but capable of describing very well what happens in reality “. A work of synergy, therefore, that unites mathematicians and doctors to work for a totally Italian primacy.
Goals, dreams and expectations
The objectives of the study are different: “We want to help the doctor to better understand how this wonderful machine works which is the heart and, therefore, to understand the problems and diseases of a specific patient, “the mathematician takes control.”It is as if the doctor had at his disposal an incredible magnifying glass that would allow him to have new information about the functioning state of the heart muscle and, in the case of a malformation or pathology, try to understand through the model the evolution of the conditions of a heart in the weeks, with a look towards the future. “” An additional help this research can give to the surgeons. “In the case that a doctor evaluates the opportunity to intervene surgically, there are several options for the intervention: these could be explored first thanks to mathematics, to help the surgeon better understand what kind of strategy to intervene and then understand a priori if type of operation could be effective or not. “The expectations in this virtual heart are high and justified, but the dream – as he defines Quarteroni – is to identify the possible evolution of behavior and heart problems of hearts in In real time, a mathematical one, therefore, complementary to clinical knowledge, which will allow to carry out non-invasive and extremely precise examinations, up to date not obtainable with traditional technologies.
Mathematics in the center of attention
The role of mathematics in Society has changed so much, until it assumes an important position. The reasons for the changes are many, both from a technical and social point of view; The fact is that today mathematics allows you to do things that were previously unthinkable. It’s a bit like I’ve been on the scene for the first time, after years of trying to be an authentic way of knowing the world, and not scientific. “This kind of applied mathematics was not there when I started,” recalls Quarteroni. “Before being a pure mathematician, I was interested in trying theorems and making theories, so I became more and more interested in application problems, first for aeronautics, then for earthquakes and again in the environment, sports and medicine. In medicine they have been for almost twenty years, while in the heart they were almost four. “The professor continues:” There are three essential components that govern the game and require a synchronous development, which had not developed sufficiently before. First, modeling-the representation of reality through equations and, therefore, the language of mathematics-was not accurate enough. So today there is a better understanding regarding the translation in algorithms of the equations. By last, there were no computers so powerful as to solve these complicated equations. “” From a social point of view, today there is a greater awareness of the fact that mathematics can be useful, there is greater openness on the part of physicians to collaborate with From this point of view, all the acquisitions of mathematics, in decades, have helped to create a greater awareness and conscience that leads, therefore, to seek a collaboration with mathematicians.To simplify, today the basic theoretical knowledge What the doctor has, the experimentation and the mathematical application are integrated and lead to a better understanding of what happens. ”
An endless search
If Quarteroni and his team are already achieving important results with the aXurge platform, which offers support in the treatment of the aneurysm abdominal aortic, the results they are looking for at the moment are really revolutionary, but Quarteroni knows it ien, the study never runs out: “It is a continuous search, there is never a final point of arrival. It is an endless direction of travel. “” We will never arrive at an absolutely complete and accurate description of the behavior of the human heart, because our nature is so complex and beautifully conceived that it is unthinkable to describe it in finite terms.” These are gigantic and inexhaustible challenges, but it is worth trying, because every small conquest can have a fundamental value. ”
By Sara Riboldi
January 17, 2018
http://www.informazionesenzafiltro.it/alfio-quarteroni-la-matematica-del-cuore/
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