Analytical Capabilities

Insilicomed uses patient-specific simulations to construct libraries of heart disease models. Varying parameters in these realistic computational models shows what clinical data must be acquired from each patient and data that can be generic, reducing the need for extra measurements. Two inventions are in development (patents pending). Artificial intelligence methods are being used to develop machine-learning algorithms for clinical decision support. And we can use these tools to help you develop your new inventions, and the libraries can serve to guide product development before expensive prototypes, animal and preclinical studies are performed. Contact Insilicomed for more information…

Insilicomed has completed an NIH SBIR entitled: Prediction of Clinical Response to Cardiac Resynchronization Therapy (CRT). In this study, a detailed workflow has been developed to construct realistic patient-specific simulations of dyssynchronous heart failure (DHF) in a group of patients using only typical clinical measurements made before treatment with CRT. The computer models were then paced employing the pacing protocols used by clinicians after implant. Resulting simulations of CRT discriminated all responders and non-responders to the treatment indicating the viability of these detailed computer models for use in the clinic. Considering the high failure rate of this widely-used and expensive procedure, the capability to predict which patients will likely respond using inexpensive computer simulations is, in and of itself, a major advance in personalized medicine.

Currently, new methods are being developed to improve diagnosis of DHF and to optimize CRT in the clinic in order to improve patient response and reduce the large number of non-responders (30 to 40% of all patients treated). Our detailed results support the use of Insilicomed’s patient-specific simulations, or simplified algorithms derived from them, to predict both clinical and echo response to CRT. Currently, leading cardiac disease rhythm management manufacturers focus on reducing electrical dyssynchrony of each patient’s cardiac function acutely.

Recent research at UCSD-Bioengineering has indicated that the current standard of care may not be most beneficial for each patient. A small patient cohort provides strong statistical evidence that a mechanical index estimated from each patient’s DHF computer model is far superior to any currently used index in diagnosing the severity of the patient’s disease. Moreover, it is useful to estimate which patients will respond best to CRT over the long term. This mechanical index is the subject of a recent patent application(patent pending). And, Insilicomed has obtained an exclusive license to utilize it for clinical purposes.

Moreover, current research at UCSD has identified a new electrical indexestimated from the simulations that may prove to be even better than the mechanical index. Ongoing clinical studies are being performed to prove the value of both indices in a much larger patient cohort. The electrical indexis the subject of a second recent patent application(patent pending). And, Insilicomed has obtained an exclusive license for its use in the clinic. Minimizing this electrical index may provide the capability to optimize CRT on a patient-by-patient basis, reduce the number of non-responders to the treatment dramatically and substantially improve cardiac function in many patients. In fact, the use of one or both computed indices has the potential to promote reverse remodeling in patients, i.e., it may be possible to reduce the size of their severely dilated hearts and return cardiac function to a more normal state, rather than simply treat the symptoms of this prevalent disease.

Four Chamber Finite Element Heart Model

Recently, advances in our finite element methods and post-processing of medical imaging have provided the capabilities to construct detailed four-chamber finite element models of the heart. These models include the left and right atrium as well as the two ventricles. As shown, the geometry of the atria is very complex requiring considerable image analysis and finite element mesh work to achieve these results. But adding patients is much easier for precision medicine applications. The existing four-chamber model can easily be morphed into smaller and larger models to account for patient-to-patient variations. This is important for implanted device design in dilated cardiomyopathy and other disease conditions where the shape from one patient to another changes greatly.

Beating Heart

Recent advances in our finite element modeling of the beating heart provide capabilities to construct even more realistic simulations of cardiac function. Here an advanced model with both ventricles and both atria is shown. Insilicomed can simulate the electrophysiology and biomechanics of the heart and circulation for use in clinical applications including precision medicine in which patient-to-patient variability must be considered for tailored diagnosis and treatment.

Dr. Waldman at CMU

Dr. Lewis Waldman, CEO of Insilicomed, gives a seminar to the Bioengineering Department at Carnegie-Mellon University. Lew described how advances in high-order finite element methods have allowed UCSD-Bioengineering and exclusive licensee Insilicomed to model complex heart geometries, as shown in the models on this page. Using extraordinary nodes (a term from mathematics), multiply-connected bodies such as biventricular hearts with four valve orifices, cardiac atria and complete four-chamber hearts can be constructed with far fewer finite elements than standard methods. Following our academic collaborators at UCSD-Cardiac Mechanics Research Group, Insilicomed is using these techniques to make advances in precision medicine in cardiology. Our focus is to advance diagnosis and treatment of heart failure, an epidemic in modern medicine. Highly-varied patient-specific cardiac computational models are being used to determine the electrophysiology and biomechanics of heart function in the clinic. For more information click here.

Lewis Waldman, CEO of Insilicomed Inc., spoke at Carnegie Mellon about his work involving the development of a 3D simulation of the heart. (credit: Abhinav Gautam/Photo Editor)