Application of In Silico Trials for the Investigation of Drug Effects on Cardiomyopathy-Diseased Heart Cycle Properties

In this paper, we present the abilities of an in silico platform used to simulate the effects of different drugs on heartbeat cycle performance. The platform is based on a finite element modelling approach with the fluid-solid interaction implemented using a loose coupling procedure. Active mechanical stresses are calculated using the Hunter excitation model while the passive mechanical stresses are calculated using a recently introduced experiment-based material model for the heart tissue. The applicability of the platform is illustrated using a simple parametric model of the left ventricle. The simulations are performed using parameters that are specific to drugs such as digoxin, mavacamten, 2-deoxy adenosine triphosphate, and disopyramide, with the concentration of calcium in the cardiac cells affected by these drugs given as an input function. The results are obtained for two geometries mimicking patients with hypertrophic and dilated cardiomyopathy, and also for different inlet/outlet boundary conditions simulating different drug effects at the macroscopic level. Using in silico simulations with virtual patients, it is possible to evaluate the influence of different drugs on cardiac output and ejection fraction. This approach can significantly reduce computational costs with an acceptable solution accuracy compared to approaches coupling finite element and biophysical muscle model methods that are used to calculate drug effects at the micro level.