Seeking Clues to Problems in Tiny Hearts

If not diagnosed early and repaired with surgery, infants with coarctation of the aorta can suffer lifelong health problems, such as high blood pressure, or even die.

The researchers led by Wei will improve detection by building a digital twin model, a viewable digital replica of an individual patient’s cardiovascular system. The model will integrate multidimensional, patient-specific data to support clinical decision-making, including assessment of whether a fetal heart defect is present. 

The team will build their model using fetal heart data collected at more than 15 cardiology programs across North America that are part of the Fetal Heart Society. The database includes information collected during two-dimensional and three-dimensional ultrasound tests that were performed on hundreds of racially and ethnically diverse pregnant women, including some whose babies were confirmed after birth to have heart defects.

Wei and his team have already used information in the database to create a model that represents blood flow in healthy fetal hearts. Going forward, the team will build its new model by focusing on measurements that reflect force on fetal blood vessel walls, pressure and flow through a narrowed fetal artery, and the resistance that can occur when freshly pumped blood collides with other blood in a vessel. 

The researchers will then test the accuracy of their model in laboratory experiments using 3D-printed silicone models of fetal aortas, fluid, and pumping mechanisms. Finally, data from the Geisinger database will be used to evaluate blood flow metrics for better diagnosis of aorta narrowing in the future.

The work builds on Wei’s development of computational and experimental models for blood flow mechanics. His fetus-related research has been supported by the American Heart Association’s Second Century Faculty Independence Award and the National Institute of Biomedical Imaging and Bioengineering Trailblazer Award, prestigious honors recognizing the innovation, significance, and potential clinical impact of his work. He also has collaborated on research to develop pediatric medical devices and 3D-printed blood vessels for heart bypass surgery.

Wei says that development of a validated digital twin model for coarctation of the fetal aorta will lay a solid foundation for future human studies that could lead to more accurate screening tools and better health outcomes for children with the birth defect.

“Surgeons can repair many heart problems in babies, but the first, and most important, step is detecting problems,” Wei said. “The earlier we can identify a condition, the more time clinicians and families have to plan for the baby’s care. The goal of my lab is to improve the detection and treatment of cardiovascular disease and, ultimately, to help ensure that patients receive the right care at the right time.”