The Next Phase: Asking "What if?"

A few problems remain to be worked out before the model heart is completely healthy. Peskin and McQueen are confident they can shake out the bugs with more "monster calculations" on the C90. "It will be a somewhat slow process," says Peskin, "because each run is so big, but the only way this work proceeds is trial-and-error. You see a result and that tells you what you have to adjust."

The researchers look forward to the next stage -- when the model can be used to pose "what if" questions that are difficult to address through animal and clinical studies. For instance, a heart attack often weakens a region of the heart, and this part of the muscle may actually stretch while the rest of the heart contracts. What effect does this have on overall heart function? Does location make a difference? When does it require surgery?

There are many similar questions about diseased valves, says Peskin. "If a valve is stiffened, how much effect does it have on valve motion? Likewise, if there is a hole in the valve, what effect will that have?"

The model's ability to arrive at significant conclusions about normal and diseased heart functioning -- and thereby to save lives -- depends primarily on one factor, says Peskin: "The thing that sets the rate of progress in our project is the computer. If we had 10 times more computing time, or if the computer we have now were 10 to 100 times faster, we could use it effectively. We feel we're on the edge of starting to use this 3-D heart as a practical scientific tool. The C90 was a real breakthrough, but we're definitely in the market for similar breakthroughs in the future."

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