On the Diagnosis of Aortic Dissection with Impedance Cardiography: A Bayesian Feasibility Study Framework with Multi-Fidelity Simulation Data

Abstract

Aortic dissection is a cardiovascular disease with a disconcertingly high mortality. When it comes to diagnosis, medical imaging techniques such as Computed Tomography, Magnetic Resonance Tomography or Ultrasound certainly do the job, but also have their shortcomings. Impedance cardiography is a standard method to monitor a patients heart function and circulatory system by injecting electric currents and measuring voltage drops between electrode pairs attached to the human body. If such measurements distinguished healthy from dissected aortas, one could improve clinical procedures. Experiments are quite difficult, and thus we investigate the feasibility with finite element simulations beforehand. In these simulations, we find uncertain input parameters, e.g., the electrical conductivity of blood. Inference on the state of the aorta from impedance measurements defines an inverse problem in which forward uncertainty propagation through the simulation with vanilla Monte Carlo demands a prohibitively large computational effort. To overcome this limitation, we combine two simulations: one simulation with a high fidelity and another simulation with a low fidelity, and low and high computational costs accordingly. We use the inexpensive low-fidelity simulation to learn about the expensive high-fidelity simulation. It all boils down to a regression problem—and reduces total computational cost after all.