because it is the passion that drives us like
mathematicians mathematics for the heart
because I want to convince v that the
math is also useful for us for the
because our health because
diseases of the cardiovascular system
they are very important they manage to
impact deadly 45 per cent
one hundred of the population to rich countries
in western countries with a cost
economic social progress
extraordinarily large it is estimated that
about 200 billion euros for
year artists systems that are this
the impact on the economy of a continent
like europe
yet still about 80 percent
of the diseases of our system
cardiovascular are somehow
predictable this is the role e
this is the point where he loves the theme of
then inserting this is the niche of
mathematical intervention
we want to use math for
try to help doctors clinicians a
better understand our system
cardiocirculatory and it is possible to
better to treat people who are affected
from pathologies and also possibly
better to design the only interventions
that are more effective for pressure
that they need the heart has
basically four rooms two others
two ventricles the venous blood enters
from the vena cava it is then sent to
lungs where oxygen is returned
through the pulmonary veins in the atrium
left and then through the valve
mitral enters the left ventricle e
from here through the val gardens
enters our circulatory system
global through the artery brings a
extremely complex system requires
a perfect single there are big ones
large formations move a large one
pressure of a contraction a
dilatation of our of our heart
there are the values that are opened and
they close very quickly and
exactly thanks to this synchronism
that the heart can work as well as
it works
what you see a real heart this
it is a true pulsation is an image
taken obviously in real time
you really realize how much
complex is the mechanism of
operation
the power that expresses the heart
extraordinary you can get an idea
thinking about if you ever did a
experiment of this kind at
compression of a tennis ball and
the strength that the work requires
you have to produce to crush one
first tennis this is good
comparable in dimensional terms to
work that the heart does in every second
to allow this to happen to this
structure that almost completely hollow
to send our system blood
circulatory
it is estimated that over a cycle of
life
the heart manages to send into ours
circulatory system the equivalent of a
one and a half million barrels of blood
so an effort is really titanic
and it is a spark that cites life into
every second is a spark is a
natural pacemaker that starts from the breast
from the atrial sinus node and then spreads
through a complex system of fibers
the so-called fibers al pur kingi
in the myocardium empire every cell of the
our myocardium is involved comes
activated
this gives rise to a complex
biochemical mechanism to a contraction
or dilatation of these cells e
the aggregate effect of this
contraction dilatation and what
then determines the contraction or the
dilatation of the cardiac system in
sense of the side
why we should trust the
math for a problem like that
complex because math helps us
to reason
math helps us to develop
what today is called the
computational reasoning that is
face a problem in his
complexity to partition ndaw lo in
under problems
each with its own intrinsic logic but
each under first connected to the others
seven problems
these skills of synthesis these
capacity for conceptual aggregation
what makes math one
absolutely powerful tool and I would like
to say that we must be able to be unique
to describe different machines that
they act in sync with the heart
electrophysiological machine then
that the model that describes the
propagation of the potential
electric in our system
then the biochemical machine the one that
then determines the operation of each
single cell its polar
polarization station then the
mechanical machine because there is a
deformative effect as we have seen
the fluid dynamic machine because
we naturally have the blood which is a
fluid inside our cavities and then
finally the activation of the valves la
then all these valve dynamics
machines are actually models
mathematicians who coexist exchanges of
information between them
and it is exactly the resolution of
this problem that is from the point of
mathematical view a monstrosity
absolute is very complex strangely
complex translated into equations that
they translate the fundamental physical principles
of our life and the resolution of
this problem I said that there
will allow us to describe the function
cardiac and also cardiac dysfunction
there is no human no marriage
unable to solve this problem is
too complex complex
we have vision of the mediation of
regulators we need to translate it
infinitely to approximate making it
accessible to the computer through the
very complex algorithms through
programming languages and will then be
calculator that will help us find
an answer and then to represent
this virtual reality that describes the
functioning of our heart
this is the problem we have to solve
the simulation is the element
fundamental therefore starting from the problem
exactly that we do not know how to solve tar
hard did not put the book on the rice
calculator and then carry out the
simulation of behavior understand it
obviously the patient is the actor
fundamental in this speech
the individual we need to acquire
data data are acquired by
Magnetic resonance imaging for
example but the important thing to succeed in
move from this representation that
it is a perception representation of
as you see a geometric model
complete like this this is the first
step two step is to
translate this geometric model conna
of very small geometric elements
the elements of a hypothetical grid of
calculation
at the end of the process we will be able to
describe the solution in each element
of this grid how many I know how many
they are necessary depends on accuracy
one million 10 million 100 million a
times a billion well we will get to
solve problems of a billion
equations for describes the behavior
human
these are the fibers of the muscle
cardiac
that these reproduced with an algorithm
mathematical because hardly
revealed detectable in terms of
magnetic resonance, axial spelling rhythm
this is already the simulation these
they are already good mathematicians here
you see thieves or left and there is one
front advancing and of the front of the
electric potential there are colors
different red is the maximum each
color each color intensity indicates
the intensity of the phenomenon therefore the
amount of potential in this case
specific well we are describing how
in a healthy heart the potential sees
so it will propagate our thread
left here we are describing with a
healthy ventricle deforms in time
real now you see the true speed
here it is only decelerated to do
see this better is speed
true of cardiac pulsation on the left
we live in the lateral image on the right
gives me an image from above how
in every state our heart is
contract from the point of view of the
from its length of around 30 for
one hundred still expands one
percentage of the decline of 25 percent e
then of and place of a twist
absolutely extraordinary and this
incredible movement in some respects
very little natural very little obvious
very little linear that causes the
heart has this kind of performance
what you see is a true heart of
a real person are two ventricles that
see from above now we see them
decelerated then slowed down that the
potential potential
electric is propagating in the nei
ventricles this a sick heart a
heart that has a pathology called
l bbb is substantially a block of
a part of the myocardium due for
example to a heart attack
it is evident that the propagation as if
it was a wave that meets an obstacle
is deviated from place of the
variations to some how to say interactions
of waves is how one develops
substantially chaotic movement
obviously out of this kind they go
cared for and math to help
understand how to intervene with which types
of relationships to be done so that then
these anomalous waves are traced back
in their bed of behavior of
natural behavior
this is a healthy heart this is one
simulation that makes you understand how the
blood flow behaves in ours
heart
at the top you see the left trio at the bottom
see the left ventricle the blood
comes from the four pulmonary veins the
oxygenated blood enter the other
sinister gives place in a dynamic
rather complex in the other left
when the blood pressure exceeds the
valve resistance pressure
mitral this valve opens this
blood enters the left ventricle in
bass
obviously it goes to swell to amplify
the left ventricle when this
pressure still is higher than that
exercised artery carries the valve
aortic opens the blood is expelled
and it is sent to our system
circulatory well understand that it is a
very complex movement
there is no radiological investigation
magnetic resonance demography that can
represent the movement in this with
this kind of realism but I would like to say
especially in this kind of means
the quantitative meaning these are
It is not only a quality survey is
a quantitative investigation
this is the same kind of simulation
here we see the formation of the
vortex structures and it is not exactly
turbulent fluid that flow that
it develops in the heart but it is almost
turbulent from the place of a vorticity
that absolutely extraordinary and thank you
to this vorticity that we do not have
no stagnation zone in ours
vehicle and thanks to this fact that i
our minds are weird clean and that
blood behaves and our heart
continues to behave in a manner
this is extraordinarily effective
another simulation still truth
the opening of the aortic valve
the three leaflets are the three leaflets from
valve gardens that close and open
obviously allows the blood to
to escape entering the orta
ascending that what you see that
what you see above
these are simulations straordina mente
effective from the point of view of the
result quality
there were also extraordinary simulations
complex mind to give you an idea
qualitative one second of real life
so a heartbeat that takes
about a second requires on a gloss
computer we say the biggest that
with the European tour about a week
of calculation time delicate because
all this because math there
is behind the extremely subject
powerful extremely refined and why
our life and a complex life
very rich the heart has an operation
extraordinarily complex from
to catch
the mathematical algorithm we use is
able to give us in every thousandths of
second
so a thousand times the delicious cardia
with the complete evolution of the phenomenon
cardiac we are all different each
we are a different heart to each other
person
not only but we say it has different times
Our heart is different moments
behave differently as
take this variability into account
well this is one of the very things
difficult we must take into account how
the variability so many hearts verses is
conditioned by the shape that obviously
different from the biological data then
for example from viscosity and density
of our blood different from a patient
of one person to another from
distribution of myocardial fibers
still fin that vary in one in one
in spaces and infinite size
basically and then data
functional that is ours we say
state of health at that precise moment
You can put the bill in more from this
variability from these a great one
challenge for us mathematicians and this the
our dream is a dream
specific passion medicine , that is
We hope we can tomorrow to
produce these results for each
single person and if possible on time
real meaning real time in a
time that is affordable that is suitable
and convenient for the analysis of the doctor
in the lane
to do this you need to put on your feet
a way of reasoning but a theme of
completely different from that
traditional
so explore a huge one
variety of patients or people those
that you see represented above for
each of these to do these
Extraordinarily accurate simulations
with supercomputers put away in
very rich database all these
simulations and then when a new one arrives
subject explore and take advantage of e
take advantage of them in a convenient way
simulations of first in such a way by
make it to the simulation for that
specific subject very agile very
quick and feasible and even on one
smartphone
can be used in real time
This is our goal for the doctor
this is our dream but it’s not me
I think too far from the possibility
to realize it then I would like to conclude
giving you a message to this is a type
math what we develop for
the cardiocirculatory system but for the
medicine in the broadest sense I have talked about
this application but of course yes
can try to generalize is last
in the accurate and quantitative theme
so complements perfectly
the clinical knowledge that is obviously
very based on knowledge and
experience on the art of doctor and
on this we say lived experience this
it is also naturally on the images
radiological images are that
allow it depends on the instant photos
and they are photos that he saw me
before specific details for
example of the sections of the system
cardiocirculatory is a mathematics
accurate accuracy and in the hands of
mathematical we have the possibility of
decide how accurately to supply the
results
this is a system check that
he did obviously thanks to the
math is not a mathematics
invasive and this very important not
we need to subdue the
patient has other investigations
therefore it is not invasive and it is not intrusive
and a virtual math is a
ritual approach is done with paper
and pen and computer of course but in the
laboratories in scientific laboratories
so we do not need to acquire
new investigations and therefore obviously
be more impact from the point of
personal view from the point of view
social and economic on the patient is one
predictive math I do not want
just understand what’s happening in
that moment to that person
I want to think I can predict what
it will happen to that person in the future
so I want to do the simulation
exactly like when I do the short ones
over time I want to understand today how it will be
the weather tomorrow and the day after tomorrow
I wish I could use these models for
understand how the evolution of a patient
especially if a certain type of
pathology will develop in a certain
way or in another way
this kind of looking forward again
once it is a characteristic
absolutely fundamental that the mafia
maria guarantees
it’s a math it would like to be like
I said specific pools first then
we would like tomorrow to be able to say it is
this is the heart of this explicit
person this specific heart yes
behave behave will behave
exactly in this way
this is a dream but we work for
this and finally I would like to say that one
mathematics substantially at no cost
because of course there is investment
of knowledge from research
intelligence
but then at this point you can
use substantially
free this I think it is the
important message once the Greeks
they thought that in ancient times the heart
was the casket of our feelings a
this is corroborated in some way and
some evidence yes we have a strong one
positive emotion the first time there
we fall in love, we certainly have a heart
which acts extremely vital manier
It seems a very negative emotion
we talk about broken heart and this
indeed it can be translated sometimes
in a release of hormones such as
to distribute poses cardio system
circulatory and therefore have an impact
it is still not clear on the behavior
of the heart
we are still at these levels of
understand how to combine emotions
feelings, passions and behavior
physiological and pathological of the heart with
mathematics
but we are already close to being able to
describe the action and the dysfunction
cardiac in extremely precise terms
[Applause]
”
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