Towards non-invasive and cost-effective digital twin solutions for cardiac electromechanics

Cardiac digital twinning is emerging as a cornerstone of precision cardiology, creating patient-specific digital replicas of the heart that integrate anatomy and electromechanical function. These cardiac digital twins (CDTs) promise personalised therapy and improved outcomes. However, current CDT technologies depend on high-quality imaging and electrocardiographic data, limiting their applicability to a small subset of cases.Cardiorama aims to revolutionise CDTs by enabling anatomical and functional twinning using standard echocardiography (echo) and electrocardiography (ECG). These first-line diagnostic tools are routinely acquired, cost-effective and widely accessible. Echo provides insights into cardiac anatomy and mechanics, while ECG captures the electrical signature of cardiac activation. By leveraging the intrinsic link between electrical activation and mechanical function, combining echo and ECG offers a deeper, synergistic understanding of electromechanical function than either modality alone.The main challenges of low resolution and spatial sparsity of echo-ECG data will be addressed through generative shape models for anatomy and advanced cardiac modelling for functionalization. Robust uncertainty quantification will provide confidence intervals for model calibration, ensuring reliability and identifying limitations in sparse-data conditions. The developed technology will be applied to two clinical challenges: scar delineation in chronic myocardial infarction and the reconstruction of electrical activation patterns in conduction disorders.Cardiorama aspires to democratise precision cardiology by creating a fast, affordable, and clinically applicable CDT solution, accessible even in low-resource settings, enabling earlier and more effective treatment of cardiovascular diseases worldwide.