Real-time Generalizable Heart Valve Mechanics for Clinical Disease Assessment via a Physics-Conditioned Neural Operator

Self-supervised learning in healthcare has largely relied on invariance-based objectives, which maximize similarity between different views of the same patient. While effective for static anatomy, this paradigm is fundamentally misaligned with clinical diagnosis, as it mathematically compels the model to suppress the transient pathological changes it is intended to detect. We propose a shift towards Action-Conditioned World Models that learn to simulate the dynamics of disease progression, or Event-Conditioned. Adapting the LeJEPA framework to physiological time-series, we define pathology not as a static label, but as a transition vector acting on a patient's latent state. By predicting the future electrophysiological state of the heart given a disease onset, our model explicitly disentangles stable anatomical features from dynamic pathological forces. Evaluated on the MIMIC-IV-ECG dataset, our approach outperforms fully supervised baselines on the critical triage task. Crucially, we demonstrate superior sample efficiency: in low-resource regimes, our world model outperforms supervised learning by over 0.05 AUROC. These results suggest that modeling biological dynamics provides a dense supervision signal that is far more robust than static classification. Source code is available at https://github.com/cljosegfer/lesaude-dynamics

Personalized virtual heart simulations face challenges in model personalization and computational cost. While neural surrogates offer state-of-the-art solutions, they typically address either efficient personalization or training generalizable models. Recent work reframes this by learning the process of personalizing a surrogate using limited subject-specific context data, through few-shot generative modeling with set-conditioned surrogates and meta-learned amortized inference. These methods, however, assume a static and diverse training distribution with known task identifiers. When new data becomes available, they require costly retraining with all prior data to avoid catastrophic forgetting - a phenomena where the model forgets earlier tasks when trained on new ones. This is a major limitation in clinical settings where often unlabeled data arrives sequentially and full retraining is infeasible. This paper presents a new continual meta-learning framework to achieve personalized neural surrogates able to not only continually integrate information but also identify whether incoming data stems from a known or unknown dynamics source. By leveraging a continual Bayesian Gaussian Mixture Model over a memory buffer, our framework can infer the identifiers and relationships of data over time - required for effective meta-learning. Empirical results on synthetic cardiac data demonstrate superior simulation forecasting, computational scalability, and resilience to catastrophic forgetting compared to existing baselines.

Continuous hemodynamic monitoring guides treatment decisions in surgery and intensive care. However, gold-standard signals are only measured in severe cases due to risks associated with invasive measurement. In this work, we introduce HIPNO (Hemodynamic Inference via Physics-informed Neural Operators) to recover hemodynamic state from ubiquitous, non-invasive signals and expand access to advanced monitoring. HIPNO addresses a problem of scale symmetry in physics-informed hemodynamic inference, where different combinations of flow, resistance, and compliance can generate the same observed pressure. We identify the symmetry group of the observation model and parameterize the network in its quotient space. For the 3-element Windkessel model, the quotient coordinates are the compliance-normalized flow $U=Q/C$, the decay time constant $τ_{WK}=R_2 C$, and the characteristic-impedance coordinate $κ=R_1 C$. Across 945499 intraoperative windows from 2562 patients, HIPNO predicts $τ_{wave}$, a proxy for vascular decay derived from pressure, with 32% lower error on the log scale than a population baseline while preserving mean arterial pressure accuracy. Because vascular decay and flow drive occupy separate coordinates, counterfactual perturbations produce the expected directional responses in at least 90% of windows in almost all prespecified scenarios, a separation unavailable to pressure-only baselines. The coordinates are also used as inputs to a calibration model for monitored cardiac output. Finally, the formulation identifies the external compliance or flow reference required to recover absolute physical scale.