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Wang Y, Yin X. Modelling coronary flow and myocardial perfusion by integrating a structured-tree coronary flow model and a hyperelastic left ventricle model. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 243:107928. [PMID: 38000321 DOI: 10.1016/j.cmpb.2023.107928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/02/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND AND OBJECTIVE There is an increasing demand to establish integrated computational models that facilitate the exploration of coronary circulation in physiological and pathological contexts, particularly concerning interactions between coronary flow dynamics and myocardial motion. The field of cardiology has also demonstrated a trend toward personalised medicine, where these integrated models can be instrumental in integrating patient-specific data to improve therapeutic outcomes. Notably, incorporating a structured-tree model into such integrated models is currently absent in the literature, which presents a promising prospect. Thus, the goal here is to develop a novel computational framework that combines a 1D structured-tree model of coronary flow in human coronary vasculature with a 3D left ventricle model utilising a hyperelastic constitutive law, enabling the physiologically accurate simulation of coronary flow dynamics. METHODS We adopted detailed geometric information from previous studies of both coronary vasculature and left ventricle to construct the coronary flow model and the left ventricle model. The structured-tree model for coronary flow was expanded to encompass the effect of time-varying intramyocardial pressure on intramyocardial blood vessels. Simultaneously, the left ventricle model served as a robust foundation for the calculation of intramyocardial pressure and subsequent quantitative evaluation of myocardial perfusion. A one-way coupling framework between the two models was established to enable the evaluation and examination of coronary flow dynamics and myocardial perfusion. RESULTS Our predicted coronary flow waveforms aligned well with published experimental data. Our model precisely captured the phasic pattern of coronary flow, including impeded or even reversed flow during systole. Moreover, our assessment of coronary flow, considering both globally and regionally averaged intramyocardial pressure, demonstrated that elevated intramyocardial pressure corresponds to increased impeding effects on coronary flow. Furthermore, myocardial blood flow simulated from our model was comparable with MRI perfusion data at rest, showcasing the capability of our model to predict myocardial perfusion. CONCLUSIONS The integrated model introduced in this study presents a novel approach to achieving physiologically accurate simulations of coronary flow and myocardial perfusion. It holds promise for its clinical applicability in diagnosing insufficient myocardial perfusion.
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Affiliation(s)
- Yingjie Wang
- School of Mathematics and Statistics, University of Glasgow, Glasgow, United Kingdom.
| | - Xueqing Yin
- School of Mathematics and Statistics, University of Glasgow, Glasgow, United Kingdom
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Koopsen T, Van Osta N, Van Loon T, Van Nieuwenhoven FA, Prinzen FW, Van Klarenbosch BR, Kirkels FP, Teske AJ, Vernooy K, Delhaas T, Lumens J. A Lumped Two-Compartment Model for Simulation of Ventricular Pump and Tissue Mechanics in Ischemic Heart Disease. Front Physiol 2022; 13:782592. [PMID: 35634163 PMCID: PMC9130776 DOI: 10.3389/fphys.2022.782592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/10/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: Computational modeling of cardiac mechanics and hemodynamics in ischemic heart disease (IHD) is important for a better understanding of the complex relations between ischemia-induced heterogeneity of myocardial tissue properties, regional tissue mechanics, and hemodynamic pump function. We validated and applied a lumped two-compartment modeling approach for IHD integrated into the CircAdapt model of the human heart and circulation. Methods: Ischemic contractile dysfunction was simulated by subdividing a left ventricular (LV) wall segment into a hypothetical contractile and noncontractile compartment, and dysfunction severity was determined by the noncontractile volume fraction (NCVF). Myocardial stiffness was determined by the zero-passive stress length (Ls0,pas) and nonlinearity (kECM) of the passive stress-sarcomere length relation of the noncontractile compartment. Simulated end-systolic pressure volume relations (ESPVRs) for 20% acute ischemia were qualitatively compared between a two- and one-compartment simulation, and parameters of the two-compartment model were tuned to previously published canine data of regional myocardial deformation during acute and prolonged ischemia and reperfusion. In six patients with myocardial infarction (MI), the NCVF was automatically estimated using the echocardiographic LV strain and volume measurements obtained acutely and 6 months after MI. Estimated segmental NCVF values at the baseline and 6-month follow-up were compared with percentage late gadolinium enhancement (LGE) at 6-month follow-up. Results: Simulation of 20% of NCVF shifted the ESPVR rightward while moderately reducing the slope, while a one-compartment simulation caused a leftward shift with severe reduction in the slope. Through tuning of the NCVF, Ls0,pas, and kECM, it was found that manipulation of the NCVF alone reproduced the deformation during acute ischemia and reperfusion, while additional manipulations of Ls0,pas and kECM were required to reproduce deformation during prolonged ischemia and reperfusion. Out of all segments with LGE>25% at the follow-up, the majority (68%) had higher estimated NCVF at the baseline than at the follow-up. Furthermore, the baseline NCVF correlated better with percentage LGE than NCVF did at the follow-up. Conclusion: We successfully used a two-compartment model for simulation of the ventricular pump and tissue mechanics in IHD. Patient-specific optimizations using regional myocardial deformation estimated the NCVF in a small cohort of MI patients in the acute and chronic phase after MI, while estimated NCVF values closely approximated the extent of the myocardial scar at the follow-up. In future studies, this approach can facilitate deformation imaging–based estimation of myocardial tissue properties in patients with cardiovascular diseases.
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Affiliation(s)
- Tijmen Koopsen
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- *Correspondence: Tijmen Koopsen,
| | - Nick Van Osta
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Tim Van Loon
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Frans A. Van Nieuwenhoven
- Department of Physiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Frits W. Prinzen
- Department of Physiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Bas R. Van Klarenbosch
- Division of Heart and Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Feddo P. Kirkels
- Division of Heart and Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Arco J. Teske
- Division of Heart and Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Kevin Vernooy
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, Netherlands
- Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Tammo Delhaas
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Joost Lumens
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
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Goonoo N. Tunable Biomaterials for Myocardial Tissue Regeneration: Promising New Strategies for Advanced Biointerface Control and Improved Therapeutic Outcomes. Biomater Sci 2022; 10:1626-1646. [DOI: 10.1039/d1bm01641e] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Following myocardial infarction (MI) and the natural healing process, the cardiac mechanostructure changes significantly leading to reduced contractile ability and putting additional pressure on the heart muscle thereby increasing the...
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Leong CO, Leong CN, Liew YM, Al Abed A, Aziz YFA, Chee KH, Sridhar GS, Dokos S, Lim E. The role of regional myocardial topography post-myocardial infarction on infarct extension. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2021; 37:e3501. [PMID: 34057819 DOI: 10.1002/cnm.3501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 04/26/2021] [Accepted: 05/28/2021] [Indexed: 06/12/2023]
Abstract
Infarct extension involves necrosis of healthy myocardium in the border zone (BZ), progressively enlarging the infarct zone (IZ) and recruiting the remote zone (RZ) into the BZ, eventually leading to heart failure. The mechanisms underlying infarct extension remain unclear, but myocyte stretching has been suggested as the most likely cause. Using human patient-specific left-ventricular (LV) numerical simulations established from cardiac magnetic resonance imaging (MRI) of myocardial infarction (MI) patients, the correlation between infarct extension and regional mechanics abnormality was investigated by analysing the fibre stress-strain loops (FSSLs). FSSL abnormality was characterised using the directional regional external work (DREW) index, which measures FSSL area and loop direction. Sensitivity studies were also performed to investigate the effect of infarct stiffness on regional myocardial mechanics and potential for infarct extension. We found that infarct extension was correlated to severely abnormal FSSL in the form of counter-clockwise loop at the RZ close to the infarct, as indicated by negative DREW values. In regions demonstrating negative DREW values, we observed substantial fibre stretching in the isovolumic relaxation (IVR) phase accompanied by a reduced rate of systolic shortening. Such stretching in IVR phase in part of the RZ was due to its inability to withstand the high LV pressure that was still present and possibly caused by regional myocardial stiffness inhomogeneity. Further analysis revealed that the occurrence of severely abnormal FSSL due to IVR fibre stretching near the RZ-BZ boundary was due to a large amount of surrounding infarcted tissue, or an excessively stiff IZ.
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Affiliation(s)
- Chen Onn Leong
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Chin Neng Leong
- Graduate School of Biomedical Engineering, Faculty of Engineering, University of New South Wales, Sydney, New South Wales, Australia
| | - Yih Miin Liew
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Amr Al Abed
- Graduate School of Biomedical Engineering, Faculty of Engineering, University of New South Wales, Sydney, New South Wales, Australia
| | - Yang Faridah Abdul Aziz
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- University Malaya Research Imaging Centre, University of Malaya, Kuala Lumpur, Malaysia
| | - Kok Han Chee
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Socrates Dokos
- Graduate School of Biomedical Engineering, Faculty of Engineering, University of New South Wales, Sydney, New South Wales, Australia
| | - Einly Lim
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
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Park C, Fan Y, Hager G, Yuk H, Singh M, Rojas A, Hameed A, Saeed M, Vasilyev NV, Steele TWJ, Zhao X, Nguyen CT, Roche ET. An organosynthetic dynamic heart model with enhanced biomimicry guided by cardiac diffusion tensor imaging. Sci Robot 2020; 5:eaay9106. [PMID: 33022595 PMCID: PMC7545316 DOI: 10.1126/scirobotics.aay9106] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 01/08/2020] [Indexed: 01/07/2023]
Abstract
The complex motion of the beating heart is accomplished by the spatial arrangement of contracting cardiomyocytes with varying orientation across the transmural layers, which is difficult to imitate in organic or synthetic models. High-fidelity testing of intracardiac devices requires anthropomorphic, dynamic cardiac models that represent this complex motion while maintaining the intricate anatomical structures inside the heart. In this work, we introduce a biorobotic hybrid heart that preserves organic intracardiac structures and mimics cardiac motion by replicating the cardiac myofiber architecture of the left ventricle. The heart model is composed of organic endocardial tissue from a preserved explanted heart with intact intracardiac structures and an active synthetic myocardium that drives the motion of the heart. Inspired by the helical ventricular myocardial band theory, we used diffusion tensor magnetic resonance imaging and tractography of an unraveled organic myocardial band to guide the design of individual soft robotic actuators in a synthetic myocardial band. The active soft tissue mimic was adhered to the organic endocardial tissue in a helical fashion using a custom-designed adhesive to form a flexible, conformable, and watertight organosynthetic interface. The resulting biorobotic hybrid heart simulates the contractile motion of the native heart, compared with in vivo and in silico heart models. In summary, we demonstrate a unique approach fabricating a biomimetic heart model with faithful representation of cardiac motion and endocardial tissue anatomy. These innovations represent important advances toward the unmet need for a high-fidelity in vitro cardiac simulator for preclinical testing of intracardiac devices.
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Affiliation(s)
- Clara Park
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Yiling Fan
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Gregor Hager
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Mechanical Engineering, Technical University of Munich, Munich, Germany
| | - Hyunwoo Yuk
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Manisha Singh
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
- NTU-Northwestern Institute for Nanomedicine, Interdisciplinary Graduate School, Nanyang Technological University, Singapore, Singapore
| | - Allison Rojas
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Aamir Hameed
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, Dublin, Ireland
- Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin, Ireland
| | - Mossab Saeed
- Harvard Medical School, Boston, MA, USA
- Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Nikolay V Vasilyev
- Harvard Medical School, Boston, MA, USA
- Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Terry W J Steele
- NTU-Northwestern Institute for Nanomedicine, Interdisciplinary Graduate School, Nanyang Technological University, Singapore, Singapore
- School of Materials Science and Engineering, Nanyang Technological University, Singapore, Singapore
| | - Xuanhe Zhao
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Christopher T Nguyen
- Harvard Medical School, Boston, MA, USA.
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA, USA
| | - Ellen T Roche
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Harvard Medical School, Boston, MA, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
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