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Fan L, Choy JS, Cai C, Teague SD, Guccione J, Lee LC, Kassab GS. Comparison of Left Ventricular Function Derived from Subject-Specific Inverse Finite Element Modeling Based on 3D ECHO and Magnetic Resonance Images. Bioengineering (Basel) 2024; 11:735. [PMID: 39061817 PMCID: PMC11273843 DOI: 10.3390/bioengineering11070735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/05/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Three-dimensional echocardiography (3D ECHO) and magnetic resonance (MR) imaging are frequently used in patients and animals to evaluate heart functions. Inverse finite element (FE) modeling is increasingly applied to MR images to quantify left ventricular (LV) function and estimate myocardial contractility and other cardiac biomarkers. It remains unclear, however, as to whether myocardial contractility derived from the inverse FE model based on 3D ECHO images is comparable to that derived from MR images. To address this issue, we developed a subject-specific inverse FE model based on 3D ECHO and MR images acquired from seven healthy swine models to investigate if there are differences in myocardial contractility and LV geometrical features derived using these two imaging modalities. We showed that end-systolic and end-diastolic volumes derived from 3D ECHO images are comparable to those derived from MR images (R2=0.805 and 0.969, respectively). As a result, ejection fraction from 3D ECHO and MR images are linearly correlated (R2=0.977) with the limit of agreement (LOA) ranging from -17.95% to 45.89%. Using an inverse FE modeling to fit pressure and volume waveforms in subject-specific LV geometry reconstructed from 3D ECHO and MR images, we found that myocardial contractility derived from these two imaging modalities are linearly correlated with an R2 value of 0.989, a gradient of 0.895, and LOA ranging from -6.11% to 36.66%. This finding supports using 3D ECHO images in image-based inverse FE modeling to estimate myocardial contractility.
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Affiliation(s)
- Lei Fan
- Joint Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI 53233, USA; (L.F.); (C.C.)
| | - Jenny S. Choy
- California Medical Innovations Institute, San Diego, CA 92121, USA;
| | - Chenghan Cai
- Joint Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI 53233, USA; (L.F.); (C.C.)
| | - Shawn D. Teague
- Department of Radiology, National Jewish Health, Denver, CO 80206, USA;
| | - Julius Guccione
- Department of Surgery, University of California at San Francisco, San Francisco, CA 94143, USA;
| | - Lik Chuan Lee
- Department of Mechanical Engineering, Michigan State University, East Lansing, MI 48824, USA;
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2
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Zheng Y, Chan WX, Charles CJ, Richards AM, Lee LC, Leo HL, Yap CH. Morphological, functional, and biomechanical progression of LV remodelling in a porcine model of HFpEF. J Biomech 2022; 144:111348. [DOI: 10.1016/j.jbiomech.2022.111348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/24/2022] [Accepted: 10/03/2022] [Indexed: 10/31/2022]
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3
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Berberoğlu E, Stoeck CT, Moireau P, Kozerke S, Genet M. In-silico study of accuracy and precision of left-ventricular strain quantification from 3D tagged MRI. PLoS One 2021; 16:e0258965. [PMID: 34739495 PMCID: PMC8570486 DOI: 10.1371/journal.pone.0258965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 10/08/2021] [Indexed: 11/18/2022] Open
Abstract
Cardiac Magnetic Resonance Imaging (MRI) allows quantifying myocardial tissue deformation and strain based on the tagging principle. In this work, we investigate accuracy and precision of strain quantification from synthetic 3D tagged MRI using equilibrated warping. To this end, synthetic biomechanical left-ventricular tagged MRI data with varying tag distance, spatial resolution and signal-to-noise ratio (SNR) were generated and processed to quantify errors in radial, circumferential and longitudinal strains relative to ground truth. Results reveal that radial strain is more sensitive to image resolution and noise than the other strain components. The study also shows robustness of quantifying circumferential and longitudinal strain in the presence of geometrical inconsistencies of 3D tagged data. In conclusion, our study points to the need for higher-resolution 3D tagged MRI than currently available in practice in order to achieve sufficient accuracy of radial strain quantification.
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Affiliation(s)
- Ezgi Berberoğlu
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Christian T. Stoeck
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Philippe Moireau
- MΞDISIM team, Inria, Palaiseau, France
- Laboratoire de Mécanique des Solides (LMS), École Polytechnique, C.N.R.S., Institut Polytechnique de Paris, Palaiseau, France
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Martin Genet
- MΞDISIM team, Inria, Palaiseau, France
- Laboratoire de Mécanique des Solides (LMS), École Polytechnique, C.N.R.S., Institut Polytechnique de Paris, Palaiseau, France
- * E-mail:
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4
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Weissmann J, Charles CJ, Richards AM, Yap CH, Marom G. Cardiac mesh morphing method for finite element modeling of heart failure with preserved ejection fraction. J Mech Behav Biomed Mater 2021; 126:104937. [PMID: 34979481 DOI: 10.1016/j.jmbbm.2021.104937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/21/2021] [Accepted: 10/24/2021] [Indexed: 10/20/2022]
Abstract
Numerical modeling of heart biomechanics can realistically capture morphological variations in diseases and has been helpful in advancing our understanding of the physiology. Subject-specific models require anatomic representation of medical images, and it is desirable to have a consistently repeatable models for any given morphology. In this study, we propose a novel and easily adaptable cardiac reconstruction algorithm by morphing an existing discretized mesh of an advanced finite element (FE) model, to match anatomies acquired from porcine cardiac magnetic resonance imaging (cMRI) scans. The morphing algorithm involves iterative FE simulations with visco-hyperelastic material properties. The living heart porcine model (LHPM) was chosen as the input baseline FE mesh, in order to preserve detailed anatomical features that cannot be captured in routine scans such as myofiber orientations and conduction pathways. The algorithm was demonstrated for the recreation of porcine hearts of a healthy subject and of a subject induced with heart failure with preserved ejection fraction (HFpEF) conditions, where there were substantial hypertrophy and anatomical alterations. We further used the morphed meshes for FE modeling of cardiac contraction and relaxation, thus demonstrating the applicability of the proposed algorithm in producing viable meshes. The results show that our algorithm can recreate the characteristic anatomical changes of cardiac remodeling, including heart muscle thickening, as well as replicate the reduction in ventricular volume. This algorithm allows for the creation of subject-specific models with the same mesh connectivity, thus enabling spatial comparison and analysis of pathologic progress.
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Affiliation(s)
| | - Christopher J Charles
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Cardiovascular Research Institute, National University of Singapore, Singapore; Christchurch Heart Institute, Department of Medicine, University of Otago, Christchurch, New Zealand
| | - A Mark Richards
- Cardiovascular Research Institute, National University of Singapore, Singapore; Christchurch Heart Institute, Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Choon Hwai Yap
- Department of Bioengineering, Imperial College London, UK
| | - Gil Marom
- School of Mechanical Engineering, Tel Aviv University, Israel.
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5
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Sharifi Kia D, Kim K, Simon MA. Current Understanding of the Right Ventricle Structure and Function in Pulmonary Arterial Hypertension. Front Physiol 2021; 12:641310. [PMID: 34122125 PMCID: PMC8194310 DOI: 10.3389/fphys.2021.641310] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/30/2021] [Indexed: 12/20/2022] Open
Abstract
Pulmonary arterial hypertension (PAH) is a disease resulting in increased right ventricular (RV) afterload and RV remodeling. PAH results in altered RV structure and function at different scales from organ-level hemodynamics to tissue-level biomechanical properties, fiber-level architecture, and cardiomyocyte-level contractility. Biomechanical analysis of RV pathophysiology has drawn significant attention over the past years and recent work has found a close link between RV biomechanics and physiological function. Building upon previously developed techniques, biomechanical studies have employed multi-scale analysis frameworks to investigate the underlying mechanisms of RV remodeling in PAH and effects of potential therapeutic interventions on these mechanisms. In this review, we discuss the current understanding of RV structure and function in PAH, highlighting the findings from recent studies on the biomechanics of RV remodeling at organ, tissue, fiber, and cellular levels. Recent progress in understanding the underlying mechanisms of RV remodeling in PAH, and effects of potential therapeutics, will be highlighted from a biomechanical perspective. The clinical relevance of RV biomechanics in PAH will be discussed, followed by addressing the current knowledge gaps and providing suggested directions for future research.
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Affiliation(s)
- Danial Sharifi Kia
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kang Kim
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States.,Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.,Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.,Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh - University of Pittsburgh Medical Center, Pittsburgh, PA, United States.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA, United States.,Center for Ultrasound Molecular Imaging and Therapeutics, University of Pittsburgh, Pittsburgh, PA, United States
| | - Marc A Simon
- Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
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6
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Shavik SM, Wall S, Sundnes J, Guccione JM, Sengupta P, Solomon SD, Burkhoff D, Lee LC. Computational Modeling Studies of the Roles of Left Ventricular Geometry, Afterload, and Muscle Contractility on Myocardial Strains in Heart Failure with Preserved Ejection Fraction. J Cardiovasc Transl Res 2021; 14:1131-1145. [PMID: 33928526 DOI: 10.1007/s12265-021-10130-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/21/2021] [Indexed: 02/08/2023]
Abstract
Global longitudinal strain and circumferential strain are found to be reduced in HFpEF, which some have interpreted that the global left ventricular (LV) contractility is impaired. This finding is, however, contradicted by a preserved ejection fraction (EF) and confounded by changes in LV geometry and afterload resistance that may also affect the global strains. To reconcile these issues, we used a validated computational framework consisting of a finite element LV model to isolate the effects of HFpEF features in affecting systolic function metrics. Simulations were performed to quantify the effects on myocardial strains due to changes in LV geometry, active tension developed by the tissue, and afterload. We found that only a reduction in myocardial contractility and an increase in afterload can simultaneously reproduce the blood pressures, EF and strains measured in HFpEF patients. This finding suggests that it is likely that the myocardial contractility is reduced in HFpEF patients. Graphical abstract.
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Affiliation(s)
- Sheikh Mohammad Shavik
- Department of Mechanical Engineering, Michigan State University, 428 S Shaw Lane, East Lansing, MI, 48824, USA.,Department of Mechanical Engineering, Bangladesh University of Engineering and Technology, Dhaka, 1000, Bangladesh
| | | | | | - Julius M Guccione
- Department of Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - Partho Sengupta
- Division of Cardiology, West Virginia Heart and Vascular Institute, Morgantown, WV, USA
| | - Scott D Solomon
- Brigham and Women's Hospital Division of Cardiovascular Medicine and Harvard Medical School, Boston, MA, USA
| | | | - Lik Chuan Lee
- Department of Mechanical Engineering, Michigan State University, 428 S Shaw Lane, East Lansing, MI, 48824, USA.
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7
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Perotti LE, Verzhbinsky IA, Moulin K, Cork TE, Loecher M, Balzani D, Ennis DB. Estimating cardiomyofiber strain in vivo by solving a computational model. Med Image Anal 2021; 68:101932. [PMID: 33383331 PMCID: PMC7956226 DOI: 10.1016/j.media.2020.101932] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 11/22/2020] [Accepted: 11/27/2020] [Indexed: 11/19/2022]
Abstract
Since heart contraction results from the electrically activated contraction of millions of cardiomyocytes, a measure of cardiomyocyte shortening mechanistically underlies cardiac contraction. In this work we aim to measure preferential aggregate cardiomyocyte ("myofiber") strains based on Magnetic Resonance Imaging (MRI) data acquired to measure both voxel-wise displacements through systole and myofiber orientation. In order to reduce the effect of experimental noise on the computed myofiber strains, we recast the strains calculation as the solution of a boundary value problem (BVP). This approach does not require a calibrated material model, and consequently is independent of specific myocardial material properties. The solution to this auxiliary BVP is the displacement field corresponding to assigned values of myofiber strains. The actual myofiber strains are then determined by minimizing the difference between computed and measured displacements. The approach is validated using an analytical phantom, for which the ground-truth solution is known. The method is applied to compute myofiber strains using in vivo displacement and myofiber MRI data acquired in a mid-ventricular left ventricle section in N=8 swine subjects. The proposed method shows a more physiological distribution of myofiber strains compared to standard approaches that directly differentiate the displacement field.
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Affiliation(s)
- Luigi E Perotti
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL, USA.
| | - Ilya A Verzhbinsky
- Department of Radiology, Stanford University, Stanford, CA, USA; Medical Scientist Training Program, University of California, San Diego, La Jolla, USA
| | - Kévin Moulin
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Tyler E Cork
- Department of Radiology, Stanford University, Stanford, CA, USA; Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Michael Loecher
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Daniel Balzani
- Chair of Continuum Mechanics, Ruhr University Bochum, Bochum, Germany
| | - Daniel B Ennis
- Department of Radiology, Stanford University, Stanford, CA, USA
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8
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Zou H, Leng S, Xi C, Zhao X, Koh AS, Gao F, Tan JL, Tan RS, Allen JC, Lee LC, Genet M, Zhong L. Three-dimensional biventricular strains in pulmonary arterial hypertension patients using hyperelastic warping. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 189:105345. [PMID: 31982668 PMCID: PMC7198336 DOI: 10.1016/j.cmpb.2020.105345] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 01/16/2020] [Accepted: 01/16/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Evaluation of biventricular function is an essential component of clinical management in pulmonary arterial hypertension (PAH). This study aims to examine the utility of biventricular strains derived from a model-to-image registration technique in PAH patients in comparison to age- and gender-matched normal controls. METHODS A three-dimensional (3D) model was reconstructed from cine short- and long-axis cardiac magnetic resonance (CMR) images and subsequently partitioned into right ventricle (RV), left ventricle (LV) and septum. The hyperelastic warping method was used to register the meshed biventricular finite element model throughout the cardiac cycle and obtain the corresponding biventricular circumferential, longitudinal and radial strains. RESULTS Intra- and inter-observer reproducibility of biventricular strains was excellent with all intra-class correlation coefficients > 0.84. 3D biventricular longitudinal, circumferential and radial strains for RV, LV and septum were significantly decreased in PAH patients compared with controls. Receiver operating characteristic (ROC) analysis showed that the 3D biventricular strains were better early markers (Area under the ROC curve = 0.96 for RV longitudinal strain) of ventricular dysfunction than conventional parameters such as two-dimensional strains and ejection fraction. CONCLUSIONS Our highly reproducible methodology holds potential for extending CMR imaging to characterize 3D biventricular strains, eventually leading to deeper understanding of biventricular mechanics in PAH.
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Affiliation(s)
- Hua Zou
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore
| | - Shuang Leng
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore
| | - Ce Xi
- Department of Mechanical Engineering, Michigan State University, MI, United States
| | - Xiaodan Zhao
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore
| | - Angela S Koh
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, Singapore
| | - Fei Gao
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore
| | - Ju Le Tan
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, Singapore
| | - Ru-San Tan
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, Singapore
| | | | - Lik Chuan Lee
- Department of Mechanical Engineering, Michigan State University, MI, United States
| | - Martin Genet
- Mechanics Department & Solid Mechanics Laboratory, École Polytechnique (Paris-Saclay University), Palaiseau, France; M3DISIM research team, INRIA (Paris-Saclay University), Palaiseau, France
| | - Liang Zhong
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, Singapore.
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9
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Zhao X, Teo SK, Zhong L, Leng S, Zhang JM, Low R, Allen J, Koh AS, Su Y, Tan RS. Reference Ranges for Left Ventricular Curvedness and Curvedness-Based Functional Indices Using Cardiovascular Magnetic Resonance in Healthy Asian Subjects. Sci Rep 2020; 10:8465. [PMID: 32439884 PMCID: PMC7242400 DOI: 10.1038/s41598-020-65153-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/27/2020] [Indexed: 11/09/2022] Open
Abstract
Curvature-based three-dimensional cardiovascular magnetic resonance (CMR) allows regional function characterization without an external spatial frame of reference. However, introduction of this modality into clinical practice is hampered by lack of reference values. We aim to establish normal ranges for 3D left ventricular (LV) regional parameters in relation to age and gender for 171 healthy subjects. LV geometrical reconstruction and automatic calculation of regional parameters were implemented by in-house software (CardioWerkz) using stacks of short-axis cine slices. Parameter normal ranges were stratified by gender and age categories (≤44, 45-64, 65-74 and 75-84 years). Our software had excellent intra- and inter-observer agreement. Ageing was significantly associated with increases in end-systolic (ES) curvedness (CES) and area strain (AS) with higher rates of increase in males, end-diastolic (ED) and ES wall thickness (WTED, WTES) with higher rates of increase in females, and reductions in ED and ES wall stress indices (σi,ED) with higher rates of increase in females. Females exhibited greater ED curvedness, CES, σi,ED and AS than males, but smaller WTED and WTES. Age × gender interaction was not observed for any parameter. This study establishes age and gender specific reference values for 3D LV regional parameters using CMR without additional image acquisition.
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Affiliation(s)
- Xiaodan Zhao
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore
| | - Soo-Kng Teo
- Institute of High Performance Computing, Agency for Science, Technology and Research (A*STAR), 1 Fusionopolis Way, #16-16 Connexis, Singapore, 138632, Singapore
| | - Liang Zhong
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore. .,Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
| | - Shuang Leng
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore
| | - Jun-Mei Zhang
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.,Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Ris Low
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore
| | - John Allen
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Angela S Koh
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.,Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Yi Su
- Institute of High Performance Computing, Agency for Science, Technology and Research (A*STAR), 1 Fusionopolis Way, #16-16 Connexis, Singapore, 138632, Singapore
| | - Ru-San Tan
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.,Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
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10
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Liu W, Wang Z. Current Understanding of the Biomechanics of Ventricular Tissues in Heart Failure. Bioengineering (Basel) 2019; 7:E2. [PMID: 31861916 PMCID: PMC7175293 DOI: 10.3390/bioengineering7010002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 12/17/2022] Open
Abstract
Heart failure is the leading cause of death worldwide, and the most common cause of heart failure is ventricular dysfunction. It is well known that the ventricles are anisotropic and viscoelastic tissues and their mechanical properties change in diseased states. The tissue mechanical behavior is an important determinant of the function of ventricles. The aim of this paper is to review the current understanding of the biomechanics of ventricular tissues as well as the clinical significance. We present the common methods of the mechanical measurement of ventricles, the known ventricular mechanical properties including the viscoelasticity of the tissue, the existing computational models, and the clinical relevance of the ventricular mechanical properties. Lastly, we suggest some future research directions to elucidate the roles of the ventricular biomechanics in the ventricular dysfunction to inspire new therapies for heart failure patients.
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Affiliation(s)
- Wenqiang Liu
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO 80523, USA;
| | - Zhijie Wang
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO 80523, USA;
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA
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11
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Finsberg H, Xi C, Zhao X, Tan JL, Genet M, Sundnes J, Lee LC, Zhong L, Wall ST. Computational quantification of patient-specific changes in ventricular dynamics associated with pulmonary hypertension. Am J Physiol Heart Circ Physiol 2019; 317:H1363-H1375. [PMID: 31674809 DOI: 10.1152/ajpheart.00094.2019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Pulmonary arterial hypertension (PAH) causes an increase in the mechanical loading imposed on the right ventricle (RV) that results in progressive changes to its mechanics and function. Here, we quantify the mechanical changes associated with PAH by assimilating clinical data consisting of reconstructed three-dimensional geometry, pressure, and volume waveforms, as well as regional strains measured in patients with PAH (n = 12) and controls (n = 6) within a computational modeling framework of the ventricles. Modeling parameters reflecting regional passive stiffness and load-independent contractility as indexed by the tissue active tension were optimized so that simulation results matched the measurements. The optimized parameters were compared with clinical metrics to find usable indicators associated with the underlying mechanical changes. Peak contractility of the RV free wall (RVFW) γRVFW,max was found to be strongly correlated and had an inverse relationship with the RV and left ventricle (LV) end-diastolic volume ratio (i.e., RVEDV/LVEDV) (RVEDV/LVEDV)+ 0.44, R2 = 0.77). Correlation with RV ejection fraction (R2 = 0.50) and end-diastolic volume index (R2 = 0.40) were comparatively weaker. Patients with with RVEDV/LVEDV > 1.5 had 25% lower γRVFW,max (P < 0.05) than that of the control. On average, RVFW passive stiffness progressively increased with the degree of remodeling as indexed by RVEDV/LVEDV. These results suggest a mechanical basis of using RVEDV/LVEDV as a clinical index for delineating disease severity and estimating RVFW contractility in patients with PAH.NEW & NOTEWORTHY This article presents patient-specific data assimilation of a patient cohort and physical description of clinical observations.
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Affiliation(s)
- Henrik Finsberg
- Simula Research Laboratory, Oslo, Norway.,Center for Cardiological Innovation, Oslo, Norway.,Department of Informatics, University of Oslo, Oslo, Norway
| | - Ce Xi
- Department of Mechanical Engineering, Michigan State University, East Lansing, Michigan
| | | | - Ju Le Tan
- National Heart Center Singapore, Singapore
| | - Martin Genet
- Mechanics Department and Solid Mechanics Laboratory, École Polytechnique/Le Centre national de la recherche scientifique/Paris-Saclay University, Palaiseau, France.,M3DISIM research team, Institut national de recherche en informatique et en automatique/Paris-Saclay University, Palaiseau, France
| | - Joakim Sundnes
- Simula Research Laboratory, Oslo, Norway.,Center for Cardiological Innovation, Oslo, Norway.,Department of Informatics, University of Oslo, Oslo, Norway
| | - Lik Chuan Lee
- Department of Mechanical Engineering, Michigan State University, East Lansing, Michigan
| | - Liang Zhong
- National Heart Center Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore
| | - Samuel T Wall
- Simula Research Laboratory, Oslo, Norway.,Center for Cardiological Innovation, Oslo, Norway
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