Yue Zhang1, Vicky Y Wang2, Ashley E Morgan3, Jiwon Kim4, Romina Tafreshi4, Arthur W Wallace5, Julius M Guccione6, Jonathan W Weinsaft4, Liang Ge2, Mark B Ratcliffe7. 1. San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA. 2. Department of Surgery, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA. 3. Department of Surgery, University of Utah, Salt Lake City, UT, USA. 4. Department of Medicine, Weill Cornell Medicine, New York, NY, USA. 5. Department of Anesthesia, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA. 6. Department of Surgery, University of California, San Francisco, CA, USA; Department of Bioengineering, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA. 7. Department of Surgery, University of California, San Francisco, CA, USA; Department of Bioengineering, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA. Electronic address: mark.ratcliffe@va.gov.
Abstract
INTRODUCTION: Left ventricular (LV) diastolic dysfunction (DD) is common after myocardial infarction (MI). Whereas current clinical assessment of DD relies on indirect markers including LV filling, finite element (FE) -based computational modeling directly measures regional diastolic stiffness. We hypothesized that an inverse deformation gradient (DG) method calculation of diastolic strain (IDGDS) allows the FE model-based calculation of regional diastolic stiffness (material parameters; MP) in post-MI patients with DD. METHODS: Cardiac magnetic resonance (CMR) with tags (CSPAMM) and late gadolinium enhancement (LGE) was performed in 10 patients with post-MI DD and 10 healthy volunteers. The 3-dimensional (3D) LV DG from end-diastole (ED) to early diastolic filling (EDF; DGED→EDF) was calculated from CSPAMM. Diastolic strain was calculated from DGEDF→ED by inverting the DGED→EDF. FE models were created with MI and non-MI (remote; RM) regions determined by LGE. Guccione MPs C, and exponential fiber, bf, and transverse, bt , terms were optimized with IDGDS strain. RESULTS: 3D circumferential and longitudinal diastolic strain (Ecc;Ell) calculated using IDGDS in CSPAMM obtained in volunteers and MI patients were [Formula: see text] = 0.27 ± 0.01, [Formula: see text] = 0.24 ± 0.03 and [Formula: see text] = 0.21 ± 0.02, and [Formula: see text] = 0.15 ± 0.02, respectively. MPs in the volunteer group were CH = 0.013 [0.001, 0.235] kPa, [Formula: see text] = 20.280 ± 4.994, and [Formula: see text] = 7.460 ± 2.171 and CRM = 0.0105 [0.010, 0.011] kPa, [Formula: see text] = 50.786 ± 13.511 (p = 0.0846), and [Formula: see text] = 17.355 ± 2.743 (p = 0.0208) in the remote myocardium of post-MI patients. CONCLUSION: Diastolic strain, calculated from CSPAMM with IDGDS, enables calculation of FE model-based regional diastolic material parameters. Transverse stiffness of the remote myocardium, , may be a valuable new metric for determination of DD in patients after MI. Published by Elsevier Ltd.
INTRODUCTION:Left ventricular (LV) diastolic dysfunction (DD) is common after myocardial infarction (MI). Whereas current clinical assessment of DD relies on indirect markers including LV filling, finite element (FE) -based computational modeling directly measures regional diastolic stiffness. We hypothesized that an inverse deformation gradient (DG) method calculation of diastolic strain (IDGDS) allows the FE model-based calculation of regional diastolic stiffness (material parameters; MP) in post-MI patients with DD. METHODS: Cardiac magnetic resonance (CMR) with tags (CSPAMM) and late gadolinium enhancement (LGE) was performed in 10 patients with post-MI DD and 10 healthy volunteers. The 3-dimensional (3D) LV DG from end-diastole (ED) to early diastolic filling (EDF; DGED→EDF) was calculated from CSPAMM. Diastolic strain was calculated from DGEDF→ED by inverting the DGED→EDF. FE models were created with MI and non-MI (remote; RM) regions determined by LGE. Guccione MPs C, and exponential fiber, bf, and transverse, bt , terms were optimized with IDGDS strain. RESULTS: 3D circumferential and longitudinal diastolic strain (Ecc;Ell) calculated using IDGDS in CSPAMM obtained in volunteers and MI patients were [Formula: see text] = 0.27 ± 0.01, [Formula: see text] = 0.24 ± 0.03 and [Formula: see text] = 0.21 ± 0.02, and [Formula: see text] = 0.15 ± 0.02, respectively. MPs in the volunteer group were CH = 0.013 [0.001, 0.235] kPa, [Formula: see text] = 20.280 ± 4.994, and [Formula: see text] = 7.460 ± 2.171 and CRM = 0.0105 [0.010, 0.011] kPa, [Formula: see text] = 50.786 ± 13.511 (p = 0.0846), and [Formula: see text] = 17.355 ± 2.743 (p = 0.0208) in the remote myocardium of post-MI patients. CONCLUSION: Diastolic strain, calculated from CSPAMM with IDGDS, enables calculation of FE model-based regional diastolic material parameters. Transverse stiffness of the remote myocardium, , may be a valuable new metric for determination of DD in patients after MI. Published by Elsevier Ltd.
Entities:
Keywords:
Computer simulation; Diastolic dysfunction; Finite element analysis; Magnetic resonance; Myocardial infarction
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