Patient-specific models of cardiac biomechanics

JOURNAL OF COMPUTATIONAL PHYSICS

卷:244

Article

Krishnamurthy, Adarsh¹  Villongco, Christopher T.¹  Chuang, Joyce¹  Frank, Lawrence R.^4,6  Nigam, Vishal^3,6  Belezzuoli, Ernest^4,6  Stark, Paul^4,6  Krummen, David E.^2,6  Narayan, Sanjiv^2,6  Omens, Jeffrey H.^1,2,5  McCulloch, Andrew D.^1,2,5  Kerckhoffs, Roy C. P.^1,5 

[1] Univ Calif San Diego, Dept Bioengn, San Diego, CA 92103 USA

[2] Univ Calif San Diego, Dept Med Cardiol, San Diego, CA 92103 USA

[3] Univ Calif San Diego, Dept Pediat, San Diego, CA 92103 USA

[4] Univ Calif San Diego, Dept Radiol, San Diego, CA 92103 USA

[5] Univ Calif San Diego, Cardiac Biomed Sci & Engn Ctr, San Diego, CA 92103 USA

[6] Vet Affairs Med Ctr, San Diego, CA 92161 USA

关键词: Patient-specific models;    Cardiac biomechanics;    Fiber architecture;    Unloaded geometry;    Finite elements;    Heart failure;   

DOI  :  10.1016/j.jcp.2012.09.015

来源: Elsevier

【 摘 要 】

Patient-specific models of cardiac function have the potential to improve diagnosis and management of heart disease by integrating medical images with heterogeneous clinical measurements subject to constraints imposed by physical first principles and prior experimental knowledge. We describe new methods for creating three-dimensional patient-specific models of ventricular biomechanics in the failing heart. Three-dimensional bi-ventricular geometry is segmented from cardiac CT images at end-diastole from patients with heart failure. Human myofiber and sheet architecture is modeled using eigenvectors computed from diffusion tensor MR images from an isolated, fixed human organ-donor heart and transformed to the patient-specific geometric model using large deformation diffeomorphic mapping. Semi-automated methods were developed for optimizing the passive material properties while simultaneously computing the unloaded reference geometry of the ventricles for stress analysis. Material properties of active cardiac muscle contraction were optimized to match ventricular pressures measured by cardiac catheterization, and parameters of a lumped-parameter closed-loop model of the circulation were estimated with a circulatory adaptation algorithm making use of information derived from echocardiography. These components were then integrated to create a multi-scale model of the patient-specific heart. These methods were tested in five heart failure patients from the San Diego Veteran's Affairs Medical Center who gave informed consent. The simulation results showed good agreement with measured echocardiographic and global functional parameters such as ejection fraction and peak cavity pressures. (c) 2012 Elsevier Inc. All rights reserved.

【 授权许可】

Free