Abnormal Tissue Zone Detection and Average Active Stress Estimation in Patients with LV Dysfunction

Abstract

Detection of regional ventricular dysfunction is a challenging problem. This study presents an efficient method based on ultrasound (US) imaging and finite element (FE) analysis, for detecting akinetic and dyskinetic regions in the left ventricle (LV). The underlying hypothesis is that the contraction of a healthy LV is approximately homogeneous. Therefore, any deviations between the image-based measured deformation and a homogeneous contraction FE model should correspond to a pathological region. The method was first successfully applied to synthetic data simulating an acute ischemia; it demonstrated that the pathological areas were revealed with a higher contrast than those observed directly in the deformation maps. The technique was then applied to a cohort of eight left bundle branch block (LBBB) patients. For this group, the heterogeneities were significantly less pronounced than those revealed for the synthetic cases but the method was still able to identify the abnormal regions of the LV. This study indicated the potential clinical utility of the method by its simplicity in a patient-specific context and its ability to quickly identify various heterogeneities in LV function. Further studies are required to determine the model accuracy in other pathologies and to investigate its robustness to noise and image artifacts.