CT-Based Simulation of Left Ventricular Hemodynamics: A Pilot Study in Mitral Regurgitation and Left Ventricle Aneurysm Patients

Obermeier, Lukas; Vellguth, Katharina; Schlief, Adriano; Tautz, Lennart; Bruening, Jan; Knosalla, Christoph; Küehne, Titus; Solowjowa, Natalia; Goubergrits, Leonid

doi:10.3389/fcvm.2022.828556

Cited by 11 publications

(39 citation statements)

References 69 publications

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“…To retrieve reasonable initial conditions, two cycles were computed in advance. As results in a previous study suggested, a sufficiently swung-in state can be assumed after two cycles for such dilated LVs with reduced EF ( 29 ). In the same study, mesh convergence was shown for the specified mesh dimensions.…”

Section: Methodsmentioning

confidence: 90%

“…The mean shapes of all seven subcohorts are used to set up the simulation. A detailed description of the workflow can be found in our recently published work ( 29 ). Average shapes are computed for the cardioid mitral annulus and the elliptical aortic annulus which are used to reconstruct the entire LVEDV via a Poisson Surface Reconstruction algorithm.…”

Section: Methodsmentioning

confidence: 99%

“…The regurgitation areas on the MV are chosen such that reasonable pressure losses over the MV result. A detailed description of the BCs as well as their detailed motivation can be found in Obermeier et al ( 29 ).…”

Section: Methodsmentioning

confidence: 99%

“…In comparison to our previous work ( 29 ), we further automated the pre-processing procedures and optimized the time-consuming numerical framework. Pre-processing now required 4–8 h, whereas the cyclic blood flow computation took 12–13 h on 4 nodes at 40 cores (Intel Skylake 6,148, 2.3 GHz) on the Emmy system of the North-German Supercomputing Alliance.…”

Section: Methodsmentioning

confidence: 99%

“…In this work, we complement our previously introduced workflow for the comprehensive Fluid-Structure-Interaction CFD simulations of the LV of an entire heart cycle ( 29 ) by a SSM representation of LV geometry and motion. A cohort of 125 CCT examinations of heart failure patients after myocardial infarction, partly combined with mitral regurgitation (MR), is used for an extensive statistical shape analysis and clustering into seven subcohorts.…”

Section: Introductionmentioning

confidence: 99%

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CT-Based Analysis of Left Ventricular Hemodynamics Using Statistical Shape Modeling and Computational Fluid Dynamics

Goubergrits

Vellguth

Obermeier

et al. 2022

Front. Cardiovasc. Med.

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BackgroundCardiac computed tomography (CCT) based computational fluid dynamics (CFD) allows to assess intracardiac flow features, which are hypothesized as an early predictor for heart diseases and may support treatment decisions. However, the understanding of intracardiac flow is challenging due to high variability in heart shapes and contractility. Using statistical shape modeling (SSM) in combination with CFD facilitates an intracardiac flow analysis. The aim of this study is to prove the usability of a new approach to describe various cohorts.Materials and MethodsCCT data of 125 patients (mean age: 60.6 ± 10.0 years, 16.8% woman) were used to generate SSMs representing aneurysmatic and non-aneurysmatic left ventricles (LVs). Using SSMs, seven group-averaged LV shapes and contraction fields were generated: four representing patients with and without aneurysms and with mild or severe mitral regurgitation (MR), and three distinguishing aneurysmatic patients with true, intermediate aneurysms, and globally hypokinetic LVs. End-diastolic LV volumes of the groups varied between 258 and 347 ml, whereas ejection fractions varied between 21 and 26%. MR degrees varied from 1.0 to 2.5. Prescribed motion CFD was used to simulate intracardiac flow, which was analyzed regarding large-scale flow features, kinetic energy, washout, and pressure gradients.ResultsSSMs of aneurysmatic and non-aneurysmatic LVs were generated. Differences in shapes and contractility were found in the first three shape modes. Ninety percent of the cumulative shape variance is described with approximately 30 modes. A comparison of hemodynamics between all groups found shape-, contractility- and MR-dependent differences. Disturbed blood washout in the apex region was found in the aneurysmatic cases. With increasing MR, the diastolic jet becomes less coherent, whereas energy dissipation increases by decreasing kinetic energy. The poorest blood washout was found for the globally hypokinetic group, whereas the weakest blood washout in the apex region was found for the true aneurysm group.ConclusionThe proposed CCT-based analysis of hemodynamics combining CFD with SSM seems promising to facilitate the analysis of intracardiac flow, thus increasing the value of CCT for diagnostic and treatment decisions. With further enhancement of the computational approach, the methodology has the potential to be embedded in clinical routine workflows and support clinicians.

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Section: Methodsmentioning

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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CT-Based Analysis of Left Ventricular Hemodynamics Using Statistical Shape Modeling and Computational Fluid Dynamics

Goubergrits

Vellguth

Obermeier

et al. 2022

Front. Cardiovasc. Med.

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An Interactive Computational Pipeline to Investigate Ventricular Hemodynamics with Real‐Time Three‐Dimensional Echocardiography and Computational Fluid Dynamics

Thiel,

Verhülsdonk,

Steinseifer

et al. 2024

Engineering Reports

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Blood flow within the ventricle can provide important information on the performance of the heart. The determined blood flow structures are used to extract flow biomarkers to quantify cardiac function. Patient‐specific computational fluid dynamics (CFD) models that import segmented ventricular deformations from noninvasive imaging data for an individualized hemodynamical analysis are often used. However, tedious preprocessing of those geometries is often necessary and decisions on the modeling of the valve and the surrounding vessels have to be made on an individual level. This leads to a lack of reproducibility and usability of the existing computational models. In this work, we introduce IP‐HEART—an interactive and open‐source computational pipeline to perform geometry processing for CFD models of ventricular blood flow. We showcase its use on real‐time three‐dimensional echocardiography data of three patient datasets from two different clinical centers. We outline how different modeling assumptions of the mitral valve can be implemented and quantify their effect on CFD simulations. The results correspond well with clinical data on transvalvular Doppler ultrasound recordings and distinct flow features such as mitral jet and diastolic vortex formation can be observed. The pipeline is accompanied by an extensive video tutorial and freely available code for further use.

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Inter‐model and inter‐modality analysis of left ventricular hemodynamics: Comparative study of two CFD approaches based on echocardiography and magnetic resonance imaging

Obermeier,

Korte,

Vellguth

et al. 2024

GAMM-Mitteilungen

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Computational fluid dynamics (CFD) carry the potential to provide detailed insights into intraventricular hemodynamics and complement in vivo flow measurement techniques. A variety of CFD approaches emerged in recent years, mostly building solely on medical image data as patient‐specific input. While the utilized medical imaging method and chosen CFD approach both influence the computed hemodynamics, thereto related differences are rarely investigated. The present study addresses this issue with an inter‐(imaging)‐modality and inter‐model comparison of intracardiac flow computations. Magnetic resonance imaging (MRI) and transthoracic echocardiography (TTE) data of a volunteer were acquired and used to reconstruct the anatomical structures. For each modality, the reconstructed shapes were applied in two previously introduced CFD approaches to compute whole‐cycle ventricular flow patterns. While both methods involved benefits and challenges, similar valve velocities were computed, being in accordance with in vivo 4D flow MRI and pulsed‐wave Doppler velocity measurements (systolic peak velocity: 1.24–1.26 m/s (MRI), 0.9–1.25 m/s (TTE); diastolic peak velocity: 0.54 m/s (MRI), 0.59–0.75 m/s (TTE)). A detailed flow analysis with vortex formation, kinetic energy, and mid‐ventricular velocities indicated the computed inter‐modality differences to be larger than inter‐method ones. Quantitatively, this could be observed in the direct flow rate ( inter‐modality: 13, inter‐method, 3). These results help to gain trust in CFD approaches to compute intraventricular flow and emphasize the importance of standardized input data. Future studies, however, should consider a broader data base.

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CT-Based Simulation of Left Ventricular Hemodynamics: A Pilot Study in Mitral Regurgitation and Left Ventricle Aneurysm Patients

Cited by 11 publications

References 69 publications

CT-Based Analysis of Left Ventricular Hemodynamics Using Statistical Shape Modeling and Computational Fluid Dynamics

CT-Based Analysis of Left Ventricular Hemodynamics Using Statistical Shape Modeling and Computational Fluid Dynamics

An Interactive Computational Pipeline to Investigate Ventricular Hemodynamics with Real‐Time Three‐Dimensional Echocardiography and Computational Fluid Dynamics

Inter‐model and inter‐modality analysis of left ventricular hemodynamics: Comparative study of two CFD approaches based on echocardiography and magnetic resonance imaging

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