Image‐based reconstruction of three‐dimensional myocardial infarct geometry for patient‐specific modeling of cardiac electrophysiology

Ukwatta, Eranga; Arevalo, Hermenegild; Rajchl, Martin; White, James A.; Pashakhanloo, Farhad; Prakosa, Adityo; Herzka, Daniel A.; McVeigh, Elliot R.; Lardo, Albert C.; Trayanova, Natalia A.; Vadakkumpadan, Fijoy

doi:10.1118/1.4926428

Cited by 43 publications

(44 citation statements)

References 76 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Accurate structural data is essential for the construction and validation of whole-heart computational models [32–35]. These models have enabled advancements in the understanding and treatment of cardiac dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Submillimeter diffusion tensor imaging and late gadolinium enhancement cardiovascular magnetic resonance of chronic myocardial infarction

Pashakhanloo

Herzka

Mori

et al. 2016

Journal of Cardiovascular Magnetic Resonance

Self Cite

View full text Add to dashboard Cite

BackgroundKnowledge of the three-dimensional (3D) infarct structure and fiber orientation remodeling is essential for complete understanding of infarct pathophysiology and post-infarction electromechanical functioning of the heart. Accurate imaging of infarct microstructure necessitates imaging techniques that produce high image spatial resolution and high signal-to-noise ratio (SNR). The aim of this study is to provide detailed reconstruction of 3D chronic infarcts in order to characterize the infarct microstructural remodeling in porcine and human hearts.MethodsWe employed a customized diffusion tensor imaging (DTI) technique in conjunction with late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) on a 3T clinical scanner to image, at submillimeter resolution, myofiber orientation and scar structure in eight chronically infarcted porcine hearts ex vivo. Systematic quantification of local microstructure was performed and the chronic infarct remodeling was characterized at different levels of wall thickness and scar transmurality. Further, a human heart with myocardial infarction was imaged using the same DTI sequence.ResultsThe SNR of non-diffusion-weighted images was >100 in the infarcted and control hearts. Mean diffusivity and fractional anisotropy (FA) demonstrated a 43% increase, and a 35% decrease respectively, inside the scar tissue. Despite this, the majority of the scar showed anisotropic structure with FA higher than an isotropic liquid. The analysis revealed that the primary eigenvector orientation at the infarcted wall on average followed the pattern of original fiber orientation (imbrication angle mean: 1.96 ± 11.03° vs. 0.84 ± 1.47°, p = 0.61, and inclination angle range: 111.0 ± 10.7° vs. 112.5 ± 6.8°, p = 0.61, infarcted/control wall), but at a higher transmural gradient of inclination angle that increased with scar transmurality (r = 0.36) and the inverse of wall thickness (r = 0.59). Further, the infarcted wall exhibited a significant increase in both the proportion of left-handed epicardial eigenvectors, and in the angle incoherency. The infarcted human heart demonstrated preservation of primary eigenvector orientation at the thinned region of infarct, consistent with the findings in the porcine hearts.ConclusionsThe application of high-resolution DTI and LGE-CMR revealed the detailed organization of anisotropic infarct structure at a chronic state. This information enhances our understanding of chronic post-infarction remodeling in large animal and human hearts.Electronic supplementary materialThe online version of this article (doi:10.1186/s12968-016-0317-3) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Submillimeter diffusion tensor imaging and late gadolinium enhancement cardiovascular magnetic resonance of chronic myocardial infarction

Pashakhanloo

Herzka

Mori

et al. 2016

Journal of Cardiovascular Magnetic Resonance

Self Cite

View full text Add to dashboard Cite

show abstract

“…Arrhythmia risk prediction in patients with MI and preserved ejection fraction previous findings of VT organizing centres in grey zone, 12,13,29,30 and experimental data which showed that the infarcted border served as the isthmus and a centrifugal pathway in different VT morphologies.…”

Section: Discussionmentioning

confidence: 99%

“…13,27,[29][30][31] Accurate reconstruction of ventricular geometry has been validated with ex-vivo and in-vivo imaging datasets. 12,32 The approach to construct a model of the iv64 infarcted ventricles by thresholding the infarct into only scar and (homogeneous) grey zone, as done in the present study, without accounting for additional small-scale heterogeneities in the grey zone, has been recently validated with experimental data.…”

Section: 31mentioning

confidence: 99%

A feasibility study of arrhythmia risk prediction in patients with myocardial infarction and preserved ejection fraction

et al. 2016

Self Cite

View full text Add to dashboard Cite

“…In creating the patient’s heart model, the 3D geometries of the infarct zones are segmented 22 and reconstructed 23 , and then merged with the ventricular geometry. Next, the 3D finite element mesh is generated using an approach developed for image-based meshes 24 .…”

Section: How To Construct a Virtual Heartmentioning

confidence: 99%

Imaging-Based Simulations for Predicting Sudden Death and Guiding Ventricular Tachycardia Ablation

Trayanova

Pashakhanloo

et al. 2017

Circ: Arrhythmia and Electrophysiology

Self Cite

View full text Add to dashboard Cite

Image‐based reconstruction of three‐dimensional myocardial infarct geometry for patient‐specific modeling of cardiac electrophysiology

Abstract: The authors have developed a novel method for reconstructing 3D infarct geometry from segmented slices of Lo-res clinical 2D LGE-CMR images. This method outperformed alternative approaches in reproducing expert manual 3D reconstructions and in electrophysiological simulations.

Cited by 43 publications

References 76 publications

Submillimeter diffusion tensor imaging and late gadolinium enhancement cardiovascular magnetic resonance of chronic myocardial infarction

Submillimeter diffusion tensor imaging and late gadolinium enhancement cardiovascular magnetic resonance of chronic myocardial infarction

A feasibility study of arrhythmia risk prediction in patients with myocardial infarction and preserved ejection fraction

Imaging-Based Simulations for Predicting Sudden Death and Guiding Ventricular Tachycardia Ablation

Contact Info

Product

Resources

About