Ventricle stress/strain comparisons between Tetralogy of Fallot patients and healthy using models with different zero-load diastole and systole morphologies

Han, Young-Min; Tang, Dalin; Geva, Tal; Yang, Chun; Wu, Zheyang; Rathod, Rahul H.; Huang, Xueying; Billiar, Kristen L.; Nido, Pedro J. del

doi:10.1371/journal.pone.0220328

Cited by 4 publications

(6 citation statements)

References 31 publications

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“…However, the information of the wall stress was lacking with current clinical examinations. A computational ventricular model of the heart that use finite element method may provide the information of ventricular wall stress and strain, which has been adopted to analyze cardiac computational mechanics and becomes increasingly common ( Walker et al, 2005 ; Tang et al, 2016 ; Yu et al, 2019 ; Yin et al, 2020 ). The present study was undertaken to investigate the mechanisms of the formation of apical aneurysm in HCM, based on the numerical simulation results of three constructed idealized finite element models with different positions of myocardial hypertrophy (healthy, subaortic obstruction, and midventricular obstruction).…”

Section: Introductionmentioning

confidence: 99%

Numerical Simulation Study on the Mechanism of Formation of Apical Aneurysm in Hypertrophic Cardiomyopathy With Midventricular Obstruction

Deng

Zuo

et al. 2021

Front. Physiol.

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Apical aneurysm was observed to be associated with midventricular obstruction (MVO) in hypertrophic cardiomyopathy (HCM). To investigate the genesis of the apical aneurysm, the idealized numerical left ventricular models (finite-element left ventricle models) of the healthy left ventricle, subaortic obstruction, and midventricular obstruction in HCM of left ventricle were created. The mechanical effects in the formation of apical aneurysm were determined by comparing the myofiber stress on the apical wall between these three models (healthy, subaortic obstruction, and midventricular obstruction models). In comparing the subaortic obstruction model and MVO model with HCM, it was found that, at the time of maximum pressure, the maximum value of myofiber stress in MVO model was 75.0% higher than that in the subaortic obstruction model (654.5 kPa vs. 373.9 kPa). The maximum stress on the apex of LV increased 79.9, 69.3, 117.8% than that on the myocardium around the apex in healthy model, subaortic obstruction model, and MVO model, respectively. Our results indicated that high myofiber stress on the apical wall might initiate the formation process of the apical aneurysm.

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Section: Introductionmentioning

confidence: 99%

Numerical Simulation Study on the Mechanism of Formation of Apical Aneurysm in Hypertrophic Cardiomyopathy With Midventricular Obstruction

Deng

Zuo

et al. 2021

Front. Physiol.

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“…Stress and strain errors were defined by L 1 -norm errors between solutions from two consecutive meshes. The details were described in Yu et al (2019).…”

Section: Solution Methods Data Extraction and Model Listmentioning

confidence: 99%

“…Sun's group has published extensively on quantifying myocardium and valve material properties, valve mechanics, and their impact on ventricle functions (Murdock et al, 2018;Kong et al, 2018;Sulejmani et al, 2019). We introduced a RV model for patients with TOF with a fluid-structure interaction (Tang et al, 2008;Tang et al, 2013;Yang et al, 2013;Tang et al, 2015;Yu et al, 2019). Our investigations included searching and identifying surgical options, possible factors which could improve post-PVR cardiac outcome prediction.…”

Section: Introductionmentioning

confidence: 99%

“…Using data from computational models for 16 patients with TOF, it was found that, among the mechanical and geometrical factors considered, mechanical stress may be the best predictor for post-PVR cardiac outcome (Tang et al, 2015). Yu et al (2019) used patient-specific CMR data from six healthy volunteers and 16 TOF patients and estimated the RV material stiffness parameter values. Their results indicated that the mean end-ejection effective YM value of TOF patients was 78.6% higher than that of the healthy group (1,952 vs. 1,093 kPa, p = 0.016).…”

Section: Introductionmentioning

confidence: 99%

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Multi-Band Surgery for Repaired Tetralogy of Fallot Patients With Reduced Right Ventricle Ejection Fraction: A Pilot Study

et al. 2020

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Introduction: Right ventricle (RV) failure is one of the most common symptoms among patients with repaired tetralogy of Fallot (TOF). The current surgery treatment approach including pulmonary valve replacement (PVR) showed mixed post-surgery outcomes. A novel PVR surgical strategy using active contracting bands is proposed to improve the post-PVR outcome. In lieu of testing the risky surgical procedures on real patients, computational simulations (virtual surgery) using biomechanical ventricle models based on patient-specific cardiac magnetic resonance (CMR) data were performed to test the feasibility of the PVR procedures with active contracting bands. Different band combination and insertion options were tested to identify optimal surgery designs. Method: Cardiac magnetic resonance data were obtained from one TOF patient (male, age 23) whose informed consent was obtained. A total of 21 finite element models were constructed and solved following our established procedures to investigate the outcomes of the band insertion surgery. The non-linear anisotropic Mooney-Rivlin model was used as the material model. Five different band insertion plans were simulated (three single band models with different band locations, one model with two bands, and one model with three bands). Three band contraction ratios (10, 15, and 20%) and passive bands (0% contraction ratio) were tested. RV ejection fraction was used as the measure for cardiac function. Results: The RV ejection fraction from the three-band model with 20% contraction increased to 41.58% from the baseline of 37.38%, a 4.20% absolute improvement. The RV ejection fractions from the other four band models with 20% contraction rate were 39.70, 39.45, and 40.70% (two-band) and 39.17%, respectively. The mean RV stress and strain values from all of the 21 models showed only modest differences (5-11%).

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“…Therefore, a non-invasive method for helping surgeons make the optimal design of the surgery is significantly required. Several heart models, such as structural finite element models, computational fluid dynamics models, fluid-structure interactions (FSI) models, multi-patient models, have been proposed in the literature to assess the hemodynamics and myocardial functions in heart and become increasingly important in cardiovascular research [3][4][5][6][7][8][9][10][11][12][13]. Cardiac tissue is generally modeled as a hyper-elastic material [14].…”

Section: Introductionmentioning

confidence: 99%

Comparisons of simulation results between passive and active fluid structure interaction models for left ventricle in hypertrophic obstructive cardiomyopathy

et al. 2021

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Background Patient-specific active fluid–structure interactions (FSI) model is a useful approach to non-invasively investigate the hemodynamics in the heart. However, it takes a lot of effort to obtain the proper external force boundary conditions for active models, which heavily restrained the time-sensitive clinical applications of active computational models. Methods The simulation results of 12 passive FSI models based on 6 patients’ pre-operative and post-operative CT images were compared with corresponding active models to investigate the differences in hemodynamics and cardiac mechanics between these models. Results In comparing the passive and active models, it was found that there was no significant difference in pressure difference and shear stress on mitral valve leaflet (MVL) at the pre-SAM time point, but a significant difference was found in wall stress on the inner boundary of left ventricle (endocardium). It was also found that pressure difference on the coapted MVL and the shear stress on MVL were significantly decreased after successful surgery in both active and passive models. Conclusion Our results suggested that the passive models may provide good approximated hemodynamic results at 5% RR interval, which is crucial for analyzing the initiation of systolic anterior motion (SAM). Comparing to active models, the passive models decrease the complexity of the modeling construction and the difficulty of convergence significantly. These findings suggest that, with proper boundary conditions and sufficient clinical data, the passive computational model may be a good substitution model for the active model to perform hemodynamic analysis of the initiation of SAM.

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Ventricle stress/strain comparisons between Tetralogy of Fallot patients and healthy using models with different zero-load diastole and systole morphologies

Cited by 4 publications

References 31 publications

Numerical Simulation Study on the Mechanism of Formation of Apical Aneurysm in Hypertrophic Cardiomyopathy With Midventricular Obstruction

Numerical Simulation Study on the Mechanism of Formation of Apical Aneurysm in Hypertrophic Cardiomyopathy With Midventricular Obstruction

Multi-Band Surgery for Repaired Tetralogy of Fallot Patients With Reduced Right Ventricle Ejection Fraction: A Pilot Study

Comparisons of simulation results between passive and active fluid structure interaction models for left ventricle in hypertrophic obstructive cardiomyopathy

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