Computational Modeling of Human Left Ventricle to Assess the Effects of Trabeculae Carneae on the Diastolic and Systolic Functions

2019 ◽  
Vol 141 (9) ◽  
Author(s):  
Fatemeh Fatemifar ◽  
Marc D. Feldman ◽  
Geoffrey D. Clarke ◽  
Ender A. Finol ◽  
Hai-Chao Han
Keyword(s):  
Left Ventricle ◽  
Systolic Function ◽  
Strain Energy Function ◽  
Patient Specific ◽  
Papillary Muscles ◽  
End Diastolic Volume ◽  
Wall Stiffness ◽  
Biaxial Tests ◽  
Cutting Model

Trabeculae carneae are irregular structures that cover the endocardial surfaces of both ventricles and account for a significant portion of human ventricular mass. The role of trabeculae carneae in diastolic and systolic functions of the left ventricle (LV) is not well understood. Thus, the objective of this study was to investigate the functional role of trabeculae carneae in the LV. Finite element (FE) analyses of ventricular functions were conducted for three different models of human LV derived from high-resolution magnetic resonance imaging (MRI). The first model comprised trabeculae carneae and papillary muscles, while the second model had papillary muscles and partial trabeculae carneae, and the third model had a smooth endocardial surface. We customized these patient-specific models with myofiber architecture generated with a rule-based algorithm, diastolic material parameters of Fung strain energy function derived from biaxial tests and adjusted with the empirical Klotz relationship, and myocardial contractility constants optimized for average normal ejection fraction (EF) of the human LV. Results showed that the partial trabeculae cutting model had enlarged end-diastolic volume (EDV), reduced wall stiffness, and even increased end-systolic function, indicating that the absence of trabeculae carneae increased the compliance of the LV during diastole, while maintaining systolic function.

scholarly journals Effective influence of sacubutril/valsartan on systolic function of left ventricle in patients with heart failure and a reduced ejеction fraction

2021 ◽  
Vol 2 (4/S) ◽  
pp. 746-752
Author(s):  
Ikbol Adilova ◽  
Gulnoza Akbarova
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Systolic Function ◽  
Clinical Status ◽  
Volume Index ◽  
Left Ventricle Mass ◽  
End Diastolic Volume ◽  
Study Results ◽  
Patients With Heart Failure

Aim: We evaluated the influence of sacubitril/valsartan on the left ventricle function and clinical status of patients with heart failure and a reduced ejection fraction. Materials and methods: From 2018 to 2020, patients cured with 50-200 mg sacubitril/valsartan after coronary bypass grafting or coronary stenting for ischemic heart disease and HFrEF (aged 54-70 years) were enrolled in this prospective study. Results: There was no death case. There was a female prevalence with female to male ratio of 1,7:1. the value of ejection fraction high significantly increased (p=0,035), whereas the indices of left ventricle end-diastolic volume (p=0,015) and end-diastolic volume index (p=0,022) as well as left ventricle mass index were high significantly decreased (p=0,001) that indicate the amelioration of left ventricle systolic function. Correspondingly, the clinical status of all patients improved according to New York Heart Association Class (p=0,001). Conclusion: The post-CABG or PCI patients with HFrEF should be cured with sacubitril/valsartan basing on its implementation instruction. Nevertheless, future studies should focus on a larger cohort of post-CABG or PCI patients to compare the effectiveness and safety of sacubitril/valsartan usage raising from its adverse event in comparison to conventional therapy.  

scholarly journals The role of subvalvular structures in the development of mitral valve prolapse in children

2012 ◽  
Vol 93 (3) ◽  
pp. 490-493
Author(s):  
Yu M Belozerov ◽  
Sh M Magomedova ◽  
Z S Abakarova ◽  
I M Osmanov
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Mitral Valve Prolapse ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Healthy Children ◽  
Papillary Muscles ◽  
Functional Parameters

Aim. To assess the role of subvalvular structures in the development of mitral valve prolapse in children. Methods. Conducted was an echocardiography investigation with comparative analysis of structural and functional parameters of subvalvular structures in healthy children (50 individuals) and children with mitral valve prolapse divided in two groups: first group - without regurgitation (34 children), the second group - with regurgitation (16 children). Results. In healthy children identified were strong correlation links between echocardiographic indices of the subvalvular structures of the mitral valve and the functional parameters of the left ventricle. The diameter of the anterolateral group of papillary muscles directly correlated with the thickness of the interventricular septum, while the diastolic distance between the papillary muscles - with the end diastolic diameter of the left ventricle. It was established that the following factors may contribute to the pathogenesis of mitral valve prolapse: (1) long papillary muscles and the corresponding chords of the valve, (2) a weak (relative to the norm) contractile ability of the papillary muscles, (3) hyperkinesis of the left ventricular apex, and (4) no relationship between the apical and the global ejection fraction. These factors contribute to the fact that the papillary muscles and chords constrain the mitral valve cusps to a lesser extent during systole, which in turn easily bulge into the left atrium under the influence of systolic blood pressure. Apical hyperkinesis contributes to even closer approximation of the subvalvular structures with the cusps. Conclusion. Mitral valve prolapse is attributed to desynchronization of the function of papillary muscles and of the left ventricle; the development of functional mitral regurgitation during mitral valve prolapse is associated with dyssynchrony of the papillary muscles’ activity.

scholarly journals Analysis of patient-specific surgical ventricular restoration: importance of an ellipsoidal left ventricular geometry for diastolic and systolic function

2013 ◽  
Vol 115 (1) ◽  
pp. 136-144 ◽  
Author(s):  
Lik Chuan Lee ◽  
Jonathan F. Wenk ◽  
Liang Zhong ◽  
Doron Klepach ◽  
Zhihong Zhang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Negative Impact ◽  
Systolic Function ◽  
Left Ventricular ◽  
Magnetic Resonance Images ◽  
Left Ventricular Geometry ◽  
Patient Specific ◽  
Surgical Ventricular Restoration ◽  
Ventricular Restoration

Surgical ventricular restoration (SVR) is a procedure designed to treat heart failure by surgically excluding infarcted tissues from the dilated failing left ventricle. To elucidate and predict the effects of geometrical changes from SVR on cardiac function, we created patient-specific mathematical (finite-element) left ventricular models before and after surgery using untagged magnetic resonance images. Our results predict that the postsurgical improvement in systolic function was compromised by a decrease in diastolic distensibility in patients. These two conflicting effects typically manifested as a more depressed Starling relationship (stroke volume vs. end-diastolic pressure) after surgery. By simulating a restoration of the left ventricle back to its measured baseline sphericity, we show that both diastolic and systolic function improved. This result confirms that the increase in left ventricular sphericity commonly observed after SVR (endoventricular circular patch plasty) has a negative impact and contributes partly to the depressed Starling relationship. On the other hand, peak myofiber stress was reduced substantially (by 50%) after SVR, and the resultant left ventricular myofiber stress distribution became more uniform. This significant reduction in myofiber stress after SVR may help reduce adverse remodeling of the left ventricle. These results are consistent with the speculation proposed in the Surgical Treatment for Ischemic Heart Failure trial ( 20 ) for the neutral outcome, that “the lack of benefit seen with surgical ventricular reconstruction is that benefits anticipated from surgical reduction of left ventricular volume (reduced wall stress and improvement in systolic function) are counter-balanced by a reduction in diastolic distensibility.”

scholarly journals The Features of Systolic Function and Remodelation of the Left Ventricle in Patients with Rheumatoid Arthritis in Combination with Arterial Hypertension

2020 ◽  
Vol 5 (5) ◽  
pp. 118-124
Author(s):  
I. O. Daniuk ◽  
◽  
N. G. Ryndina ◽  
Y. V. Ivashchuk ◽  
◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Essential Hypertension ◽  
Left Ventricle ◽  
Systolic Function ◽  
Control Group ◽  
Myocardial Mass ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume ◽  
Left Atrium Size

Recent studies have shown that heart disease in patients with rheumatoid arthritis occurs according to various data in 20-100% of cases. Hypertension is often the first objectively detectable marker of cardiovascular pathology in patients with rheumatoid arthritis. Hypertension in patients with rheumatoid arthritis usually becomes an active initiator and accelerator of the progression of atherosclerosis and remodeling of the left ventricle. Cardiac remodeling in patients with hypertension and in patients with rheumatoid arthritis, combined with hypertension is a significant factor that affects to the quality of life and prognosis and requires careful study of this problem. The purpose of the work was to study the systolic function and morphological parameters of the left ventricle in patients with rheumatoid arthritis in combination with hypertension and to establish indicators associated with high cardiovascular risk. Material and methods. The main group of patients consisted of 93 patients with rheumatoid arthritis of moderate activity in combination with hypertension stage II. The second group included 45 patients with essential hypertension stage II. The control group had 31 almost healthy people. An ultrasound examination of the heart was performed with studying of systolic function and the main morphological parameters of the left ventricle. Results and discussion. We found a significant increase in the left ventricle myocardial mass index by 11.97% in patients with rheumatoid arthritis in combination with hypertension compared to the patients with essential hypertension and by 30.1% compared to the control group. We also detected the significant increase of the interventricular septum thickness by 9.02%, the posterior wall of left ventricle – by 5.51%, and the relative wall thickness of left ventricle – by 6.0% in patients with rheumatoid arthritis in combination with hypertension compared to the patient with essential hypertension. There was a significant increase in end-diastolic volume by 8.64%; end-systolic volume – by 12.95%; and a decrease of ejection fraction by 2.5% in patients with rheumatoid arthritis in combination with hypertension with m SCORE >4 points compared to the corresponding indicators of patients with m SCORE ≤4 points. The study showed that the most common type of left ventricle remodeling was concentric left ventricle hypertrophy (79% of patients) in patients with rheumatoid arthritis with hypertension. In addition, the subgroup of patients with m SCORE >4 points left ventricle myocardial mass and left ventricle myocardial mass index were by 15.01% and 14.86% significantly higher than the corresponding indicators in the subgroup of patients with m SCORE ≤4 points. Conclusion. The patients with rheumatoid arthritis in combination with hypertension showed an association between increasing of the left atrium size and the volume parameters of the left ventricle, and the presence of fluid in the pericardial cavity. This was manifested by the left atrium size increase by 10.65%, end-diastolic volume – by 8.62%, end-systolic volume – by 12.2% and the ejection fraction decrease by 2.23% in patients with fluid versus to a subgroup of patients without fluid in the pericardium

Mathematical myocardium elasticity properties modeling in echocardiography study of diastolic and systolic function of the left ventricle (Preprint)

2020 ◽  
Author(s):  
Lucian Popescu ◽  
Nelu-Mihai Trofenciuc ◽  
Simina Crisan ◽  
Aurora Diana Bordejevic ◽  
Alexandru Mischie ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Cardiac Cycle ◽  
Systolic Function ◽  
Study Group ◽  
Mathematical Approach ◽  
Energetic Approach ◽  
Elasticity Property ◽  
Property Modeling ◽  
Coefficient Of Elasticity ◽  
Mechanical Movement

BACKGROUND A systematic and quantitative comparative analysis for this subject has not been done so far. Thus defined, the coefficient of elasticity is a whole new dimension. OBJECTIVE This study proposes a new mathematical myocardium elasticity property modeling in characterizing of the ventricular diastole and systole. METHODS The study group consisted of 2283 consecutive patients evaluated by echocardiography. The mathematical approach is made starting from energetic consideration, by applying the energy conservation low for the blood entering from left atrium into left ventricle during diastole period. RESULTS Analyzing all the data obtained we developed two brand new coefficients to describe the cardiac cycle and we had verified if the coefficients are correlated with classically used parameters. We consider that the energetic approach take into consideration the whole mechanical movement that is happening inside the heart and can offer a very synthetic and scientific solid view about the cardiac cycle. CONCLUSIONS The new coefficients are simply to be calculated and as you will see from our research the correlation with other classically used parameters is obvious. The direct physical approach of blood flow within the heart can generate new, beneficial perspectives in diagnosing various heart conditions, or even in understanding how works the filling of the ventricles and atria during a heartbeat.

Mathematical myocardium elasticity properties modeling in echocardiography study of diastolic and systolic function of the left ventricle

2018 ◽  
Author(s):  
Lucian Popescu ◽  
Adina Ligia Pop-Moldovan ◽  
Nelu-Mihai Trofenciuc ◽  
Maria Puschita
Keyword(s):  
Left Ventricle ◽  
Systolic Function

scholarly journals Myocardial deformation in patients with a single left ventricle using 2D cardiovascular magnetic resonance feature tracking: a case–control study

2021 ◽  
Author(s):  
Fabian Strodka ◽  
Jana Logoteta ◽  
Roman Schuwerk ◽  
Mona Salehi Ravesh ◽  
Dominik Daniel Gabbert ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Feature Tracking ◽  
Systolic Function ◽  
Radial Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Significant Difference ◽  
Lv Volumes

AbstractVentricular dysfunction is a well-known complication in single ventricle patients in Fontan circulation. As studies exclusively examining patients with a single left ventricle (SLV) are sparse, we assessed left ventricular (LV) function in SLV patients by using 2D-cardiovascular magnetic resonance (CMR) feature tracking (2D-CMR-FT) and 2D-speckle tracking echocardiography (2D-STE). 54 SLV patients (11.4, 3.1–38.1 years) and 35 age-matched controls (12.3, 6.3–25.8 years) were included. LV global longitudinal, circumferential and radial strain (GLS, GCS, GRS) and strain rate (GLSR, GCSR, GRSR) were measured using 2D-CMR-FT. LV volumes, ejection fraction (LVEF) and mass were determined from short axis images. 2D-STE was applied in patients to measure peak systolic GLS and GLSR. In a subgroup analysis, we compared double inlet left ventricle (DILV) with tricuspid atresia (TA) patients. The population consisted of 19 DILV patients, 24 TA patients and 11 patients with diverse diagnoses. 52 patients were in NYHA class I and 2 patients were in class II. Most SLV patients had a normal systolic function but median LVEF in patients was lower compared to controls (55.6% vs. 61.2%, p = 0.0001). 2D-CMR-FT demonstrated reduced GLS, GCS and GCSR values in patients compared to controls. LVEF correlated with GS values in patients (p < 0.05). There was no significant difference between GLS values from 2D-CMR-FT and 2D-STE in the patient group. LVEF, LV volumes, GS and GSR (from 2D-CMR-FT) were not significantly different between DILV and TA patients. Although most SLV patients had a preserved EF derived by CMR, our results suggest that, LV deformation and function may behave differently in SLV patients compared to healthy subjects.

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