Finite-element based optimization of left ventricular passive stiffness in normal volunteers and patients after myocardial infarction: Utility of an inverse deformation gradient calculation of regional diastolic strain

Yue Zhang; Vicky Y Wang; Ashley E Morgan; Jiwon Kim; Romina Tafreshi; Arthur W Wallace; Julius M Guccione; Jonathan W Weinsaft; Liang Ge; Mark B Ratcliffe

doi:10.1016/j.jmbbm.2021.104431

Finite-element based optimization of left ventricular passive stiffness in normal volunteers and patients after myocardial infarction: Utility of an inverse deformation gradient calculation of regional diastolic strain

J Mech Behav Biomed Mater. 2021 Jul:119:104431. doi: 10.1016/j.jmbbm.2021.104431. Epub 2021 Mar 27.

Authors

Affiliations

¹ San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
² Department of Surgery, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
³ Department of Surgery, University of Utah, Salt Lake City, UT, USA.
⁴ Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
⁵ Department of Anesthesia, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
⁶ Department of Surgery, University of California, San Francisco, CA, USA; Department of Bioengineering, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
⁷ Department of Surgery, University of California, San Francisco, CA, USA; Department of Bioengineering, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA. Electronic address: mark.ratcliffe@va.gov.

PMID: 33930653
DOI: 10.1016/j.jmbbm.2021.104431

Abstract

Introduction: Left ventricular (LV) diastolic dysfunction (DD) is common after myocardial infarction (MI). Whereas current clinical assessment of DD relies on indirect markers including LV filling, finite element (FE) -based computational modeling directly measures regional diastolic stiffness. We hypothesized that an inverse deformation gradient (DG) method calculation of diastolic strain (IDGDS) allows the FE model-based calculation of regional diastolic stiffness (material parameters; MP) in post-MI patients with DD.

Methods: Cardiac magnetic resonance (CMR) with tags (CSPAMM) and late gadolinium enhancement (LGE) was performed in 10 patients with post-MI DD and 10 healthy volunteers. The 3-dimensional (3D) LV DG from end-diastole (ED) to early diastolic filling (EDF; DG_ED→EDF) was calculated from CSPAMM. Diastolic strain was calculated from DG_EDF→ED by inverting the DG_ED→EDF. FE models were created with MI and non-MI (remote; RM) regions determined by LGE. Guccione MPs C, and exponential fiber, b_f, and transverse, b_t , terms were optimized with IDGDS strain.

Results: 3D circumferential and longitudinal diastolic strain (E_cc;E_ll) calculated using IDGDS in CSPAMM obtained in volunteers and MI patients were [Formula: see text] = 0.27 ± 0.01, [Formula: see text] = 0.24 ± 0.03 and [Formula: see text] = 0.21 ± 0.02, and [Formula: see text] = 0.15 ± 0.02, respectively. MPs in the volunteer group were C_H = 0.013 [0.001, 0.235] kPa, [Formula: see text] = 20.280 ± 4.994, and [Formula: see text] = 7.460 ± 2.171 and C_RM = 0.0105 [0.010, 0.011] kPa, [Formula: see text] = 50.786 ± 13.511 (p = 0.0846), and [Formula: see text] = 17.355 ± 2.743 (p = 0.0208) in the remote myocardium of post-MI patients.

Conclusion: Diastolic strain, calculated from CSPAMM with IDGDS, enables calculation of FE model-based regional diastolic material parameters. Transverse stiffness of the remote myocardium, , may be a valuable new metric for determination of DD in patients after MI.

Keywords: Computer simulation; Diastolic dysfunction; Finite element analysis; Magnetic resonance; Myocardial infarction.

Published by Elsevier Ltd.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Contrast Media*
Diastole
Gadolinium
Healthy Volunteers
Humans
Myocardial Infarction* / diagnostic imaging
Myocardium

Substances

Contrast Media
Gadolinium

Grants and funding

R01 HL128278/HL/NHLBI NIH HHS/United States