A Novel Method for Quantifying In-Vivo Regional Left Ventricular Myocardial Contractility in the Border Zone of a Myocardial Infarction

Author:

Lee Lik Chuan1,Wenk Jonathan F.1,Klepach Doron1,Zhang Zhihong2,Saloner David3,Wallace Arthur W.4,Ge Liang1,Ratcliffe Mark B.1,Guccione Julius M.1

Affiliation:

1. Departments of Surgery and Bioengineering, University of California, San Francisco, CA 94143; Department of Veterans Affairs Medical Center, San Francisco, CA 94121

2. Department of Surgery, University of California, San Francisco, CA 94143; Department of Veterans Affairs Medical Center, San Francisco, CA 94121

3. Department of Radiology, University of California, San Francisco, CA 94143; Department of Veterans Affairs Medical Center, San Francisco, CA 94121

4. Department of Anesthesia, University of California, San Francisco, CA 94143; Department of Veterans Affairs Medical Center, San Francisco, CA 94121

Abstract

Homogeneous contractility is usually assigned to the remote region, border zone (BZ), and the infarct in existing infarcted left ventricle (LV) mathematical models. Within the LV, the contractile function is therefore discontinuous. Here, we hypothesize that the BZ may in fact define a smooth linear transition in contractility between the remote region and the infarct. To test this hypothesis, we developed a mathematical model of a sheep LV having an anteroapical infarct with linearly–varying BZ contractility. Using an existing optimization method (Sun et al., 2009, “A Computationally Efficient Formal Optimization of Regional Myocardial Contractility in a Sheep With Left Ventricular Aneurysm,” J. Biomech. Eng., 131(11), pp. 111001), we use that model to extract active material parameter Tmax and BZ width dn that “best” predict in–vivo systolic strain fields measured from tagged magnetic resonance images (MRI). We confirm our hypothesis by showing that our model, compared to one that has homogeneous contractility assigned in each region, reduces the mean square errors between the predicted and the measured strain fields. Because the peak fiber stress differs significantly (∼15%) between these two models, our result suggests that future mathematical LV models, particularly those used to analyze myocardial infarction treatment, should account for a smooth linear transition in contractility within the BZ.

Publisher

ASME International

Subject

Physiology (medical),Biomedical Engineering

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