A non-invasive method for estimating regional myocardial contractility in vivo would be of great value in the design and evaluation of new surgical and medical strategies to treat and/or prevent infarction-induced heart failure. As a first step towards developing such a method, an explicit finite element (FE) model-based formal optimization of regional myocardial contractility in a sheep with left ventricular (LV) aneurysm was performed using tagged magnetic resonance (MR) images and cardiac catheterization pressures. From the tagged MR images, 3-dimensional (3D) myocardial strains, LV volumes and geometry for the animal-specific 3D FE model of the LV were calculated, while the LV pressures provided physiological loading conditions. Active material parameters (T max_B and T max_R ) in the non-infarcted myocardium adjacent to the aneurysm (borderzone) and in myocardium remote from the aneurysm were estimated by minimizing the errors between FE model-predicted and measured systolic strains and LV volumes using the successive response surface method for optimization. The significant depression in optimized T max_B relative to T max_R was confirmed by direct ex vivo force measurements from skinned fiber preparations. The optimized values of T max_B and T max_R were not overly sensitive to the passive material parameters specified. The computation time of less than 5 hours associated with our proposed method for estimating regional myocardial contractility in vivo makes it a potentially very useful clinical tool.

Heart failure continues to present a significant medical and economic burden throughout the developed world. Novel treatments involving the injection of polymeric materials into the myocardium of the failing left ventricle (LV) are currently being developed, which may reduce elevated myofiber stresses during the cardiac cycle and act to retard the progression of heart failure. A finite element (FE) simulation-based method was developed in this study that can automatically optimize the injection pattern of the polymeric "inclusions" according to a specific objective function, using commercially available software tools. The FE preprocessor TRUEGRID((R)) was used to create a parametric axisymmetric LV mesh matched to experimentally measured end-diastole and end-systole metrics from dogs with coronary microembolization-induced heart failure. Passive and active myocardial material properties were defined by a pseudo-elastic-strain energy function and a time-varying elastance model of active contraction, respectively, that were implemented in the FE software LS-DYNA. The companion optimization software LS-OPT was used to communicate directly with TRUEGRID((R)) to determine FE model parameters, such as defining the injection pattern and inclusion characteristics. The optimization resulted in an intuitive optimal injection pattern (i.e., the one with the greatest number of inclusions) when the objective function was weighted to minimize mean end-diastolic and end-systolic myofiber stress and ignore LV stroke volume. In contrast, the optimization resulted in a nonintuitive optimal pattern (i.e., 3 inclusions longitudinallyx6 inclusions circumferentially) when both myofiber stress and stroke volume were incorporated into the objective function with different weights.

Response surface methodology can be used to construct global and midrange approximations to functions in structural optimization. Since structural optimization requires expensive function evaluations, it is important to construct accurate function approximations so that rapid convergence may be achieved. In this paper techniques to ÿnd the region of interest containing the optimal design, and techniques for ÿnding more accurate approximations are reviewed and investigated. Aspects considered are experimental design techniques, the selection of the 'best' regression equation, intermediate response functions and the location and size of the region of interest. Standard examples in structural optimization are used to show that the accuracy is largely dependent on the choice of the approximating function with its associated subregion size, while the selection of a larger number of points is not necessarily cost-e ective. In a further attempt to improve e ciency, di erent regression models were investigated. The results indicate that the use of the two methods investigated does not signiÿcantly improve the results. Finding an accurate global approximation is challenging, and su cient accuracy could only be achieved in the example problems by considering a smaller region of the design space. ? 1998 John Wiley & Sons, Ltd.

This paper evaluates a Successive Response Surface Method (SRSM) specifically developed for simulation-based design optimization, e.g. that of explicit nonlinear dynamics in crashworthiness design. Linear response surfaces are constructed in a subregion of the design space using a design of experiments approach with a D-optimal experimental design. To converge to an optimum, a domain reduction scheme is utilized. The scheme requires only one user-defined parameter, namely the size of the initial subregion. During optimization, the size of this region is adapted using a move reversal criterion to counter oscillation and a move distance criterion to gauge accuracy. To test its robustness, the results using the method are compared to SQP results of a selection of the well-known Hock and Schittkowski problems. Although convergence to a small tolerance is slow when compared to SQP, the SRSM method does remarkably well for these sometimes pathological analytical problems. The second test concerns three engineering problems sampled from the nonlinear structural dynamics field to investigate the method's handling of numerical noise and non-linearity. It is shown that, despite its simplicity, the SRSM method converges stably and is relatively insensitive to its only user-required input parameter.

Objective To describe the clinical features of dogs treated for suspected anaphylaxis in Perth, Western Australia.Design Single-centre observational case series with retrospective and prospective phases.Methods This was a two-phase study of dogs with clinical suspicion of anaphylaxis presenting to the emergency service of a university teaching hospital. Dogs required evidence of, and appropriate treatment of, a type 1 hypersensitivity reaction as well as two or more organs affected (or cardiovascular signs alone) to be included. Phase 1 includes retrospective case series of 186 dogs (March 2006-December 2018. Phase 2 includes prospective descriptive case series of 46 dogs (October 2017-July 2018) focused on clinical signs. ResultsIn phase 1, 88 (47%) dogs had evidence of insect exposure prior to the acute event. One hundred forty (75%) dogs had dermatological signs, 141 (76%) had gastrointestinal signs and 129 (69%) had cardiovascular signs. Ninety-two (49%) dogs had vasoconstrictive shock (5 with bradycardia), 24 (13%) had vasodilatory shock, 8 (4%) had mixed vasodilatory and vasoconstrictive shock and 5 (3%) had unclassifiable shock. On focused abdominal ultrasound, 42 of 71 (59%) dogs had gallbladder wall oedema and 3 of 71 (4%) dogs had peritoneal free fluid. In phase 2, the distributions of insect exposure, organ dysfunction and sonographic abnormalities were similar to phase 1.Conclusion Dogs presenting with suspected anaphylaxis showed a broad range of presentations. Dermatological signs were absent in a proportion of dogs, vasoconstrictive shock was more frequent than vasodilatory and unique features of shock were identified. This study highlights the challenges of diagnosis based on presenting features alone.

A critical assessment of the 4‐node assumed strain element as proposed by Dvorkin and Bathe is made. The element performed excellently in all investigated shell problems which sometimes caused difficulties for other assumed strain techniques. For efficient computation in the non‐linear range, linearization of the virtual work equation is done to yield the consistent tangent stiffness. The shell formulation is done for stress and strain tensors based on local element coordinates. To demonstrate the effectiveness and rapid convergence of the non‐linear formulation, three examples are tested for large displacements.

Background Endoventricular patch plasty (Dor) is used to reduce left ventricular (LV) volume after myocardial infarction (MI) and subsequent LV remodeling. Methods and Results End-diastolic and end-systolic pressure volume and Starling relationships were measured and magnetic resonance (MRI) images with non-invasive tags used to calculate 3D myocardial strain in six sheep 2 weeks before, and 2 and 6 weeks after the Dor procedure. These experimental results were previously reported. The imaging data from one sheep was incomplete. Animal specific finite element (FE) models were created from the remaining five animals using MRI images and LV pressure obtained at early diastolic filling. FE models were optimized using 3D strain and used to determine systolic material properties, Tmax,skinned-fiber, and diastolic and systolic stress in remote myocardium and borderzone (BZ). Six weeks after Dor procedure, end-diastolic and end-systolic stress in the BZ were substantially reduced. However, although there was a slight increase in Tmax,skinned-fiber in the BZ near the MI at 6 weeks, the change was not significant. Conclusions The Dor procedure decreases end-diastolic and end-systolic stress but fails to improve contractility in the infarct BZ. Future work should focus on measures that will enhance BZ function alone or in combination with surgical remodeling.

No abstract