Cardiac Magnetic Resonance and Computed Tomography in Hypertrophic Cardiomyopathy: an Update

Oliveira, Diogo Costa Leandro de; Assunção, Fernanda Boldrini; Santos, Alair Agusto Sarmet Moreira Damas dos; Nacif, Marcelo Souto

doi:10.5935/abc.20160081

Cited by 9 publications

(7 citation statements)

References 48 publications

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“…where C, b f , b t and b f t are the parameters of the Guccione model, E ij (i, j ∈ [1,2,3]) are elements of the Green strain tensor, det(F ) is the determinant of the deformation tensor and K scales the incompressibility term. For the contractile tissue, K = 10 6 Pa was chosen and the parameters for the pericardium were chosen as in [28].…”

Section: The Numerical Solvermentioning

confidence: 99%

Causes of Altered Ventricular Mechanics in Hypertrophic Cardiomyopathy—an In-Silico Study

Kovacheva

Gerach

Schuler

et al. 2021

Preprint

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Background: Hypertrophic cardiomyopathy is a common heart disease causing alteration in the mechanical behaviour of the left ventricle (LV). Decreased myocardial velocities, reduced strain and strain rates have been reported clinically. These alterations result from underlying pathological mechanisms in the tissue: increased wall thickness, altered active and passive force development and/or fiber disarray, which are cumbersome to measure clinically. With a numerical study, we aim to answer: how the variability in each of these mechanisms contributes to altered mechanics of the LV and if the deformation obtained in in-silico experiments is comparable to values reported from clinical measurements. Results: We conducted an in-silico sensitivity study on physiological and pathological mechanisms potentially underlying the clinical hypertrophic cardiomyopathy phenotype. Deformation and mechanical behaviour of whole heart models was evaluated globally and regionally. Hypertrophy of the LV affected the course of strain, strain rate and wall thickening—the root mean squared difference of the wall thickening between control (mean thickness 10 mm) and hypertrophic geometries (17 mm) was >10 %. A reduction of active force development by 40 % led to less overall deformation: maximal radial strain reduced from 26 % to 21 %. A five-fold increase in tissue stiffness caused a more homogeneous distribution of the strain values among the 17 AHA segments. Fiber disarray led to minor changes in the circumferential and radial strain. A combination of pathological mechanisms led to reduced and slower deformation of the LV and halved the longitudinal shortening of the left atria. Conclusions: This study uses a computer model to determine the changes in LV deformation caused by pathological mechanisms that are presumed to underlay hypertrophic cardiomybopathy. This knowledge can complement imaging-derived information to obtain a more accurate diagnosis of hypertrophic cardiomyopathy.

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Section: The Numerical Solvermentioning

confidence: 99%

Causes of Altered Ventricular Mechanics in Hypertrophic Cardiomyopathy—an In-Silico Study

Kovacheva

Gerach

Schuler

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…HCM is an autosomal dominant genetic disease characterized by ventricular hypertrophy, preserved systolic function and diastolic dysfunction, in the absence of secondary causes that may promote myocardial hypertrophy, such as systemic arterial hypertension, aortic and subaortic valve disease, infiltrative cardiomyopathies, etc. 3,4 Its development is determined by mutations in the genes encoding the cardiac sarcomere, the most common being heavy chain beta-myosin and myosin-bound protein C.…”

Section: Definition Of Hypertrophic Cardiomyopathymentioning

confidence: 99%

Current Role of Cardiac Magnetic Resonance Imaging in Hypertrophic Cardiomyopathy

F¹,

Bello²,

Shiozaki³

et al. 2018

Arquivos Brasileiros De Cardiologia - Imagem Cardiovascular

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“…Hypertrophic cardiomyopathy (HCM) is a relatively common inherited disorder, with a prevalence of 1:500, which develops in the absence of an identifiable cause [ 1 , 2 ]. There are several phenotypes of HCM, depending on the localization and distribution of hypertrophy in the heart: asymmetric, symmetric/concentric, apical, or mid-ventricular obstruction [ 3 ]. HCM results in an increased ratio of wall to lumen volume, which can be diagnosed by echocardiographic or magnetic resonance assessment of left-ventricular anatomy [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Causes of altered ventricular mechanics in hypertrophic cardiomyopathy: an in-silico study

et al. 2021

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Background Hypertrophic cardiomyopathy (HCM) is typically caused by mutations in sarcomeric genes leading to cardiomyocyte disarray, replacement fibrosis, impaired contractility, and elevated filling pressures. These varying tissue properties are associated with certain strain patterns that may allow to establish a diagnosis by means of non-invasive imaging without the necessity of harmful myocardial biopsies or contrast agent application. With a numerical study, we aim to answer: how the variability in each of these mechanisms contributes to altered mechanics of the left ventricle (LV) and if the deformation obtained in in-silico experiments is comparable to values reported from clinical measurements. Methods We conducted an in-silico sensitivity study on physiological and pathological mechanisms potentially underlying the clinical HCM phenotype. The deformation of the four-chamber heart models was simulated using a finite-element mechanical solver with a sliding boundary condition to mimic the tissue surrounding the heart. Furthermore, a closed-loop circulatory model delivered the pressure values acting on the endocardium. Deformation measures and mechanical behavior of the heart models were evaluated globally and regionally. Results Hypertrophy of the LV affected the course of strain, strain rate, and wall thickening—the root-mean-squared difference of the wall thickening between control (mean thickness 10 mm) and hypertrophic geometries (17 mm) was >10%. A reduction of active force development by 40% led to less overall deformation: maximal radial strain reduced from 26 to 21%. A fivefold increase in tissue stiffness caused a more homogeneous distribution of the strain values among 17 heart segments. Fiber disarray led to minor changes in the circumferential and radial strain. A combination of pathological mechanisms led to reduced and slower deformation of the LV and halved the longitudinal shortening of the LA. Conclusions This study uses a computer model to determine the changes in LV deformation caused by pathological mechanisms that are presumed to underlay HCM. This knowledge can complement imaging-derived information to obtain a more accurate diagnosis of HCM.

show abstract

Cardiac Magnetic Resonance and Computed Tomography in Hypertrophic Cardiomyopathy: an Update

Cited by 9 publications

References 48 publications

Causes of Altered Ventricular Mechanics in Hypertrophic Cardiomyopathy—an In-Silico Study

Causes of Altered Ventricular Mechanics in Hypertrophic Cardiomyopathy—an In-Silico Study

Current Role of Cardiac Magnetic Resonance Imaging in Hypertrophic Cardiomyopathy

Causes of altered ventricular mechanics in hypertrophic cardiomyopathy: an in-silico study

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