Comparisons of simulation results between passive and active fluid structure interaction models for left ventricle in hypertrophic obstructive cardiomyopathy

Abstract

Background Patient-specific active fluid–structure interactions (FSI) model is a useful approach to non-invasively investigate the hemodynamics in the heart. However, it takes a lot of effort to obtain the proper external force boundary conditions for active models, which heavily restrained the time-sensitive clinical applications of active computational models. Methods The simulation results of 12 passive FSI models based on 6 patients’ pre-operative and post-operative CT images were compared with corresponding active models to investigate the differences in hemodynamics and cardiac mechanics between these models. Results In comparing the passive and active models, it was found that there was no significant difference in pressure difference and shear stress on mitral valve leaflet (MVL) at the pre-SAM time point, but a significant difference was found in wall stress on the inner boundary of left ventricle (endocardium). It was also found that pressure difference on the coapted MVL and the shear stress on MVL were significantly decreased after successful surgery in both active and passive models. Conclusion Our results suggested that the passive models may provide good approximated hemodynamic results at 5% RR interval, which is crucial for analyzing the initiation of systolic anterior motion (SAM). Comparing to active models, the passive models decrease the complexity of the modeling construction and the difficulty of convergence significantly. These findings suggest that, with proper boundary conditions and sufficient clinical data, the passive computational model may be a good substitution model for the active model to perform hemodynamic analysis of the initiation of SAM.

Computational analysis of ventricular mechanics in hypertrophic cardiomyopathy patients

“…They also did not consider patient-specific LV geometries that encapsulate the heterogeneous distribution of wall thickness associated with this disease. Other computational studies are focused only on obstructive HCM 35 , 36 , but they did not consider the effects of myofiber disarray.…”

Optimization of Left Ventricle Pace Maker Location Using Echo-Based Fluid-Structure Interaction Models

“…Lee et al (2018) focus on the contribution of electrophysiology, mechanics, and circulatory computer models of the heart to understanding cardiac resynchronization therapy response. In our previous studies, we introduced patient-specific cardiac magnetic resonance (CMR)-based left ventricular/right ventricular (LV/RV) models with fluid-structure interactions (FSI) with various surgical design and potential applications (Tang et al, 2010(Tang et al, , 2011(Tang et al, , 2016Huang et al, 2021). Echo-based 3D LV FSI models were introduced to perform ventricle mechanical analysis and investigate flow behaviors (Fan et al, 2018).…”