Simulating ventricular systolic motion in a four-chamber heart model with spatially varying robin boundary conditions to model the effect of the pericardium

Strocchi, Marina; Gsell, Matthias A. F.; Augustin, Christoph M.; Razeghi, Orod; Roney, Caroline H.; Prassl, Anton J.; Vigmond, Edward J.; Behar, Jonathan M.; Gould, Justin; Rinaldi, Christopher Aldo; Bishop, Martin J.; Plank, Gernot; Niederer, Steven

doi:10.1016/j.jbiomech.2020.109645

Cited by 75 publications

(83 citation statements)

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“…Therefore, the active stress computed by the cellular model was added to the passive stress in the fiber direction only [47]. Including transverse active stress was reported to improve simulated strains [56], but was shown to have minimal effects on simulated motion [11]. However, the aim of active contraction test was not to match physiological strains but to show the suitability of the meshes for electro-mechanics simulations.…”

Section: Plos Onementioning

confidence: 99%

“…Small patient cohorts, however, have a limited capability to capture patient anatomical variability. Furthermore, biventricular models have limitations in representing realistic systolic motion, as anatomical cardiac structures surrounding the ventricles are not included [11].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, computational electro-mechanics started moving towards four-chamber models [11][12][13][14]. Simulations including the atria as well as the major vessels allow for a more realistic predicted motion, therefore offering an increased predictive power of the model.…”

Section: Introductionmentioning

confidence: 99%

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A publicly available virtual cohort of four-chamber heart meshes for cardiac electro-mechanics simulations

et al. 2020

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Computational models of the heart are increasingly being used in the development of devices, patient diagnosis and therapy guidance. While software techniques have been developed for simulating single hearts, there remain significant challenges in simulating cohorts of virtual hearts from multiple patients. To facilitate the development of new simulation and model analysis techniques by groups without direct access to medical data, image analysis techniques and meshing tools, we have created the first publicly available virtual cohort of twenty-four four-chamber hearts. Our cohort was built from heart failure patients, age 67±14 years. We segmented four-chamber heart geometries from end-diastolic (ED) CT images and generated linear tetrahedral meshes with an average edge length of 1.1 ±0.2mm. Ventricular fibres were added in the ventricles with a rule-based method with an orientation of-60˚and 80˚at the epicardium and endocardium, respectively. We additionally refined the meshes to an average edge length of 0.39±0.10mm to show that all given meshes can be resampled to achieve an arbitrary desired resolution. We ran simulations for ventricular electrical activation and free mechanical contraction on all 1.1mm-resolution meshes to ensure that our meshes are suitable for electro-mechanical simulations. Simulations for electrical activation resulted in a total activation time of 149±16ms. Free mechanical contractions gave an average left ventricular (LV) and right ventricular (RV) ejection fraction (EF) of 35±1% and 30±2%, respectively, and a LV and RV stroke volume (SV) of 95±28mL and 65±11mL, respectively. By making the cohort publicly available, we hope to facilitate large cohort computational studies and to promote the development of cardiac computational electro-mechanics for clinical applications.

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Section: Plos Onementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A publicly available virtual cohort of four-chamber heart meshes for cardiac electro-mechanics simulations

et al. 2020

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“…Peak in active tension, twitch duration, rising time and decay time were set to 135kPa, 550ms, 130ms and 100ms, respectively [4]. The motion of the heart was constrained with normal springs on the outer surface of the heart to represent the effect of the pericardium (Figure 3, green) [4,7]. Motion tracking applied to ECG-gated CT images acquired on the cohort showed that the roof of the atria and the regions close to the apex of the ventricles moved the least [7].…”

Section: Electro-mechanics Simulationmentioning

confidence: 99%

“…The motion of the heart was constrained with normal springs on the outer surface of the heart to represent the effect of the pericardium (Figure 3, green) [4,7]. Motion tracking applied to ECG-gated CT images acquired on the cohort showed that the roof of the atria and the regions close to the apex of the ventricles moved the least [7]. Therefore, we scaled normal spring stiffness to constrain these regions the most.…”

Section: Electro-mechanics Simulationmentioning

confidence: 99%

His Bundle Pacing but not Left Bundle Pacing Corrects Septal Flash in Left Bundle Branch Block Patients

Strocchi

Neic²,

Gsell

et al. 2020

2020 Computing in Cardiology Conference (CinC)

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His bundle pacing (HBP) and left bundle pacing (LBP) are novel delivery methods for cardiac resynchronisation therapy (CRT) for left bundle branch block (LBBB) patients. Septal flash (SF), an abnormal pre-ejection motion of the septum towards the left ventricle (LV) arising from dyssynchronous activation, has been shown in the past to be a robust and independent predictor for CRT response. Although small-cohort studies showed the feasibility and efficacy of HBP and LBP, the effects of HBP and LBP on septal motion have yet to be investigated. In this study, we used our four-chamber heart electro-mechanics simulation framework to determine whether HBP and LBP can correct for SF. We performed simulations in four fourchamber heart models. In synchronous and LBBB activation, simulated mean lateral septal movement from the right ventricle (RV) into the LV was-0.4±0.5mm and-3.7±0.9mm (p<0.05), respectively. HBP reduced septal motion to-0.4±0.5mm (p=0.5 when compared to synchronous activation). In LBP, septal motion was reversed to 0.9±0.5mm and significantly different from synchronous activation (p<0.05). HBP was better able to recover septal function over LBP in patients with complete atrioventricular block.

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Polygonal surface processing and mesh generation tools for the numerical simulation of the cardiac function

Fedele

Quarteroni

2021

Numer Methods Biomed Eng

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In order to simulate the cardiac function for a patient‐specific geometry, the generation of the computational mesh is crucially important. In practice, the input is typically a set of unprocessed polygonal surfaces coming either from a template geometry or from medical images. These surfaces need ad‐hoc processing to be suitable for a volumetric mesh generation. In this work we propose a set of new algorithms and tools aiming to facilitate the mesh generation process. In particular, we focus on different aspects of a cardiac mesh generation pipeline: (1) specific polygonal surface processing for cardiac geometries, like connection of different heart chambers or segmentation outputs; (2) generation of accurate boundary tags; (3) definition of mesh‐size functions dependent on relevant geometric quantities; (4) processing and connecting together several volumetric meshes. The new algorithms—implemented in the open‐source software vmtk—can be combined with each other allowing the creation of personalized pipelines, that can be optimized for each cardiac geometry or for each aspect of the cardiac function to be modeled. Thanks to these features, the proposed tools can significantly speed‐up the mesh generation process for a large range of cardiac applications, from single‐chamber single‐physics simulations to multi‐chambers multi‐physics simulations. We detail all the proposed algorithms motivating them in the cardiac context and we highlight their flexibility by showing different examples of cardiac mesh generation pipelines.

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Simulating ventricular systolic motion in a four-chamber heart model with spatially varying robin boundary conditions to model the effect of the pericardium

Cited by 75 publications

References 50 publications

A publicly available virtual cohort of four-chamber heart meshes for cardiac electro-mechanics simulations

A publicly available virtual cohort of four-chamber heart meshes for cardiac electro-mechanics simulations

His Bundle Pacing but not Left Bundle Pacing Corrects Septal Flash in Left Bundle Branch Block Patients

Polygonal surface processing and mesh generation tools for the numerical simulation of the cardiac function

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