BACKGROUND HeartModel(HM)is a fully automated adaptive quantification software that can quickly quantify left heart volume and left ventricular function.This study used HM to quantify the left ventricular end-diastoli...BACKGROUND HeartModel(HM)is a fully automated adaptive quantification software that can quickly quantify left heart volume and left ventricular function.This study used HM to quantify the left ventricular end-diastolic(LVEDV)and end-systolic volumes(LVESV)of patients with dilated cardiomyopathy(DCM),coronary artery heart disease with segmental wall motion abnormality,and hypertrophic cardiomyopathy(HCM)to determine whether there were differences in the feasibility,accuracy,and repeatability of measuring the LVEDV,LVESV,LV ejection fraction(LVEF)and left atrial end-systolic volume(LAESV)and to compare these measurements with those obtained with traditional twodimensional(2D)and three-dimensional(3D)methods.AIM To evaluate the application value of HM in quantifying left heart chamber volume and LVEF in clinical patients.METHODS A total of 150 subjects who underwent 2D and 3D echocardiography were divided into 4 groups:(1)42 patients with normal heart shape and function(control group,Group A);(2)35 patients with DCM(Group B);(3)41 patients with LV remodeling after acute myocardial infarction(Group C);and(4)32 patients with HCM(Group D).The LVEDV,LVESV,LVEF and LAESV obtained by HM with(HM-RE)and without regional endocardial border editing(HM-NE)were compared with those measured by traditional 2D/3D echocardiographic methods to assess the correlation,consistency,and repeatability of all methods.RESULTS(1)The parameters measured by HM were significantly different among the groups(P<0.05 for all).Compared with Groups A,C,and D,Group B had higher LVEDV and LVESV(P<0.05 for all)and lower LVEF(P<0.05 for all);(2)HM-NE overestimated LVEDV,LVESV,and LAESV with wide biases and underestimated LVEF with a small bias;contour adjustment reduced the biases and limits of agreement(bias:LVEDV,28.17 mL,LVESV,14.92 mL,LAESV,8.18 mL,LVEF,-0.04%).The correlations between HM-RE and advanced cardiac 3D quantification(3DQA)(r_(s)=0.91-0.95,P<0.05 for all)were higher than those between HM-NE(r_(s)=0.85-0.93,P<0.05 for all)and the traditional 2D methods.The correlations between HM-RE and 3DQA were good for Groups A,B,and C but remained weak for Group D(LVEDV and LVESV,r_(s)=0.48-0.54,P<0.05 for all);and(3)The intraobserver and interobserver variability for the HM-RE measurements were low.CONCLUSION HM can be used to quantify the LV volume and LVEF in patients with common heart diseases and sufficient image quality.HM with contour editing is highly reproducible and accurate and may be recommended for clinical practice.展开更多
We reviewand compare different fluid-structure interaction(FSI)numerical methods in the context of heart modeling,aiming at assessing their computational efficiency for cardiac numerical simulations and selecting the ...We reviewand compare different fluid-structure interaction(FSI)numerical methods in the context of heart modeling,aiming at assessing their computational efficiency for cardiac numerical simulations and selecting the most appropriate method for heart FSI.Blood dynamics within the human heart is characterized by active muscular action,during both contraction and relaxation phases of the heartbeat.The efficient solution of the FSI problem in this context is challenging,due to the added-mass effect(caused by the comparable densities of fluid and solid,typical of biomechanics)and to the complexity,nonlinearity and anisotropy of cardiac consitutive laws.In this work,we review existing numerical coupling schemes for FSI in the two classes of strongly-coupled partitioned and monolithic schemes.The schemes are compared on numerical tests that mimic the flow regime characterizing the heartbeat in a human ventricle,during both systole and diastole.Active mechanics is treated in both the active stress and active strain frameworks.Computational costs suggest the use of a monolithic method.We employ it to simulate a full heartbeat of a human ventricle,showing how it allows to efficiently obtain physiologically meaningful results.展开更多
文摘BACKGROUND HeartModel(HM)is a fully automated adaptive quantification software that can quickly quantify left heart volume and left ventricular function.This study used HM to quantify the left ventricular end-diastolic(LVEDV)and end-systolic volumes(LVESV)of patients with dilated cardiomyopathy(DCM),coronary artery heart disease with segmental wall motion abnormality,and hypertrophic cardiomyopathy(HCM)to determine whether there were differences in the feasibility,accuracy,and repeatability of measuring the LVEDV,LVESV,LV ejection fraction(LVEF)and left atrial end-systolic volume(LAESV)and to compare these measurements with those obtained with traditional twodimensional(2D)and three-dimensional(3D)methods.AIM To evaluate the application value of HM in quantifying left heart chamber volume and LVEF in clinical patients.METHODS A total of 150 subjects who underwent 2D and 3D echocardiography were divided into 4 groups:(1)42 patients with normal heart shape and function(control group,Group A);(2)35 patients with DCM(Group B);(3)41 patients with LV remodeling after acute myocardial infarction(Group C);and(4)32 patients with HCM(Group D).The LVEDV,LVESV,LVEF and LAESV obtained by HM with(HM-RE)and without regional endocardial border editing(HM-NE)were compared with those measured by traditional 2D/3D echocardiographic methods to assess the correlation,consistency,and repeatability of all methods.RESULTS(1)The parameters measured by HM were significantly different among the groups(P<0.05 for all).Compared with Groups A,C,and D,Group B had higher LVEDV and LVESV(P<0.05 for all)and lower LVEF(P<0.05 for all);(2)HM-NE overestimated LVEDV,LVESV,and LAESV with wide biases and underestimated LVEF with a small bias;contour adjustment reduced the biases and limits of agreement(bias:LVEDV,28.17 mL,LVESV,14.92 mL,LAESV,8.18 mL,LVEF,-0.04%).The correlations between HM-RE and advanced cardiac 3D quantification(3DQA)(r_(s)=0.91-0.95,P<0.05 for all)were higher than those between HM-NE(r_(s)=0.85-0.93,P<0.05 for all)and the traditional 2D methods.The correlations between HM-RE and 3DQA were good for Groups A,B,and C but remained weak for Group D(LVEDV and LVESV,r_(s)=0.48-0.54,P<0.05 for all);and(3)The intraobserver and interobserver variability for the HM-RE measurements were low.CONCLUSION HM can be used to quantify the LV volume and LVEF in patients with common heart diseases and sufficient image quality.HM with contour editing is highly reproducible and accurate and may be recommended for clinical practice.
基金funding from the European Research Council(ERC)under the European Union’s Horizon 2020 research and innovation programme(grant agreement No 740132,iHEART-An Integrated Heart Model for the simulation of the cardiac function,P.I.Prof.A.Quarteroni).
文摘We reviewand compare different fluid-structure interaction(FSI)numerical methods in the context of heart modeling,aiming at assessing their computational efficiency for cardiac numerical simulations and selecting the most appropriate method for heart FSI.Blood dynamics within the human heart is characterized by active muscular action,during both contraction and relaxation phases of the heartbeat.The efficient solution of the FSI problem in this context is challenging,due to the added-mass effect(caused by the comparable densities of fluid and solid,typical of biomechanics)and to the complexity,nonlinearity and anisotropy of cardiac consitutive laws.In this work,we review existing numerical coupling schemes for FSI in the two classes of strongly-coupled partitioned and monolithic schemes.The schemes are compared on numerical tests that mimic the flow regime characterizing the heartbeat in a human ventricle,during both systole and diastole.Active mechanics is treated in both the active stress and active strain frameworks.Computational costs suggest the use of a monolithic method.We employ it to simulate a full heartbeat of a human ventricle,showing how it allows to efficiently obtain physiologically meaningful results.
