On estimating intraventricular hemodynamic forces from endocardial dynamics: A comparative study with 4D flow MRI |
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| Affiliation: | 1. Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon, Republic of Korea;2. Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden;3. Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden;4. Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway;1. Section of Cardiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, USA;2. Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark;3. Department of Medicine, Nykøbing F Hospital, Nykøbing F, Denmark;4. Department of Clinical Physiology, Lund University, Skåne University Hospital, Lund, Sweden;5. Assistance Publique Hôpitaux de Paris, Hôpital Henri Mondor, Créteil, France;6. Department of Cardiology B, Oslo University Hospital Ullevål, Faculty of Medicine, University of Oslo, Oslo, Norway;7. Department of Clinical Science, University of Bergen, Bergen, Norway;8. Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark;9. Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark;10. Department of General and Interventional Cardiology, University Heart Center Hamburg-Eppendorf, Hamburg, Germany;11. Department of Cardiology, Houston Methodist Hospital, Houston, TX, USA;12. Department of Cardiology, Herlev University Hospital, Herlev, Denmark;1. Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden;2. Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden;3. Division of Media and Information Technology, Department of Science and Technology/Swedish e-Science Research Centre (SeRC), Linköping University, Linköping, Sweden;4. Department of Cardiovascular Surgery, Linköping University Hospital, County Council of Östergötland, Linköping, Sweden |
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| Abstract: | Intraventricular pressure gradients or hemodynamic forces, which are their global measure integrated over the left ventricular volume, have a fundamental importance in ventricular function. They may help revealing a sub-optimal cardiac function that is not evident in terms of tissue motion, which is naturally heterogeneous and variable, and can influence cardiac adaptation. However, hemodynamic forces are not utilized in clinical cardiology due to the unavailability of simple non-invasive measurement tools.Hemodynamic forces depend on the intraventricular flow; nevertheless, most of them are imputable to the dynamics of the endocardial flow boundary and to the exchange of momentum across the mitral and aortic orifices. In this study, we introduce a simplified model based on first principles of fluid dynamics that allows estimating hemodynamic forces without knowing the velocity field inside the LV.The model is validated with 3D phase-contrast MRI (known as 4D flow MRI) in 15 subjects, (5 healthy and 10 patients) using the endocardial surface reconstructed from the three standard long-axis projections. Results demonstrate that the model provides consistent estimates for the base-apex component (mean correlation coefficient r = 0.77 for instantaneous values and r = 0.88 for root mean square) and good estimates of the inferolateral-anteroseptal component (r = 0.50 and 0.84, respectively).The present method represents a potential integration to the existing ones quantifying endocardial deformation in MRI and echocardiography to add a physics-based estimation of the corresponding hemodynamic forces. These could help the clinician to early detect sub-clinical diseases and differentiate between different cardiac dysfunctional states. |
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| Keywords: | Cardiac fluid dynamics Hemodynamic forces Intraventricular pressure gradient 4D flow MRI |
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