Abstract

In myocardial infarction, muscle tissue of the heart is damaged as a result of ceased or severely impaired blood flow. Survivors have an increased risk of further complications, possibly leading to heart failure. Material properties play an important role in determining post-infarction outcome. Due to spatial variation in scarring, material properties can be expected to vary throughout the tissue of a heart after an infarction. In this study we propose a data assimilation technique that can efficiently estimate heterogeneous elastic material properties in a personalized model of cardiac mechanics. The proposed data assimilation is tested on a clinical dataset consisting of regional left ventricular strains and in vivo pressures during atrial systole from a human with a myocardial infarction. Good matches to regional strains are obtained, and simulated equi-biaxial tests are carried out to demonstrate regional heterogeneities in stress–strain relationships. A synthetic data test shows a good match of estimated versus ground truth material parameter fields in the presence of no to low levels of noise. This study is the first to apply adjoint-based data assimilation to the important problem of estimating cardiac elastic heterogeneities in 3-D from medical images.

Highlights

  • Myocardial infarction (MI) is a condition in which muscle tissue in the heart is damaged due to a loss of blood supply

  • A promising way to study the elastic properties of in vivo myocardium is by mathematical modelling and computer simulation

  • We consider the case of a 64-year-old man in systolic heart failure, with left bundle branch block, coronary artery disease, and chronic infarction predominantly in the inferior and inferolateral sections of the left ventricular wall

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Summary

Introduction

Myocardial infarction (MI) is a condition in which muscle tissue in the heart is damaged due to a loss of blood supply. Post-MI, the elastic properties of the myocardium. University Hospital, Rikhospitalet, Oslo, Norway have been shown to play a large role in determining the outcome (Morita et al 2011; Fomovsky et al 2012). A promising way to study the elastic properties of in vivo myocardium is by mathematical modelling and computer simulation. With simulation it is possible to create an in silico representation of a patient’s heart after an infarction. This opens up new possibilities for quantification of elasticity, beyond what is available in medical imaging today. An in silico model that is personalized to a patient can potentially simulate the effects of treatments or therapies on the patient, thereby improving the outcome and reducing risks after MI

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