Background: A finite-element model of the left ventricle (LV) is used to produce LV pressure and volume curves over the entire cardiac cycle under normal and ischemic conditions. The regional myocardial contractions defined by finite elements are then related to the time-varying LV elastance (instantaneous pressure over volume ratio). This model provides a computationally efficient way to assess how localized ischemic zones affect global LV systolic function. Method: A 3D model of the LV with an axisymmetric truncated-ellipsoidal geometry is represented by a 2D grid of long-axis cross-section. The initial end-diastolic grid is generated from a set of elliptic curves with user-defined parameters such as wall thickness, long and short axis lengths. The strain-stress relationship for each element is assumed to be linear but with a time-varying Young's modulus. Empirical curves of the Young's modulus for the finite elements are defined by the user to simulate normal and ischemic myocardium. To configure an ischemic zone of certain size and geometry, the contractile state of each finite element over a cardiac cycle can be individually assigned. Result: Simulations of normal and ischemic LV's were performed. Figures below show a comparison between control and the presence of an ischemic zone. The ejection fraction (EF) was reduced from 64% of control (A) to 43% of ischemia (B). The stroke volume (SV) was reduced from 70 ml to 50 ml. The LV pressure was set the same in both cases to show how the ischemic zone affects the LV volume curve over a cardiac cycle (C). The LV elastance curves were compared to the time-varying Young's modulus curves assigned to normal and ischemic finite elements (D). Conclusion: The model provides a computational method that relates regional myocardial impairment to LV systolic function. The drastic difference in wave shape between individual Young's modulus and global LV elastance suggests a built-in nonlinearity in the geometry of the finite-element model, even under the assumption of linear stress-strain relationships. The model should be useful for studying the hemodynamic consequences of different severity, size and location of regional myocardial impairments.
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