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• W4280593807 abstract "Introduction: Computational modeling of cardiac mechanics and hemodynamics in ischemic heart disease (IHD) is important for a better understanding of the complex relations between ischemia-induced heterogeneity of myocardial tissue properties, regional tissue mechanics, and hemodynamic pump function. We validated and applied a lumped two-compartment modeling approach for IHD integrated into the CircAdapt model of the human heart and circulation. Methods: Ischemic contractile dysfunction was simulated by subdividing a left ventricular (LV) wall segment into a hypothetical contractile and noncontractile compartment, and dysfunction severity was determined by the noncontractile volume fraction ( <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m1><mml:mrow><mml:mi>N</mml:mi><mml:mi>C</mml:mi><mml:mi>V</mml:mi><mml:mi>F</mml:mi></mml:mrow></mml:math> ). Myocardial stiffness was determined by the zero-passive stress length ( <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m2><mml:mrow><mml:msub><mml:mi>L</mml:mi><mml:mrow><mml:mi>s</mml:mi><mml:mn>0</mml:mn><mml:mo>,</mml:mo><mml:mi>p</mml:mi><mml:mi>a</mml:mi><mml:mi>s</mml:mi></mml:mrow></mml:msub><mml:mo>)</mml:mo></mml:mrow></mml:math> and nonlinearity ( <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m3><mml:mrow><mml:msub><mml:mi>k</mml:mi><mml:mrow><mml:mi>E</mml:mi><mml:mi>C</mml:mi><mml:mi>M</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math> ) of the passive stress-sarcomere length relation of the noncontractile compartment. Simulated end-systolic pressure volume relations (ESPVRs) for 20% acute ischemia were qualitatively compared between a two- and one-compartment simulation, and parameters of the two-compartment model were tuned to previously published canine data of regional myocardial deformation during acute and prolonged ischemia and reperfusion. In six patients with myocardial infarction (MI), the <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m4><mml:mrow><mml:mi>N</mml:mi><mml:mi>C</mml:mi><mml:mi>V</mml:mi><mml:mi>F</mml:mi></mml:mrow></mml:math> was automatically estimated using the echocardiographic LV strain and volume measurements obtained acutely and 6 months after MI. Estimated segmental <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m5><mml:mrow><mml:mi>N</mml:mi><mml:mi>C</mml:mi><mml:mi>V</mml:mi><mml:mi>F</mml:mi></mml:mrow></mml:math> values at the baseline and 6-month follow-up were compared with percentage late gadolinium enhancement (LGE) at 6-month follow-up. Results: Simulation of 20% of <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m6><mml:mrow><mml:mi>N</mml:mi><mml:mi>C</mml:mi><mml:mi>V</mml:mi><mml:mi>F</mml:mi></mml:mrow></mml:math> shifted the ESPVR rightward while moderately reducing the slope, while a one-compartment simulation caused a leftward shift with severe reduction in the slope. Through tuning of the <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m7><mml:mrow><mml:mi>N</mml:mi><mml:mi>C</mml:mi><mml:mi>V</mml:mi><mml:mi>F</mml:mi></mml:mrow></mml:math> , <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m8><mml:mrow><mml:msub><mml:mi>L</mml:mi><mml:mrow><mml:mi>s</mml:mi><mml:mn>0</mml:mn><mml:mo>,</mml:mo><mml:mi>p</mml:mi><mml:mi>a</mml:mi><mml:mi>s</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math> , and <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m9><mml:mrow><mml:msub><mml:mi>k</mml:mi><mml:mrow><mml:mi>E</mml:mi><mml:mi>C</mml:mi><mml:mi>M</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math> , it was found that manipulation of the <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m10><mml:mrow><mml:mi>N</mml:mi><mml:mi>C</mml:mi><mml:mi>V</mml:mi><mml:mi>F</mml:mi></mml:mrow></mml:math> alone reproduced the deformation during acute ischemia and reperfusion, while additional manipulations of <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m11><mml:mrow><mml:msub><mml:mi>L</mml:mi><mml:mrow><mml:mi>s</mml:mi><mml:mn>0</mml:mn><mml:mo>,</mml:mo><mml:mi>p</mml:mi><mml:mi>a</mml:mi><mml:mi>s</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math> and <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m12><mml:mrow><mml:msub><mml:mi>k</mml:mi><mml:mrow><mml:mi>E</mml:mi><mml:mi>C</mml:mi><mml:mi>M</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math> were required to reproduce deformation during prolonged ischemia and reperfusion. Out of all segments with LGE&gt;25% at the follow-up, the majority (68%) had higher estimated <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m13><mml:mrow><mml:mi>N</mml:mi><mml:mi>C</mml:mi><mml:mi>V</mml:mi><mml:mi>F</mml:mi></mml:mrow></mml:math> at the baseline than at the follow-up. Furthermore, the baseline <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m14><mml:mrow><mml:mi>N</mml:mi><mml:mi>C</mml:mi><mml:mi>V</mml:mi><mml:mi>F</mml:mi></mml:mrow></mml:math> correlated better with percentage LGE than <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m15><mml:mrow><mml:mi>N</mml:mi><mml:mi>C</mml:mi><mml:mi>V</mml:mi><mml:mi>F</mml:mi></mml:mrow></mml:math> did at the follow-up. Conclusion: We successfully used a two-compartment model for simulation of the ventricular pump and tissue mechanics in IHD. Patient-specific optimizations using regional myocardial deformation estimated the <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m16><mml:mrow><mml:mi>N</mml:mi><mml:mi>C</mml:mi><mml:mi>V</mml:mi><mml:mi>F</mml:mi></mml:mrow></mml:math> in a small cohort of MI patients in the acute and chronic phase after MI, while estimated <mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=m17><mml:mrow><mml:mi>N</mml:mi><mml:mi>C</mml:mi><mml:mi>V</mml:mi><mml:mi>F</mml:mi></mml:mrow></mml:math> values closely approximated the extent of the myocardial scar at the follow-up. In future studies, this approach can facilitate deformation imaging–based estimation of myocardial tissue properties in patients with cardiovascular diseases." @default.
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• W4280593807 date "2022-05-11" @default.
• W4280593807 modified "2023-09-30" @default.
• W4280593807 title "A Lumped Two-Compartment Model for Simulation of Ventricular Pump and Tissue Mechanics in Ischemic Heart Disease" @default.
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• W4280593807 doi "https://doi.org/10.3389/fphys.2022.782592" @default.
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