Incorporation of a Left Ventricle Finite Element Model Defining Infarction Into the XCAT Imaging Phantom

The 4D extended cardiac-torso (XCAT) phantom was developed to provide a realistic and flexible model of the human anatomy and cardiac and respiratory motions for use in medical imaging research. A prior limitation to the phantom was that it did not accurately simulate altered functions of the heart that result from cardiac pathologies such as coronary artery disease (CAD). We overcame this limitation in a previous study by combining the phantom with a finite-element (FE) mechanical model of the left ventricle (LV) capable of more realistically simulating regional defects caused by ischemia. In the present work, we extend this model giving it the ability to accurately simulate motion abnormalities caused by myocardial infarction (MI), a far more complex situation in terms of altered mechanics compared with the modeling of acute ischemia. The FE model geometry is based on high resolution CT images of a normal male subject. An anterior region was defined as infarcted and the material properties and fiber distribution were altered, according to the bio-physiological properties of two types of infarction, i.e., fibrous and remodeled infarction (30% thinner wall than fibrous case). Compared with the original, surface-based 4D beating heart model of the XCAT, where regional abnormalities are modeled by simply scaling down the motion in those regions, the FE model was found to provide a more accurate representation of the abnormal motion of the LV due to the effects of fibrous infarction as well as depicting the motion of remodeled infarction. In particular, the FE models allow for the accurate depiction of dyskinetic motion. The average circumferential strain results were found to be consistent with measured dyskinetic experimental results. Combined with the 4D XCAT phantom, the FE model can be used to produce realistic multimodality sets of imaging data from a variety of patients in which the normal or abnormal cardiac function is accurately represented.

[1]  K. Weber,et al.  Infarct scar: a dynamic tissue. , 2000, Cardiovascular research.

[2]  Timothy G Reese,et al.  Cardiac diffusion MRI without motion effects , 2002, Magnetic resonance in medicine.

[3]  J. Guccione,et al.  MRI-based finite-element analysis of left ventricular aneurysm. , 2005, American journal of physiology. Heart and circulatory physiology.

[4]  A D McCulloch,et al.  Transmural distribution of three-dimensional strain in the isolated arrested canine left ventricle. , 1991, The American journal of physiology.

[5]  Yin Wu,et al.  MR study of the effect of infarct size and location on left ventricular functional and microstructural alterations in porcine models , 2009, Journal of magnetic resonance imaging : JMRI.

[6]  M Puso,et al.  NIKE3D a nonlinear, implicit, three-dimensional finite element code for solid and structural mechanics user's manual update summary , 1991 .

[7]  P. Vokonas,et al.  Experimental myocardial infarction. XIII. Sequential changes in left ventricular pressure-length relationships in the acute phase. , 1976, Circulation.

[8]  Arthur W Wallace,et al.  Myosplint decreases wall stress without depressing function in the failing heart: a finite element model study. , 2003, The Annals of thoracic surgery.

[9]  A D McCulloch,et al.  Structural basis of regional dysfunction in acutely ischemic myocardium. , 2000, Cardiovascular research.

[10]  W. Leslie,et al.  Prognostic value of automated quantification of 99mTc-sestamibi myocardial perfusion imaging. , 2005, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[11]  H. Halperin,et al.  Imaging asynchronous mechanical activation of the paced heart with tagged MRI , 1998, Magnetic resonance in medicine.

[12]  Peter J Hunter,et al.  Modeling total heart function. , 2003, Annual review of biomedical engineering.

[13]  Nael F Osman,et al.  Spatially resolved imaging of myocardial function with strain-encoded MR: comparison with delayed contrast-enhanced MR imaging after myocardial infarction. , 2004, Radiology.

[14]  Frederick J. Vetter,et al.  Three-Dimensional Stress and Strain in Passive Rabbit Left Ventricle: A Model Study , 2000, Annals of Biomedical Engineering.

[15]  Robert C Gorman,et al.  Border zone geometry increases wall stress after myocardial infarction: contrast echocardiographic assessment. , 2003, American journal of physiology. Heart and circulatory physiology.

[16]  Stuart S Berr,et al.  MR tagging early after myocardial infarction in mice demonstrates contractile dysfunction in adjacent and remote regions , 2002, Magnetic resonance in medicine.

[17]  T. Borg,et al.  Structure and mechanics of healing myocardial infarcts. , 2005, Annual review of biomedical engineering.

[18]  Alexander I. Veress,et al.  Normal and Pathological NCAT Image and Phantom Data Based on Physiologically Realistic Left Ventricle Finite-Element Models , 2006, IEEE Transactions on Medical Imaging.

[19]  R. Millard,et al.  Defining the mechanical border zone: a study in the pig heart. , 1985, The American journal of physiology.

[20]  K. Hayashi.  Cardiovascular solid mechanics. Cells, tissues, and organs , 2003 .

[21]  Theo Arts,et al.  Computational analysis of the myocardial structure: Adaptation of cardiac myofiber orientations through deformation , 2009, Medical Image Anal..

[22]  A D McCulloch,et al.  Gradients of epicardial strain across the perfusion boundary during acute myocardial ischemia. , 1994, The American journal of physiology.

[23]  E. McVeigh,et al.  Electromechanical analysis of infarct border zone in chronic myocardial infarction. , 2005, American journal of physiology. Heart and circulatory physiology.

[24]  W. Kramer,et al.  Mechanisms of altered myocardial contractility during hemodialysis: Importance of changes in the ionized calcium to plasma potassium ratio , 1985, Klinische Wochenschrift.

[25]  Roy C. P. Kerckhoffs,et al.  Multi-scale modeling of excitation-contraction coupling in the normal and failing heart , 2009, 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[26]  Roy C. P. Kerckhoffs,et al.  Effects of biventricular pacing and scar size in a computational model of the failing heart with left bundle branch block , 2009, Medical Image Anal..

[27]  J W Covell,et al.  Functional implications of myocardial scar structure. , 1997, The American journal of physiology.

[28]  Yin Wu,et al.  MR diffusion tensor imaging study of postinfarct myocardium structural remodeling in a porcine model , 2007, Magnetic resonance in medicine.

[29]  E. McVeigh,et al.  Mapping propagation of mechanical activation in the paced heart with MRI tagging. , 1999, The American journal of physiology.

[30]  A. McCulloch,et al.  Regional Myocardial Perfusion and Mechanics: A Model-Based Method of Analysis , 1998, Annals of Biomedical Engineering.

[31]  J. O. Hallquist,et al.  NIKE2D: A nonlinear, implicit, two-dimensional finite element code for solid mechanics , 1991 .

[32]  A D McCulloch,et al.  Mechanics of active contraction in cardiac muscle: Part I--Constitutive relations for fiber stress that describe deactivation. , 1993, Journal of biomechanical engineering.

[33]  P. Hunter,et al.  Computational Mechanics of the Heart , 2000 .

[34]  Udo Sechtem,et al.  Left ventricular wall motion abnormalities as well as reduced wall thickness can cause false positive results of routine SPECT perfusion imaging for detection of myocardial infarction. , 2005, European heart journal.

[35]  Charles J Bruce,et al.  Ultrasound Strain Imaging of Altered Myocardial Stiffness: Stunned Versus Infarcted Reperfused Myocardium , 2004, Circulation.

[36]  R. Dinsmore,et al.  Imaging myocardial fiber architecture in vivo with magnetic resonance , 1995, Magnetic resonance in medicine.

[37]  M. Fishbein,et al.  The histopathologic evolution of myocardial infarction. , 1978, Chest.

[38]  Edward W Hsu,et al.  Helical myofiber orientation after myocardial infarction and left ventricular surgical restoration in sheep. , 2005, The Journal of thoracic and cardiovascular surgery.

[39]  Roy C. P. Kerckhoffs,et al.  Coupling of a 3D Finite Element Model of Cardiac Ventricular Mechanics to Lumped Systems Models of the Systemic and Pulmonic Circulation , 2006, Annals of Biomedical Engineering.

[40]  William Paul Segars,et al.  Development of a new dynamic NURBS-based cardiac-torso (NCAT) phantom , 2001 .

[41]  R S Reneman,et al.  Regional wall mechanics in the ischemic left ventricle: numerical modeling and dog experiments. , 1996, The American journal of physiology.

[42]  Roy C. P. Kerckhoffs,et al.  Cardiac resynchronization: insight from experimental and computational models. , 2008, Progress in biophysics and molecular biology.

[43]  Whirley.  DYNA3D: A nonlinear, explicit, three-dimensional finite element code for solid and structural mechanics , 1993 .

[44]  Robert C Gorman,et al.  Akinetic myocardial infarcts must contain contracting myocytes: finite-element model study. , 2005, American journal of physiology. Heart and circulatory physiology.

[45]  Kevin D Costa,et al.  Contribution of laminar myofiber architecture to load-dependent changes in mechanics of LV myocardium. , 2002, American journal of physiology. Heart and circulatory physiology.

[46]  A. McCulloch,et al.  Relating myocardial laminar architecture to shear strain and muscle fiber orientation. , 2001, American journal of physiology. Heart and circulatory physiology.

[47]  D. E. Guyer,et al.  The natural history of regional wall motion in the acutely infarcted canine ventricle. , 1986, Journal of the American College of Cardiology.

[48]  A. McCulloch,et al.  Passive material properties of intact ventricular myocardium determined from a cylindrical model. , 1991, Journal of biomechanical engineering.

[49]  Y. Fung,et al.  Transmural Myocardial Deformation in the Canine Left Ventricle: Normal in Vivo Three‐Dimensional Finite Strains , 1985, Circulation research.

[50]  J M Guccione,et al.  Residual stress produced by ventricular volume reduction surgery has little effect on ventricular function and mechanics: a finite element model study. , 2001, The Journal of thoracic and cardiovascular surgery.

[51]  Sheng-Kwei Song,et al.  Remodeling of cardiac fiber structure after infarction in rats quantified with diffusion tensor MRI. , 2003, American journal of physiology. Heart and circulatory physiology.

[52]  K. Gallagher,et al.  Subendocardial segment length shortening at lateral margins of ischemic myocardium in dogs. , 1987, The American journal of physiology.

[53]  Theo Arts,et al.  Computational modeling of volumetric soft tissue growth: application to the cardiac left ventricle , 2009, Biomechanics and modeling in mechanobiology.

[54]  Hervé Delingette,et al.  An electromechanical model of the heart for image analysis and simulation , 2006, IEEE Transactions on Medical Imaging.

[55]  N. Tamaki,et al.  Septal perfusion and wall thickening in patients with left bundle branch block assessed by technetium-99m-sestamibi gated tomography. , 1997, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[56]  A D McCulloch,et al.  Mechanics of active contraction in cardiac muscle: Part II--Cylindrical models of the systolic left ventricle. , 1993, Journal of biomechanical engineering.

[57]  Frederick H Epstein,et al.  Measurement of myocardial mechanics in mice before and after infarction using multislice displacement-encoded MRI with 3D motion encoding. , 2005, American journal of physiology. Heart and circulatory physiology.

[58]  H. Malcolm Hudson,et al.  Accelerated image reconstruction using ordered subsets of projection data , 1994, IEEE Trans. Medical Imaging.

[59]  Edward W Hsu,et al.  Magnetic resonance imaging-based finite element stress analysis after linear repair of left ventricular aneurysm. , 2008, The Journal of thoracic and cardiovascular surgery.

[60]  M. Daemen,et al.  The alpha-smooth muscle actin-positive cells in healing human myocardial scars. , 1994, The American journal of pathology.

[61]  Theo Arts,et al.  Structure and torsion in the normal and situs inversus totalis cardiac left ventricle. II. Modeling cardiac adaptation to mechanical load. , 2008, American journal of physiology. Heart and circulatory physiology.

[62]  M. Daemen,et al.  The infarcted myocardium: simply dead tissue, or a lively target for therapeutic interventions. , 1999, Cardiovascular research.

[63]  Tokuo Kasai,et al.  Decreased septal wall thickening in patients with left bundle branch block , 2004, Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology.

[64]  P. Vokonas,et al.  Experimental myocardial infarction. XV. Segmental mechanical behavior and morphology of ischemic myocardium during hypothermia. , 1978, The American journal of physiology.

[65]  D. Manocha,et al.  Development and application of the new dynamic Nurbs-based Cardiac-Torso (NCAT) phantom. , 2001 .

[66]  J W Covell,et al.  Transverse shear along myocardial cleavage planes provides a mechanism for normal systolic wall thickening. , 1995, Circulation research.

[67]  Andrew D McCulloch,et al.  Laminar fiber architecture and three-dimensional systolic mechanics in canine ventricular myocardium. , 1999, American journal of physiology. Heart and circulatory physiology.

[68]  J W Covell,et al.  Structural and mechanical factors influencing infarct scar collagen organization. , 2000, American journal of physiology. Heart and circulatory physiology.

[69]  P. Vokonas,et al.  Experimental myocardial infarction: XII. Dynamic changes in segmental mechanical behavior of infarcted and non-infarcted myocardium. , 1976, The American journal of cardiology.

[70]  Yin Wu,et al.  Diffusion Tensor MRI Study of Myocardium Structural Remodeling after Infarction in Porcine Model , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[71]  Nael F Osman,et al.  Quantitative MR measurements of regional and global left ventricular function and strain after intramyocardial transfer of VM202 into infarcted swine myocardium. , 2008, American journal of physiology. Heart and circulatory physiology.

[72]  David S. Lalush,et al.  Development of an interactive software application to model patient populations in the 4D NURBS-based cardiac torso phantom , 2000, 2000 IEEE Nuclear Science Symposium. Conference Record (Cat. No.00CH37149).

[73]  K. Gallagher,et al.  The Distribution of Functional Impairment across the Lateral Border of Acutely Ischemic Myocardium , 1986, Circulation research.

[74]  Robert C Gorman,et al.  Effect of ventricular size and patch stiffness in surgical anterior ventricular restoration: a finite element model study. , 2005, The Annals of thoracic surgery.

[75]  A. McCulloch,et al.  Modelling cardiac mechanical properties in three dimensions , 2001, Philosophical Transactions of the Royal Society of London. Series A: Mathematical, Physical and Engineering Sciences.

[76]  D. Lalush,et al.  A realistic spline-based dynamic heart phantom , 1998, 1998 IEEE Nuclear Science Symposium Conference Record. 1998 IEEE Nuclear Science Symposium and Medical Imaging Conference (Cat. No.98CH36255).

[77]  J. Covell,et al.  Remodeling in myocardium adjacent to an infarction in the pig left ventricle. , 2004, American journal of physiology. Heart and circulatory physiology.

[78]  R T Constable,et al.  Quantification of 3-D regional myocardial deformation: shape-based analysis of magnetic resonance images. , 2001, American journal of physiology. Heart and circulatory physiology.

[79]  J. Covell,et al.  Relation Between Transmural Deformation and Local Myofiber Direction in Canine Left Ventricle , 1988, Circulation research.

[80]  J. Weiss,et al.  Impaired thickening of nonischemic myocardium during acute regional ischemia in the dog. , 1985, Circulation.

[81]  J. Weiss,et al.  Finite element implementation of incompressible, transversely isotropic hyperelasticity , 1996 .

[82]  P J Hunter,et al.  A three-dimensional finite element method for large elastic deformations of ventricular myocardium: II--Prolate spheroidal coordinates. , 1996, Journal of biomechanical engineering.

[83]  Maxime Sermesant,et al.  Cardiac Function Estimation from MRI Using a Heart Model and Data Assimilation: Advances and Difficulties , 2005, FIMH.