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Computer-based Assessment of Left Ventricular Wall Stiffness in Patients with Ischemic Dilated Cardiomyopathy

机译:基于计算机的缺血性扩张型心肌病患者左室壁僵硬度的评估

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Ischemic dilated cardiomyopathy (IDCM) is a degenerative disease of the myocardial tissue accompanied by left ventricular (LV) structural changes such as interstitial flbrosis. This can induce increased passive stiffness of the LV wall. However, quantification of LV passive wall stiffness in vivo is extremely difficult, particularly in ventricles with complex geometry. Therefore, we sought to (ⅰ) develop a computer-based assessment of LV passive wall stiffness from cardiac magnetic resonance (CMR) imaging in terms of a nominal stiffness index (E~*); and (ⅱ) investigate whether E* can offer an insight into cardiac mechanics in IDCM. CMR scans were performed in 5 normal subjects and 5 patients with IDCM. For each data sample, an in-house software was used to generate a 1 -to-1 corresponding mesh pair of the LV from the ED and ES phases. The E* values are then computed as a function of local ventricular wall strain. We found that E* in the IDCM group (40.66 - 215.12) was at least one order of magnitude larger than the normal control group (1.00 - 6.14). In addition, the IDCM group revealed much higher inhomogeneity of E~* values manifested by a greater spread of E~* values throughout the LV. In conclusion, there is a substantial elevated ventricular stiffness index in IDCM. This would suggest that E~* could be used as discriminator for early detection of disease state. The computational performance per data sample took approximately 25 seconds, which demonstrates its clinical potential as a real-time cardiac assessment tool.
机译:缺血性扩张型心肌病(IDCM)是心肌组织的变性疾病,伴有左心室(LV)结构变化,如间质性纤维化。这会导致LV壁的被动刚度增加。但是,体内LV被动壁硬度的量化非常困难,特别是在具有复杂几何形状的心室中。因此,我们试图(ⅰ)开发基于计算机的心脏磁共振(CMR)成像的LV被动壁僵硬度的标称刚度指数(E〜*)评估; (ⅱ)研究E *是否可以提供IDCM心脏力学方面的见识。在5名正常受试者和5名IDCM患者中进行了CMR扫描。对于每个数据样本,使用内部软件从ED和ES阶段生成LV的一对一对应网格对。然后根据局部心室壁应变计算E *值。我们发现IDCM组(40.66-215.12)中的E *比正常对照组(1.00-6.14)大至少一个数量级。此外,IDCM组显示E〜*值的不均匀性更高,这表现为E〜*值在整个LV中的分布更大。总之,IDCM的心室刚度指数显着升高。这表明E〜*可以用作早期发现疾病状态的判别器。每个数据样本的计算性能大约需要25秒,这证明了其作为实时心脏评估工具的临床潜力。

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