Computational Modeling Studies of the Roles of Left Ventricular Geometry, Afterload, and Muscle Contractility on Myocardial Strains in Heart Failure with Preserved Ejection Fraction.
Computational Modeling Studies of the Roles of Left Ventricular Geometry, Afterload, and Muscle Contractility on Myocardial Strains in Heart Failure with Preserved Ejection Fraction.
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DOI：
10.1007/s12265-021-10130-y
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发表时间：
2021-12
影响因子：
3.4
通讯作者：
Lee, Lik Chuan
中科院分区：
文献类型：
--
作者：
Shavik, Sheikh Mohammad;Wall, Samuel;Sundnes, Joakim;Guccione, Julius M.;Sengupta, Partho;Solomon, Scott D.;Burkhoff, Daniel;Lee, Lik Chuan
整体纵向应变和周向应变在HFpEF中被发现降低，一些人认为这是整体左心室(LV)收缩能力受损。然而，这一发现与保存的射血分数(EF)相矛盾，并被左室几何形状和后负荷阻力的变化所混淆，这些变化也可能影响整体应变。为了协调这些问题，我们使用了一个由有限元LV模型组成的经过验证的计算框架来分离HFpEF特征对心脏收缩功能指标的影响。模拟被用来量化由于左室几何形状的改变、组织产生的主动张力和后负荷对心肌应变的影响。我们发现，只有心肌收缩能力的降低和后负荷的增加才能同时再现HFpEF患者测得的血压、EF和应变。这一发现表明，HFpEF患者的心肌收缩能力可能降低。
Global longitudinal strain and circumferential strain are found to be reduced in HFpEF, which some have interpreted that the global left ventricular (LV) contractility is impaired. This finding is, however, contradicted by a preserved ejection fraction (EF) and confounded by changes in LV geometry and afterload resistance that may also affect the global strains. To reconcile these issues, we used a validated computational framework consisting of a finite element LV model to isolate the effects of HFpEF features in affecting systolic function metrics. Simulations were performed to quantify the effects on myocardial strains due to changes in LV geometry, active tension developed by the tissue, and afterload. We found that only a reduction in myocardial contractility and an increase in afterload can simultaneously reproduce the blood pressures, EF and strains measured in HFpEF patients. This finding suggests that it is likely that the myocardial contractility is reduced in HFpEF patients.
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