Changes and classification in myocardial contractile function in the left ventricle following acute myocardial infarction.
Changes and classification in myocardial contractile function in the left ventricle following acute myocardial infarction.
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DOI：
10.1098/rsif.2017.0203
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发表时间：
2017-07
期刊：
影响因子：
--
通讯作者：
Berry C
中科院分区：
文献类型：
--
作者：
Gao H;Aderhold A;Mangion K;Luo X;Husmeier D;Berry C
在这项研究中，我们假设新的生物力学参数在急性ST段抬高型心肌梗死（STEMI）患者中具有区分性。为了识别这些生物力学生物标志物并使计算生物力学“更接近临床”，我们将最先进的多物理学心脏建模与先进的机器学习和多元统计推断相结合，应用于心肌梗死的临床数据库。我们从11名STEMI患者（ClinicalTrials.gov NCT 01717573）和27名健康志愿者中获得数据，并使用浸入边界法开发了左心室（LV）的个性化数学模型。通过与临床测量值匹配获得受试者特定的组成参数。我们首次发现，与健康对照组相比，ST段抬高型心肌梗死患者在收缩压正常化时，左室壁主动张力增加，这表明对远端功能性心肌收缩储备的需求增加。统计分析表明，所需的患者特异性收缩力，标准化的主动张力和收缩肌丝运动学识别心肌梗死后心肌功能变化的解释力最强。我们进一步观察到两种生物标志物与6个月时左心室射血分数较基线的变化（所需收缩力（r =-0.79，p < 0.01）和收缩肌丝运动学（r = 0.70，p = 0.02））之间存在强相关性。这些生物力学参数的临床和预后意义值得进一步研究。
In this research, we hypothesized that novel biomechanical parameters are discriminative in patients following acute ST-segment elevation myocardial infarction (STEMI). To identify these biomechanical biomarkers and bring computational biomechanics ‘closer to the clinic’, we applied state-of-the-art multiphysics cardiac modelling combined with advanced machine learning and multivariate statistical inference to a clinical database of myocardial infarction. We obtained data from 11 STEMI patients (ClinicalTrials.gov NCT01717573) and 27 healthy volunteers, and developed personalized mathematical models for the left ventricle (LV) using an immersed boundary method. Subject-specific constitutive parameters were achieved by matching to clinical measurements. We have shown, for the first time, that compared with healthy controls, patients with STEMI exhibited increased LV wall active tension when normalized by systolic blood pressure, which suggests an increased demand on the contractile reserve of remote functional myocardium. The statistical analysis reveals that the required patient-specific contractility, normalized active tension and the systolic myofilament kinematics have the strongest explanatory power for identifying the myocardial function changes post-MI. We further observed a strong correlation between two biomarkers and the changes in LV ejection fraction at six months from baseline (the required contractility (r = − 0.79, p < 0.01) and the systolic myofilament kinematics (r = 0.70, p = 0.02)). The clinical and prognostic significance of these biomechanical parameters merits further scrutinization.
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影响因子：
2.4
作者：
Chen WW;Gao H;Luo XY;Hill NA
通讯作者：
Hill NA
DOI：
10.1002/cnm.2652
发表时间：
2014-11
影响因子：
2.1
作者：
Gao H;Wang H;Berry C;Luo X;Griffith BE
通讯作者：
Griffith BE
影响因子：
3.5
作者：
Asner, Liya;Hadjicharalambous, Myrianthi;Chabiniok, Radomir;Peresutti, Devis;Sammut, Eva;Wong, James;Carr-White, Gerald;Chowienczyk, Philip;Lee, Jack;King, Andrew;Smith, Nicolas;Razavi, Reza;Nordsletten, David
通讯作者：
Nordsletten, David
影响因子：
3.5
作者：
Chabiniok, R.;Moireau, P.;Chapelle, D.
通讯作者：
Chapelle, D.
影响因子：
24
作者：
Carrick, David;Oldroyd, Keith G.;Berry, Colin
通讯作者：
Berry, Colin