VIRTUAL TOOLS FOR CARDIAC VENTRICULAR REMODELING SURGERY

心室重构手术的虚拟工具

• 批准号: 7089174
• 负责人: Julius Matteo Guccione
• 金额: $ 42.75万
• 依托单位: NORTHERN CALIFORNIA INSTITUTE/RES/EDU
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-15 至 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7089174
• 关键词: bioimaging /biomedical imaging; cardiography; cardiovascular surgery; computational biology; computer program /software; computer system design /evaluation; dobutamine; heart contraction; image guided surgery /therapy; magnetic resonance imaging; model design /development; myocardial infarction; myocardial ischemia /hypoxia; myocardium; nonhuman therapy evaluation; phantom model; sheep; therapy design /development; three dimensional imaging /topography

DESCRIPTION (provided by applicant): Heart failure has reached epidemic proportions in the United States and is responsible for nearly 500,000 deaths each year. The majority of heart failure cases is now the result of infarction-induced ventricular remodeling. The lack of a well-established effective treatment has lead to a continually expanding list of medical and surgical options for the palliation of heart failure patients. Unfortunately, the absence of ventricular wall motion or thickening (akinesis) can be misleading. On the other hand, through the power of computational mechanics based on the finite element (FE) method, it is possible to predict with confidence any changes in global LV function (stroke volume versus end-diastolic pressure) and regional mechanics (end-diastolic and end-systolic myofiber stress distributions) when geometric or loading conditions or myocardial material properties (diastolic stiffness and systolic contractility) are changed, thus approaching the objectives of bioengineering and deductive medicine. Broad, Long-Term Objective: Develop an easy-to-use Myocardial Material Property Software Tool (MMPST) that will enable rapid progress in cardiovascular disease research through the ability of FE models to simulate changes in global LV function and regional mechanics due to medical and/or surgical treatment. Specific Aims: 1. (A) Develop and (B) validate an MMPST that will enable cardiovascular disease researchers to easily measure regional 3-D myocardial material properties. Validation will involve both Monte Carlo simulations and a deformable silicon gel phantom that is well-described by a single material parameter. 2. Use this MMPST to: A. Measure in-vivo regional 3-D myocardial material properties in normal sheep and sheep with an akinetic or dyskinetic myocardial infarct (Ml). Dobutamine will be given to sheep with an akinetic Ml to test our hypothesis that these MIs must contain contracting myocytes. B. Measure ex-vivo regional 3-D myocardial material properties after arresting and isolating the hearts studied in Aim #2A and inflating the LV with our Vivitro servo-pump system. Additionally, biaxial mechanical testing will be performed on excised akinetic and dyskinetic MIs to further validate our MMPST.

描述(申请人提供)：心力衰竭在美国已经达到流行的程度，每年导致近50万人死亡。现在大多数心力衰竭病例都是由梗塞引起的心室重构引起的。由于缺乏完善的有效治疗方法，心力衰竭患者姑息治疗的内科和外科选择不断增加。不幸的是，缺乏室壁运动或增厚(运动迟缓)可能具有误导性。另一方面，通过基于有限元(FE)方法的计算力学的能力，可以准确地预测当几何或负荷条件或心肌材料特性(舒张期硬度和收缩收缩能力)改变时，整体左心功能(每搏量对舒张期末压)和局部力学(舒张期和收缩末期肌纤维应力分布)的任何变化，从而接近生物工程和演绎医学的目标。广泛的长期目标：开发一种易于使用的心肌材料特性软件工具(MMPST)，该工具将通过有限元模型模拟由于内科和/或外科治疗而导致的全球左心功能和局部力学的变化，从而使心血管疾病研究快速发展。具体目标：1.(A)开发和(B)验证MMPST，它将使心血管疾病研究人员能够轻松地测量局部3-D心肌材料特性。验证将涉及蒙特卡罗模拟和可变形硅胶模型，该模型可通过单一材料参数很好地描述。2.使用该MMPST：A.测量正常绵羊和无动力或动力障碍心肌梗死的绵羊体内局部3-D心肌材料特性(Ml)。多巴酚丁胺将被给予绵羊无动力毫升，以检验我们的假设，这些心肌梗死一定包含收缩的心肌细胞。B.在阻断和隔离在AIM#2A中研究的心脏并使用我们的VIVELITAL伺服泵系统充气左室后，测量体外局部3-D心肌材料特性。此外，还将对切除的运动迟缓和运动障碍的心肌梗死进行双轴力学测试，以进一步验证我们的MMPST。