CT-Based Simulation of Left Ventricular Hemodynamics: A Pilot Study in Mitral Regurgitation and Left Ventricle Aneurysm Patients
BackgroundCardiac CT (CCT) is well suited for a detailed analysis of heart structures due to its high spatial resolution, but in contrast to MRI and echocardiography, CCT does not allow an assessment of intracardiac flow. Computational fluid dynamics (CFD) can complement this shortcoming. It enables...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.828556/full |
| _version_ | 1818356894030364672 |
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| author | Lukas Obermeier Katharina Vellguth Adriano Schlief Lennart Tautz Lennart Tautz Jan Bruening Christoph Knosalla Christoph Knosalla Christoph Knosalla Titus Kuehne Titus Kuehne Titus Kuehne Natalia Solowjowa Leonid Goubergrits Leonid Goubergrits |
| author_facet | Lukas Obermeier Katharina Vellguth Adriano Schlief Lennart Tautz Lennart Tautz Jan Bruening Christoph Knosalla Christoph Knosalla Christoph Knosalla Titus Kuehne Titus Kuehne Titus Kuehne Natalia Solowjowa Leonid Goubergrits Leonid Goubergrits |
| author_sort | Lukas Obermeier |
| collection | DOAJ |
| description | BackgroundCardiac CT (CCT) is well suited for a detailed analysis of heart structures due to its high spatial resolution, but in contrast to MRI and echocardiography, CCT does not allow an assessment of intracardiac flow. Computational fluid dynamics (CFD) can complement this shortcoming. It enables the computation of hemodynamics at a high spatio-temporal resolution based on medical images. The aim of this proposed study is to establish a CCT-based CFD methodology for the analysis of left ventricle (LV) hemodynamics and to assess the usability of the computational framework for clinical practice.Materials and MethodsThe methodology is demonstrated by means of four cases selected from a cohort of 125 multiphase CCT examinations of heart failure patients. These cases represent subcohorts of patients with and without LV aneurysm and with severe and no mitral regurgitation (MR). All selected LVs are dilated and characterized by a reduced ejection fraction (EF). End-diastolic and end-systolic image data was used to reconstruct LV geometries with 2D valves as well as the ventricular movement. The intraventricular hemodynamics were computed with a prescribed-motion CFD approach and evaluated in terms of large-scale flow patterns, energetic behavior, and intraventricular washout.ResultsIn the MR patients, a disrupted E-wave jet, a fragmentary diastolic vortex formation and an increased specific energy dissipation in systole are observed. In all cases, regions with an impaired washout are visible. The results furthermore indicate that considering several cycles might provide a more detailed view of the washout process. The pre-processing times and computational expenses are in reach of clinical feasibility.ConclusionThe proposed CCT-based CFD method allows to compute patient-specific intraventricular hemodynamics and thus complements the informative value of CCT. The method can be applied to any CCT data of common quality and represents a fair balance between model accuracy and overall expenses. With further model enhancements, the computational framework has the potential to be embedded in clinical routine workflows, to support clinical decision making and treatment planning. |
| first_indexed | 2024-12-13T20:04:27Z |
| format | Article |
| id | doaj.art-a42da9da3e114061be2cf319f5a3e317 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-13T20:04:27Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-a42da9da3e114061be2cf319f5a3e3172022-12-21T23:33:04ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-03-01910.3389/fcvm.2022.828556828556CT-Based Simulation of Left Ventricular Hemodynamics: A Pilot Study in Mitral Regurgitation and Left Ventricle Aneurysm PatientsLukas Obermeier0Katharina Vellguth1Adriano Schlief2Lennart Tautz3Lennart Tautz4Jan Bruening5Christoph Knosalla6Christoph Knosalla7Christoph Knosalla8Titus Kuehne9Titus Kuehne10Titus Kuehne11Natalia Solowjowa12Leonid Goubergrits13Leonid Goubergrits14Institute of Computer-Assisted Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, Berlin, GermanyInstitute of Computer-Assisted Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, Berlin, GermanyInstitute of Computer-Assisted Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, Berlin, GermanyInstitute of Computer-Assisted Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, Berlin, GermanyFraunhofer Institute for Digital Medicine MEVIS, Bremen, GermanyInstitute of Computer-Assisted Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, Berlin, GermanyDepartment of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, GermanyDZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, GermanyCharité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin and Berlin Institute of Health, Berlin, GermanyInstitute of Computer-Assisted Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, Berlin, GermanyDZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, GermanyDepartment of Congenital Heart Disease, German Heart Center Berlin, Berlin, GermanyDepartment of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, GermanyInstitute of Computer-Assisted Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, Berlin, GermanyEinstein Center Digital Future, Berlin, GermanyBackgroundCardiac CT (CCT) is well suited for a detailed analysis of heart structures due to its high spatial resolution, but in contrast to MRI and echocardiography, CCT does not allow an assessment of intracardiac flow. Computational fluid dynamics (CFD) can complement this shortcoming. It enables the computation of hemodynamics at a high spatio-temporal resolution based on medical images. The aim of this proposed study is to establish a CCT-based CFD methodology for the analysis of left ventricle (LV) hemodynamics and to assess the usability of the computational framework for clinical practice.Materials and MethodsThe methodology is demonstrated by means of four cases selected from a cohort of 125 multiphase CCT examinations of heart failure patients. These cases represent subcohorts of patients with and without LV aneurysm and with severe and no mitral regurgitation (MR). All selected LVs are dilated and characterized by a reduced ejection fraction (EF). End-diastolic and end-systolic image data was used to reconstruct LV geometries with 2D valves as well as the ventricular movement. The intraventricular hemodynamics were computed with a prescribed-motion CFD approach and evaluated in terms of large-scale flow patterns, energetic behavior, and intraventricular washout.ResultsIn the MR patients, a disrupted E-wave jet, a fragmentary diastolic vortex formation and an increased specific energy dissipation in systole are observed. In all cases, regions with an impaired washout are visible. The results furthermore indicate that considering several cycles might provide a more detailed view of the washout process. The pre-processing times and computational expenses are in reach of clinical feasibility.ConclusionThe proposed CCT-based CFD method allows to compute patient-specific intraventricular hemodynamics and thus complements the informative value of CCT. The method can be applied to any CCT data of common quality and represents a fair balance between model accuracy and overall expenses. With further model enhancements, the computational framework has the potential to be embedded in clinical routine workflows, to support clinical decision making and treatment planning.https://www.frontiersin.org/articles/10.3389/fcvm.2022.828556/fullcardiac computed tomographyintraventricular hemodynamicsimage-based modelingleft ventricle aneurysmmitral regurgitationfluid-structure interaction |
| spellingShingle | Lukas Obermeier Katharina Vellguth Adriano Schlief Lennart Tautz Lennart Tautz Jan Bruening Christoph Knosalla Christoph Knosalla Christoph Knosalla Titus Kuehne Titus Kuehne Titus Kuehne Natalia Solowjowa Leonid Goubergrits Leonid Goubergrits CT-Based Simulation of Left Ventricular Hemodynamics: A Pilot Study in Mitral Regurgitation and Left Ventricle Aneurysm Patients Frontiers in Cardiovascular Medicine cardiac computed tomography intraventricular hemodynamics image-based modeling left ventricle aneurysm mitral regurgitation fluid-structure interaction |
| title | CT-Based Simulation of Left Ventricular Hemodynamics: A Pilot Study in Mitral Regurgitation and Left Ventricle Aneurysm Patients |
| title_full | CT-Based Simulation of Left Ventricular Hemodynamics: A Pilot Study in Mitral Regurgitation and Left Ventricle Aneurysm Patients |
| title_fullStr | CT-Based Simulation of Left Ventricular Hemodynamics: A Pilot Study in Mitral Regurgitation and Left Ventricle Aneurysm Patients |
| title_full_unstemmed | CT-Based Simulation of Left Ventricular Hemodynamics: A Pilot Study in Mitral Regurgitation and Left Ventricle Aneurysm Patients |
| title_short | CT-Based Simulation of Left Ventricular Hemodynamics: A Pilot Study in Mitral Regurgitation and Left Ventricle Aneurysm Patients |
| title_sort | ct based simulation of left ventricular hemodynamics a pilot study in mitral regurgitation and left ventricle aneurysm patients |
| topic | cardiac computed tomography intraventricular hemodynamics image-based modeling left ventricle aneurysm mitral regurgitation fluid-structure interaction |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.828556/full |
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