Uniqueness of local myocardial strain patterns with respect to activation time and contractility of the failing heart: a computational study

Borut Kirn*, John Walmsley, Joost Lumens

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Myocardial deformation measured by strain is used to detect electromechanical abnormalities in cardiac tissue. Estimation of myocardial properties from regional strain patterns when multiple pathologies are present is therefore a promising application of computer modelling. However, if different tissue properties lead to indistinguishable strain patterns ('degeneracy'), the applicability of any such method will be limited. We investigated whether estimation of local activation time (AT) and contractility from myocardial strain patterns is theoretically possible.

Methods: For four different global cardiac pathologies local myocardial strain patterns for 1025 combinations of AT and contractility were simulated with a computational model (CircAdapt). For each strain pattern, a cohort of similar patterns was found within estimated measurement error using the sum of least-squared differences. Cohort members came from (1) the same pathology only, and (2) all four pathologies. Uncertainty was calculated as accuracy and precision of cohort members in parameter space. Connectedness within the cohorts was also studied.

Results: We found that cohorts drawn from one pathology had parameters with adjacent values although their distribution was neither constant nor symmetrical. In comparison cohorts drawn from four pathologies had disconnected components with drastically different parameter values and accuracy and precision values up to three times higher.

Conclusions: Global pathology must be known when extracting AT and contractility from strain patterns, otherwise degeneracy occurs causing unacceptable uncertainty in derived parameters.

Original languageEnglish
Article number182
Number of pages18
JournalBiomedical Engineering Online
Volume17
Issue number1
DOIs
Publication statusPublished - 5 Dec 2018

Keywords

  • Activation time
  • Cardiac strain
  • Computer simulation
  • Contractility
  • Reverse engineering
  • System degeneration
  • VENTRICULAR LEAD POSITION
  • CARDIAC ELECTROPHYSIOLOGY
  • SENSITIVITY-ANALYSIS
  • RESYNCHRONIZATION
  • MODELS
  • FAILURE
  • ECHOCARDIOGRAPHY
  • UNCERTAINTY
  • TRABECULAE
  • PREDICTION

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