Changes and classification in myocardial contractile function in the left ventricle following acute myocardial infarction

Gao, H. , Aderhold, A., Mangion, K., Luo, X. , Husmeier, D. and Berry, C. (2017) Changes and classification in myocardial contractile function in the left ventricle following acute myocardial infarction. Interface Focus, 14(132), 20170203. (doi:10.1098/rsif.2017.0203)

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Abstract

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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Berry, Professor Colin and Luo, Professor Xiaoyu and Aderhold, Mr Andrej and Mangion, Dr Kenneth and Gao, Dr Hao and Husmeier, Professor Dirk
Authors: Gao, H., Aderhold, A., Mangion, K., Luo, X., Husmeier, D., and Berry, C.
College/School:College of Science and Engineering > School of Mathematics and Statistics > Mathematics
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Science and Engineering > School of Mathematics and Statistics > Statistics
Journal Name:Interface Focus
Publisher:The Royal Society
ISSN:2042-8901
ISSN (Online):2042-8901
Published Online:26 July 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in Interface Focus 14(132):20170203
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
662681"First steps towards modelling myocardial infarction (a computed MI Physiome): A case-control study of novel biomechanical parameters in acute MI survivors with left ventricular dysfunction."Colin BerryBritish Heart Foundation (BHF)PG/14/64/31043RI CARDIOVASCULAR & MEDICAL SCIENCES
544551Validation and significance of myocardial haemorrhage revealed by "bright blood" T2-weighted MRI in heart attack survivors: a prospective cohort study.Colin BerryBritish Heart Foundation (BHF)PG/11/2/28474RI CARDIOVASCULAR & MEDICAL SCIENCES
694461EPSRC Centre for Multiscale soft tissue mechanics with application to heart & cancerRaymond OgdenEngineering and Physical Sciences Research Council (EPSRC)EP/N014642/1M&S - MATHEMATICS
689601The first fully coupled mitral valve - left ventricle computational modelXiaoyu LuoLeverhulme Trust (LEVERHUL)RF-2015-510M&S - MATHEMATICS