Temporal Changes in Infarct Material Properties: An In Vivo Assessment Using Magnetic Resonance Imaging and Finite Element Simulations Jeremy R. McGarvey,

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Date of download: 1/9/2018 Copyright © ASME. All rights reserved.

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Presentation transcript:

Temporal Changes in Infarct Material Properties: An In Vivo Assessment Using Magnetic Resonance Imaging and Finite Element Simulations Jeremy R. McGarvey, MD, Dimitri Mojsejenko, MS, Shauna M. Dorsey, PhD, Amir Nikou, MS, Jason A. Burdick, PhD, Joseph H. Gorman, MD, Benjamin M. Jackson, MD, James J. Pilla, PhD, Robert C. Gorman, MD, Jonathan F. Wenk, PhD The Annals of Thoracic Surgery Volume 100, Issue 2, Pages 582-589 (August 2015) DOI: 10.1016/j.athoracsur.2015.03.015 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 In vivo function was assessed in an established porcine posterior infarct model. (A) Magnetic resonance imaging (MRI) was performed at baseline and 1, 4, 8, and 12 weeks after myocardial infarction (MI). (B) Infarction was induced by ligation of the LCX and select OM, with MRI-compatible markers attached around the boundary of MI. MRI data were analyzed to assess (C) global cardiac structure and function from cine MRI, (D) infarct expansion from DCE MRI, and (E) myocardial wall function from SPAtial Modulation of Magnetization—tagged MRI. Scale bar = 1 cm. (DCE = delayed contrast enhanced; LAD = left anterior descending artery; LCX = left circumflex artery; OM = obtuse marginal branch artery; PD = posterior descending artery.) The Annals of Thoracic Surgery 2015 100, 582-589DOI: (10.1016/j.athoracsur.2015.03.015) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Finite element models were generated by fitting magnetic resonance imaging—derived endocardial and epicardial contours with (A, B) 3-dimensional surfaces to represent the animal-specific geometry and filling the myocardial space with hexahedral brick elements. (C) The boundary between the infarct (blue) and remote (red) region was defined using 3-dimensional curves created from MRI-derived infarct contours. (D) Myofiber angles varied transmurally and were fixed for the remote region and assigned by optimization for the infarct region with respect to the circumferential direction. The Annals of Thoracic Surgery 2015 100, 582-589DOI: (10.1016/j.athoracsur.2015.03.015) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Infarction leads to (A, B) increased left ventricular volumes relative to baseline (BL) and (C) decreased ejection fraction 1, 4, 8, and 12 weeks after infarction. Data presented as mean ± standard error of the mean. All data (end-diastolic volume, end systolic volume, ejection fraction) statistically significant from baseline (p < 0.05). The Annals of Thoracic Surgery 2015 100, 582-589DOI: (10.1016/j.athoracsur.2015.03.015) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 (A) Infarct wall thickness was measured in vivo throughout the study by analyzing cine magnetic resonance images at end diastole. (B) In vivo assessment shows thinning of the myocardial wall in the infarct region after myocardial infarction. Data presented as mean ± standard error of the mean. All results for (B) are statistically significant relative to baseline (BL) and for infarct (INF) vs remote (REM) thickness at each time point (p < 0.05). Scale bar = 1 cm. The Annals of Thoracic Surgery 2015 100, 582-589DOI: (10.1016/j.athoracsur.2015.03.015) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 (A) Representative finite element models of the same animal at baseline (BL) and 1, 4, 8, and 12 week after MI. (B) Short axis views taken from roughly the same position at midventricle demonstrate thinning of the infarct region (blue) over time. The model geometry is based on early diastole. The Annals of Thoracic Surgery 2015 100, 582-589DOI: (10.1016/j.athoracsur.2015.03.015) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Equibiaxial extension tests were simulated by use of the material parameters determined from the optimization. Mean stress-strain plots of (A, B) the infarct and (C, D) remote regions in the (A, C) fiber and (B, D) cross-fiber directions over time. (BL = baseline.) The Annals of Thoracic Surgery 2015 100, 582-589DOI: (10.1016/j.athoracsur.2015.03.015) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 7 Quantification of the modulus from the simulated equibiaxial extension tests at different strain ranges. The moduli are given in the (A, C) fiber and (B, D) cross-fiber directions for both the remote and infarct regions over time. Data presented as mean ± standard error of the mean. BL = baseline. *p < 0.05 vs baseline myocardium. The Annals of Thoracic Surgery 2015 100, 582-589DOI: (10.1016/j.athoracsur.2015.03.015) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions