Biventricular finite element modeling of the fetal heart in health and during critical aortic stenosis.

Autor: Ren M; Department of Biomedical Engineering, National University of Singapore, 4, Engineering Drive 3, E4-04-08, Singapore, 117583, Singapore., Chan WX; Department of Bioengineering, Imperial College London, L2 Bessemer Building, South Kensington Campus, London, SW7 2AZ, UK., Green L; Department of Bioengineering, Imperial College London, L2 Bessemer Building, South Kensington Campus, London, SW7 2AZ, UK., Buist ML; Department of Biomedical Engineering, National University of Singapore, 4, Engineering Drive 3, E4-04-08, Singapore, 117583, Singapore. martin.buist@nus.edu.sg., Yap CH; Department of Bioengineering, Imperial College London, L2 Bessemer Building, South Kensington Campus, London, SW7 2AZ, UK. c.yap@imperial.ac.uk.
Jazyk: angličtina
Zdroj: Biomechanics and modeling in mechanobiology [Biomech Model Mechanobiol] 2024 Aug; Vol. 23 (4), pp. 1331-1345. Date of Electronic Publication: 2024 Apr 08.
DOI: 10.1007/s10237-024-01842-6
Abstrakt: Finite Element simulations are a robust way of investigating cardiac biomechanics. To date, it has only been performed with the left ventricle (LV) alone for fetal hearts, even though results are likely different with biventricular (BiV) simulations. In this research, we conduct BiV simulations of the fetal heart based on 4D echocardiography images to show that it can capture the biomechanics of the normal healthy fetal heart, as well as those of fetal aortic stenosis better than the LV alone simulations. We found that performing LV alone simulations resulted in overestimation of LV stresses and pressures, compared to BiV simulations. Interestingly, inserting a compliance between the LV and right ventricle (RV) in the lumped parameter model of the LV only simulation effectively resolved these overestimations, demonstrating that the septum could be considered to play a LV-RV pressure communication role. However, stresses and strains spatial patterns remained altered from BiV simulations after the addition of the compliance. The BiV simulations corroborated previous studies in showing disease effects on the LV, where fetal aortic stenosis (AS) drastically elevated LV pressures and reduced strains and stroke volumes, which were moderated down with the addition of mitral regurgitation (MR). However, BiV simulations enabled an evaluation of the RV as well, where we observed that effects of the AS and MR on pressures and stroke volumes were generally much smaller and less consistent. The BiV simulations also enabled investigations of septal dynamics, which showed a rightward shift with AS, and partial restoration with MR. Interestingly, AS tended to enhance RV stroke volume, but MR moderated that down.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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