Developing a Technique to Combine 3-Dimensional Echocardiography with Finite Element Analysis to Determine Patient-specific Regional Ventricular Wall Stress in Diastole
This project aims to develop and rigorously test a novel technique that combines real-time 3D echocardiography with advanced finite element models that can incorporate material heterogeneity and anisotropy with realistic LV geometry in order to calculate patient-specific LV wall stress distribution.
Active stress generation by cardiac muscle fibres is crucial to myocardial function and is the major determinant of myocardial oxygen demand. Abnormal LV wall stress due to disease results in alterations in regional coronary flow remodelling, changes in gene expression and increased arrhythmia risk. However despite recent advances in LV image analyses software, myocardial wall stress cannot be easily measured in vivo. This is a major setback as the ability to assess LV wall stress non-invasively would have wide application in many diagnostic scenarios.
With the proposed technique, we will analyse patients in a large 20-year follow-up study (SABRE) involving a unique cohort of Europeans, South Asians and African Caribbeans, the largest tri-ethnic cohort in the UK (age 55-85yrs). Heart disease is a major cause of death and disability in older individuals and ethnic minorities are particularly susceptible. We will investigate potential relationship between LV wall stress patterns and disease, and its dependency on ethnic origin.
It has been proven that 3D echocardiography is a safe, reproducible and accurate process. It has significant advantage in the temporal resolution and cost effectiveness, which make it an attractive alternative to cardiac MRI particularly for longitudinal studies with frequent follow-ups, such as SABRE. We will also develop novel procedures to integrate left ventricular anatomy derived from 3D echo with functional measurements obtained by tissue Doppler echocardiography (TDE) and speckle tracking. The integrated imaging framework, also with finite element model, will provide a comprehensive set of information to investigate patient specific LV mechanics non-invasively.
Related Methodological Themes