A Centerline-Based Model Morphing Algorithm for Patient-Specific Finite Element Modeling of the Left Ventricle.

GOAL: Hexahedral automatic model generation is a recurrent problem in computer vision and computational biomechanics. It may even become a challenging problem when one wants to develop a patient-specific finite element (FE) model of the left ventricle (LV), particularly when only low resolution images are available. In the present study, a fast and efficient algorithm is presented and tested to address such a situation. METHODS: A template FE hexahedral model was created for an LV geometry using a general electric ultrasound (US) system. A system of centerline was considered for this LV mesh. Then, the nodes located over the endocardial and epicardial surfaces are, respectively, projected from this centerline onto the actual endocardial and epicardial surfaces reconstructed from a patient's US data. Finally, the position of the internal nodes is derived by finding the deformations with minimal elastic energy. This approach was applied to eight patients suffering from congestive heart disease. An FE analysis was performed to derive the stress induced in the LV tissue by diastolic blood pressure on each of them. RESULTS: Our model morphing algorithm was applied successfully and the obtained meshes showed only marginal mismatches when compared to the corresponding US geometries. The diastolic FE analyses were successfully performed in seven patients to derive the distribution of principal stresses. CONCLUSION: The original model morphing algorithm is fast and robust with low computational cost. SIGNIFICANCE: This low-cost model morphing algorithm may be highly beneficial for future patient-specific reduced-order modeling of the LV with potential application to other crucial organs.

Importance of material parameters and strain energy function on the wall stresses in the left ventricle.

Patient-specific estimates of the stress distribution in the left ventricles (LV) may have important applications for therapy planning, but computing the stress generally requires knowledge of the material behaviour. The passive stress-strain relation of myocardial tissue has been characterized by a number of models, but material parameters (MPs) remain difficult to estimate. The aim of this study is to implement a zero-pressure algorithm to reconstruct numerically the stress distribution in the LV without precise knowledge of MPs. We investigate the sensitivity of the stress distribution to variations in the different sets of constitutive parameters. We show that the sensitivity of the LV stresses to MPs can be marginal for an isotropic constitutive model. However, when using a transversely isotropic exponential strain energy function, the LV stresses become sensitive to MPs, especially to the linear elastic coefficient before the exponential function. This indicates that in-vivo identification efforts should focus mostly on this MP for the development of patient-specific finite-element analysis.