title: Sensitivity analysis of left ventricle with dilated cardiomyopathy in fluid structure simulation.
abstract: Dilated cardiomyopathy (DCM) is the most common myocardial disease. It not only leads to systolic dysfunction but also diastolic deficiency. We sought to investigate the effect of idiopathic and ischemic DCM on the intraventricular fluid dynamics and myocardial wall mechanics using a 2D axisymmetrical fluid structure interaction model. In addition, we also studied the individual effect of parameters related to DCM, i.e. peak E-wave velocity, end systolic volume, wall compliance and sphericity index on several important fluid dynamics and myocardial wall mechanics variables during ventricular filling. Intraventricular fluid dynamics and myocardial wall deformation are significantly impaired under DCM conditions, being demonstrated by low vortex intensity, low flow propagation velocity, low intraventricular pressure difference (IVPD) and strain rates, and high-end diastolic pressure and wall stress. Our sensitivity analysis results showed that flow propagation velocity substantially decreases with an increase in wall stiffness, and is relatively independent of preload at low-peak E-wave velocity. Early IVPD is mainly affected by the rate of change of the early filling velocity and end systolic volume which changes the ventriculo:annular ratio. Regional strain rate, on the other hand, is significantly correlated with regional stiffness, and therefore forms a useful indicator for myocardial regional ischemia. The sensitivity analysis results enhance our understanding of the mechanisms leading to clinically observable changes in patients with DCM.
authors.affiliation: Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia. beetn_chan@yahoo.com
authors.forename: Bee Ting
authors.initials: BT
authors.lastname: Chan
authors.forename: Noor Azuan
authors.initials: NA
authors.lastname: Abu Osman
authors.forename: Einly
authors.initials: E
authors.lastname: Lim
authors.forename: Kok Han
authors.initials: KH
authors.lastname: Chee
authors.forename: Yang Faridah
authors.initials: YF
authors.lastname: Abdul Aziz
authors.forename: Amr Al
authors.initials: AA
authors.lastname: Abed
authors.forename: Nigel H
authors.initials: NH
authors.lastname: Lovell
authors.forename: Socrates
authors.initials: S
authors.lastname: Dokos
mesh_terms: D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D057446:Hydrodynamics; D008955:Models, Cardiovascular; D009203:Myocardial Infarction / Q000150:complications; D009929:Organ Size; D013314:Stress, Mechanical; D013318:Stroke Volume