Estimating prognosis in patients with acute myocardial infarction using personalized computational heart models. Issue 1 (December 2017)

• Record Type: Journal Article
• Authors: Gao, Hao; Mangion, Kenneth; Carrick, David; Husmeier, Dirk; Luo, Xiaoyu; Berry, Colin
• Is Part Of: Scientific reports. Volume 7:Issue 1(2017)
• Page Start: 1
• Page End: 14
• Publication Date: 2017-12
• Subjects: Natural history -- Research -- Periodicals; Biology -- Research -- Periodicals; Physical sciences -- Research -- Periodicals; Earth sciences -- Research -- Periodicals; Environmental sciences -- Research -- Periodicals; 502.85
• DOI: 10.1038/s41598-017-13635-2
• Languages: English
• ISSNs: 2045-2322

Abstract

Abstract Biomechanical computational models have potential prognostic utility in patients after an acute ST-segment–elevation myocardial infarction (STEMI). In a proof-of-concept study, we defined two groups (1) an acute STEMI group (n = 6, 83% male, age 54 ± 12 years) complicated by left ventricular (LV) systolic dysfunction; (2) an age- and sex- matched hyper-control group (n = 6, 83% male, age 46 ± 14 years), no prior history of cardiovascular disease and normal systolic blood pressure (SBP < 130 mmHg). Cardiac MRI was performed in the patients (2 days & 6 months post-STEMI) and the volunteers, and biomechanical heart models were synthesized for each subject. The candidate parameters included normalized active tension (AT norm ) and active tension at the resting sarcomere length (T req, reflecting required contractility). Myocardial contractility was inversely determined from personalized heart models by matching CMR-imaged LV dynamics. Compared with controls, patients with recent STEMI exhibited increased LV wall active tension when normalized by SBP. We observed a linear relationship betweenT req 2 days post-MI and global longitudinal strain 6 months later (r = 0.86; p = 0.03).T req may be associated with changes in LV function in the longer term in STEMI patients complicated by LV dysfunction. Further studies seem warranted.