| 1. |
- Marlevi, David, et al.
(författare)
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Non-invasive estimation of relative pressure for intracardiac flows using virtual work-energy
- 2021
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Ingår i: Medical Image Analysis. - : Elsevier. - 1361-8415 .- 1361-8423. ; 68
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Tidskriftsartikel (refereegranskat)abstract
- Intracardiac blood flow is driven by differences in relative pressure, and assessing these is critical in understanding cardiac disease. Non-invasive image-based methods exist to assess relative pressure, however, the complex flow and dynamically moving fluid domain of the intracardiac space limits assessment. Recently, we proposed a method, ?WERP, utilizing an auxiliary virtual field to probe relative pressure through complex, and previously inaccessible flow domains. Here we present an extension of ?WERP for intracardiac flow assessments, solving the virtual field over sub-domains to effectively handle the dynamically shifting flow domain. The extended ?WERP is validated in an in-silico benchmark problem, as well as in a patient-specific simulation model of the left heart, proving accurate over ranges of realistic image resolutions and noise levels, as well as superior to alternative approaches. Lastly, the extended ?WERP is applied on clinically acquired 4D Flow MRI data, exhibiting realistic ventricular relative pressure patterns, as well as indicating signs of diastolic dysfunction in an exemplifying patient case. Summarized, the extended ?WERP approach represents a directly applicable implementation for intracardiac flow assessments.
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| 2. |
- Marlevi, David, doktorand, et al.
(författare)
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Altered Aortic Hemodynamics and Relative Pressure in Patients with Dilated Cardiomyopathy
- 2021
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Ingår i: Journal of Cardiovascular Translational Research. - : Springer Nature. - 1937-5387 .- 1937-5395.
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Tidskriftsartikel (refereegranskat)abstract
- Ventricular-vascular interaction is central in the adaptation to cardiovascular disease. However, cardiomyopathy patients are predominantly monitored using cardiac biomarkers. The aim of this study is therefore to explore aortic function in dilated cardiomyopathy (DCM). Fourteen idiopathic DCM patients and 16 controls underwent cardiac magnetic resonance imaging, with aortic relative pressure derived using physics-based image processing and a virtual cohort utilized to assess the impact of cardiovascular properties on aortic behaviour. Subjects with reduced left ventricular systolic function had significantly reduced aortic relative pressure, increased aortic stiffness, and significantly delayed time-to-pressure peak duration. From the virtual cohort, aortic stiffness and aortic volumetric size were identified as key determinants of aortic relative pressure. As such, this study shows how advanced flow imaging and aortic hemodynamic evaluation could provide novel insights into the manifestation of DCM, with signs of both altered aortic structure and function derived in DCM using our proposed imaging protocol. Graphic Abstractr: [Figure not available: see fulltext.].
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