期刊
JOURNAL OF THE ROYAL SOCIETY INTERFACE
卷 14, 期 132, 页码 -出版社
ROYAL SOC
DOI: 10.1098/rsif.2017.0203
关键词
myocardial infarction; contractility; cardiac modelling; machine learning; statistical inference; immersed boundary method
资金
- British Heart Foundation [PG/14/64/31043, PG/11/2/28474]
- Engineering and Physical Sciences Research Council Centre for Multiscale Soft Tissue Mechanics [EP/N014642/1]
- National Health Service
- Chief Scientist Office
- Scottish Funding Council
- Leverhulme Trust [RF-2015-510]
- EPSRC [EP/N014642/1] Funding Source: UKRI
- MRC [MR/N003403/1] Funding Source: UKRI
- British Heart Foundation [FS/15/54/31639, PG/11/2/28474, PG/14/64/31043] Funding Source: researchfish
- Engineering and Physical Sciences Research Council [EP/N014642/1] Funding Source: researchfish
- Medical Research Council [MR/N003403/1] Funding Source: researchfish
In this research, we hypothesized that novel biomechanical parameters are discriminative in patients following acute ST-segment elevation myocardial infarction (STEMI). To identify these biomechanical biomarkers and bring computational biomechanics 'closer to the clinic', we applied state-of-the-art multiphysics cardiac modelling combined with advanced machine learning and multivariate statistical inference to a clinical database of myocardial infarction. We obtained data from 11 STEMI patients (ClinicalTrials.gov NCT01717573) and 27 healthy volunteers, and developed personalized mathematical models for the left ventricle (LV) using an immersed boundary method. Subject-specific constitutive parameters were achieved by matching to clinical measurements. We have shown, for the first time, that compared with healthy controls, patients with STEMI exhibited increased LV wall active tension when normalized by systolic blood pressure, which suggests an increased demand on the contractile reserve of remote functional myocardium. The statistical analysis reveals that the required patient-specific contractility, normalized active tension and the systolic myofilament kinematics have the strongest explanatory power for identifying the myocardial function changes post-MI. We further observed a strong correlation between two biomarkers and the changes in LV ejection fraction at six months from baseline (the required contractility (r = -0.79, p < 0.01) and the systolic myofilament kinematics (r = 0.70, p = 0.02)). The clinical and prognostic significance of these biomechanical parameters merits further scrutinization.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据