Abstract
Heart failure is known to be associated with substantial changes in the mechanical properties of the heart muscle. Biomechanical parameters, such as myocardial stiffness, have the potential to help clinicians diagnose and determine and monitor treatment options. The impact of inter-observer variability of geometric modelling on the estimation of passive myocardial stiffness has not yet been systematically investigated. We aimed to examine the sensitivity of myocardial stiffness estimates with respect to inter-observer geometric model variability. Twenty-four subjects (5 controls, 19 patients with heart failure) underwent left heart catheterisation and cardiovascular magnetic resonance (CMR) imaging. Three expert analysts independently constructed three-dimensional geometric models of the left ventricle (LV), which were used to estimate myocardial stiffness using finite element simulations that combined cine CMR data and LV pressure measurements. Bland-Altman analysis was used to assess the inter-observer effects on the reproducibility of myocardial stiffness. The inter-observer variations were ±7.69 mL/m\(^2\) and ±9.78 g/m\(^2\) for the LV end-diastolic volume and mass indices, respectively. Meanwhile, the variability ranged by up to ±0.51 kPa for inter-observer analysis on the estimated intrinsic myocardial stiffness values. Findings from this pilot study highlight the importance of the accuracy of image-based geometric modelling when estimating myocardial stiffness.
A. I. Hasaballa and T. P. Babarenda Gamage—Joint first authorship.
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Mangion, K., Gao, H., Husmeier, D., Luo, X., Berry, C.: Advances in computational modelling for personalised medicine after myocardial infarction. Heart 104, 550–557 (2018)
Wang, V., Nielsen, P., Nash, M.: Image-based predictive modeling of heart mechanics. Ann. Rev. Biomed. Eng. 17, 351–383 (2015)
Rumindo, G.K., Ohayon, J., Croisille, P., Clarysse, P.: In vivo estimation of normal left ventricular stiffness and contractility based on routine cine MR acquisition. Med. Eng. Phys. 85, 16–26 (2020)
Feisst, A., et al.: Influence of observer experience on cardiac magnetic resonance strain measurements using feature tracking and conventional tagging. IJC Heart Vasculature 18, 46–51 (2018)
Wang, Z.J., Wang, V.Y., Bradley, C.P., Nash, M.P., Young, A.A., Cao, J.J.: Left ventricular diastolic myocardial stiffness and end-diastolic myofibre stress in human heart failure using personalised biomechanical analysis. J. Cardiovas. Transl. Res. 11, 346–356 (2018)
Young, A.A., Cowan, B.R., Thrupp, S.F., Hedley, W.J., Dell’Italia, L.: Left ventricular mass and volume: fast calculation with guide-point modeling on MR images. Radiology 216, 597–602 (2000)
Wang, Z.: Left ventricular mechanics in human heart failure. Ph.D. thesis, The University of Auckland (2018)
Wang, V.Y., Lam, H., Ennis, D.B., Cowan, B.R., Young, A.A., Nash, M.P.: Modelling passive diastolic mechanics with quantitative MRI of cardiac structure and function. Med. Image Anal. 13, 773–784 (2009)
Guccione, J.M., Costa, K.D., McCulloch, A.D.: Finite element stress analysis of left ventricular mechanics in the beating dog heart. J. Biomech. 28, 1167–1177 (1995)
Wang, V.Y., Ennis, D.B., Cowan, B.R., Young, A.A., Nash, M.P.: Myocardial contractility and regional work throughout the cardiac cycle using FEM and MRI. In: Camara, O., Konukoglu, E., Pop, M., Rhode, K., Sermesant, M., Young, A. (eds.) STACOM 2011. LNCS, vol. 7085, pp. 149–159. Springer, Heidelberg (2012). https://doi.org/10.1007/978-3-642-28326-0_15
Luijnenburg, S.E., Robbers-Visser, D., Moelker, A., Vliegen, H.W., Mulder, B.J., Helbing, W.A.: Intra-observer and inter-observer variability of biventricular function, volumes and mass in patients with congenital heart disease measured by CMR imaging. Int. J. Cardiovascular Imaging 26, 57–64 (2010)
Buechel, E.R.V., et al.: Remodelling of the right ventricle after early pulmonary valve replacement in children with repaired tetralogy of Fallot: assessment by cardiovascular magnetic resonance. Eur. Heart J. 26, 2721–2727 (2005)
Xi, J., Lamata, P., Niederer, S., Land, S., Shi, W., Zhuang, X., Ourselin, S., Duckett, S.G., Shetty, A.K., Rinaldi, C.A.: The estimation of patient-specific cardiac diastolic functions from clinical measurements. Med. image Anal. 17, 133–146 (2013)
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We gratefully acknowledge the financial support from the Health Research Council of New Zealand (grant 17/608).
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Hasaballa, A.I. et al. (2021). Sensitivity of Myocardial Stiffness Estimates to Inter-observer Variability in LV Geometric Modelling. In: Ennis, D.B., Perotti, L.E., Wang, V.Y. (eds) Functional Imaging and Modeling of the Heart. FIMH 2021. Lecture Notes in Computer Science(), vol 12738. Springer, Cham. https://doi.org/10.1007/978-3-030-78710-3_28
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DOI: https://doi.org/10.1007/978-3-030-78710-3_28
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