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Changes in left ventricular shape and morphology in the presence of heart failure: a four-dimensional quantitative and qualitative analysis

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Abstract

Purpose

The presence and progression of heart failure (HF) are associated with cardiac remodelling, defined as cellular, molecular and interstitial changes which occur after injury and manifest as changes in left ventricular (LV) size, mass, geometry and function. This research study was designed to investigate the changes to LV morphology and shape which occur in the presence of heart failure using three-dimensional (3D) modelling and analysis of cardiac-gated CT scans from both healthy individuals and patients classified with HF.

Methods

A number of quantitative and qualitative strategies were applied to cardiac CT scans of HF patients and healthy controls (n = 7) in order to analyse changes to LV size, shape and structure and to examine LV remodelling in the different classes of HF. Three-dimensional wireframe representations of endocardial and epicardial borders were created, three-dimensional computer stereolithography models of the inner LV cavity and myocardial wall segments were generated and three-dimensionally printed and a number of clinical LV dimension and shape indices were measured. All data were analysed using one-way ANOVA with post hoc Tukey method for multiple comparisons for significant variables.

Results

Results of most significance included abnormalities in LV mass and end-systolic dimensions and significantly increased septal wall thickness among mid-range ejection fraction cases. Also of importance were significant increases in both dimension-based and volumetric sphericity index measures in all HF cases. Three-dimensional printed models provided qualitative information as to changes in inner LV cavity and myocardial wall morphology across the cardiac cycle for healthy and HF cases and validated quantitative findings.

Conclusion

Findings from this study can successfully be applied to motivate the research and development of new HF treatment strategies and devices as well as for the development of a realistic cardiac simulator system.

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Authors and Affiliations

  1. Department of Mechanical and Industrial Engineering, Galway Medical Technology Centre (GMedTech), Galway Mayo Institute of Technology, Dublin Road, Galway, Ireland

    Helen O’Grady & Liam Morris

  2. Cardiovascular Research Centre, National University of Ireland Galway, University Road, Galway, Ireland

    Helen O’Grady, Haroon Zafar & Faisal Sharif

  3. Department of Cardiology, University Hospital Galway, Newcastle Road, Galway, Ireland

    Khalid Mostafa & Faisal Sharif

  4. Lambe Institute for Translational Research, National University of Ireland Galway, Galway, Ireland

    Haroon Zafar & Faisal Sharif

  5. College of Engineering and Informatics, National University of Ireland Galway, Galway, Ireland

    Haroon Zafar

  6. Department of Radiology, Galway Clinic, Doughiska, Galway, Ireland

    Derek Lohan

  7. CÚRAM, SFI Centre for Research in Medical Devices, Galway, Ireland

    Faisal Sharif

  8. BioInnovate Ireland, Galway, Ireland

    Faisal Sharif

Authors
  1. Helen O’Grady
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  4. Derek Lohan
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  5. Liam Morris
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  6. Faisal Sharif
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Corresponding author

Correspondence to Helen O’Grady.

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Conflict of interest

Helen O’ Grady declares that she has no conflict of interest. Khalid Mostafa declares that he has no conflict of interest. Haroon Zafar declares that he has no conflict of interest. Derek Lohan declares that he has no conflict of interest. Liam Morris declares that he has no conflict of interest. Faisal Sharif declares that he has no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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O’Grady, H., Mostafa, K., Zafar, H. et al. Changes in left ventricular shape and morphology in the presence of heart failure: a four-dimensional quantitative and qualitative analysis. Int J CARS 14, 1415–1430 (2019). https://doi.org/10.1007/s11548-019-01985-3

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  • DOI: https://doi.org/10.1007/s11548-019-01985-3

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