Introduction

Left ventricular (LV) remodeling is a critical process underlying heart failure (HF) development and progression. While LV global longitudinal strain determined by speckle-tracking echocardiography (STE) provides a promising basis to monitor LV remodeling, reported strain measures are limited by the masking of regional differences and a dependency on hemodynamic load.

Objectives

Our goal is to extend two-dimensional STE to enhance regional mechanical assessment of the LV myocardium—providing clinically accessible and load-independent response variables that directly reflect the LV remodeling process.

Methods

An inverse finite element analysis was employed with a pattern search optimization algorithm to identify regional indices of LV myocardial stiffness based on STE-derived regional LV longitudinal strains and wall geometries. Our framework was applied in two distinct porcine models of early LV remodeling, specifically following myocardial infarction and onset of LV pressure overload.

Results

Regional and temporal changes in computed indices of LV myocardial stiffness over diastolic pressures correlate with conventional indices of LV remodeling and show enhanced early sensitivity as compared to LV global longitudinal strain.

Conclusion

Our findings suggest that STE-integrated computational modeling can be used to track indices of LV myocardial stiffness and, thus, is a potential tool for HF diagnosis and prognosis.

中文翻译：

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斑点跟踪超声心动图技术可实现基于模型的左心室心肌区域硬度指标的识别。

介绍

左心室（LV）重塑是心力衰竭（HF）发生和发展的关键过程。虽然通过斑点跟踪超声心动图（STE）确定的LV总体纵向应变为监测LV重塑提供了有希望的基础，但已报道的应变措施受到区域差异的掩盖和对血流动力学负荷的依赖性的限制。

目标

我们的目标是扩展二维STE，以增强LV心肌的区域力学评估-提供可直接反映LV重塑过程的临床可及且独立于负荷的反应变量。

方法

逆向有限元分析与模式搜索优化算法一起使用，以基于STE衍生的局部LV纵向应变和壁几何形状来确定LV心肌僵硬的区域指标。我们的框架应用于早期LV重塑的两种不同的猪模型，特别是在心肌梗塞和LV压力超负荷发作之后。

结果

与舒张压相关的左心室心肌硬度计算指标的区域和时间变化与左心室重塑的常规指标相关，并且与左心室整体纵向应变相比，显示出增强的早期敏感性。

结论

我们的发现表明，STE集成的计算模型可用于跟踪LV心肌僵硬度的指标，因此，它是用于HF诊断和预后的潜在工具。