Investigating Heart Failure Using Ventricular Imaging and Modelling

It is well-established that ventricular hypertrophy is a transitional phase through the development of heart failure. A hypertrophic heart can remodel to compensate the loss of pump function, but it eventually becomes incapable of working efficiently, leading to heart failure. Many heart failure patients have preserved pump function (e.g. normal ejection fraction), but increased LV wall thickness and sometimes increased LV mass, which can mask a decrease in contractility. Alterations in the myofibre structure and myocardial material properties can potentially account for the progression of heart failure. We have developed a canine LV finite element model to investigate the effect of ventricular size, myocardial passive material properties, and cardiac contractility on the LV mechanical performance. By comparing mechanical function of normal and abnormal LVs, due to dilation and/or loss of anisotropy and/or reduced contractility, we found that dilation and compromised muscle contractility decreased most indices of cardiac performance. This modelling framework provides insight into the underlying mechanisms of heart failure.