The Separate Effects of Wall-Thickening and Epicardial Volume as Determinants of Left Ventricular Ejection Fraction
European Journal of Clinical and Biomedical Sciences
Volume 3, Issue 6, December 2017, Pages: 129-133
Received: Oct. 12, 2016;
Accepted: Nov. 17, 2017;
Published: Dec. 13, 2017
Views 1740 Downloads 102
Jijie Zhou, Shanghai Institute of Applied Mathematics and Mechanics, Shanghai, China; College of Science, Shanghai University, Shanghai, China
Ventricular torque magically pushes systolic ejection fraction, and such torsional moments originate in the Frenet frame of a curve of cardiac muscle. Since surgical treatments involve preoperative anatomy calculations of the cardiac muscle, the understanding of chamber geometric effects may guide left ventricular chamber-reduction surgery. We decomposed ejection fraction for an interpretation of geometric parameters in restoration and optimization of cardiac function. Three systolic geometric parameters--sphericity, contractility, ventricular torsion--were extracted for the ejection fraction from an epicardial view. The decomposing approach allowed us to estimate each factor’s contribution to the total ejection fraction with the exception of the myocardium-to-chamber volume ratio, which represented the thickening effect during systole. All other effects took parts in ‘shrinkage factor’ (β), which corresponded the ejection fraction with an infinitesimal layer of muscle. Through comparing parameters for left ventricular ejection fraction, geometrical rearrangement of muscle bands for ventricular torsion is the most effective mechanical axis during partial left ventriculectomy, while ventricular shape factor only plays a less important role during systole in dilated cardiomyopathy, which often misleads the surgeon’s assessment.
The Separate Effects of Wall-Thickening and Epicardial Volume as Determinants of Left Ventricular Ejection Fraction, European Journal of Clinical and Biomedical Sciences.
Vol. 3, No. 6,
2017, pp. 129-133.
Nishina T, Shimamoto T, Marui A, Komeda M. 2009. Impact of apex-sparing partial left ventriculectomy on left ventricular geometry, function, and long-term survival of patients with end-stage dilated cardiomyopathy. J Card Surg. 24(5):499-502.
Enzweiler CNH, Wiese TH, Lembcke AE, Hotz H, Kivelitz DE, et al. 2003. Effect of partial left ventriculectomy on left and right ventricular volumes and function as assessed with electron beam tomography: preliminary results. European Radiology 13: 1394-401.
Assunção FB, de Oliveira DC, Souza VF, Nacif MS. 2016. Cardiac magnetic resonance imaging and computed tomography in ischemic cardiomyopathy: an update. Radiol Bras. 49(1):26-34.
Polsinelli VB, Shah SJ. 2017. Advances in the pharmacotherapy of chronic heart failure with preserved ejection fraction: an ideal opportunity for precision medicine. Expert Opin Pharmacother. 18(4):399-409.
Velagaleti RS, Gona P, Pencina MJ, Aragam J, Wang TJ, et al. 2014. Left ventricular hypertrophy patterns and incidence of heart failure with preserved versus reduced ejection fraction. Am J Cardiol. 113(1):117-22.
Melvin DB. 1999. Ventricular radius reduction without resection: A computational analysis. Asaio Journal 45: 160-5.
Sabbah HN, Kono T, Stein PD, Mancini GBJ, Goldstein S. 1992. Left-Ventricular Shape Changes During the Course of Evolving Heart-Failure. American Journal of Physiology 263: H266-H70.
Buckberg GD, Weisfeldt ML, Ballester M, Beyar R, Burkhoff D, et al. 2004. Left ventricular form and function: scientific priorities and strategic planning for development of new views of disease. In Circulation, pp. e333.
Bowman AW, Kovacs SJ. 2003. Assessment and consequences of the constant-volume attribute of the four-chambered heart. American Journal of Physiology-Heart and Circulatory Physiology 285: H2027-H33.
Waters EA, Bowman AW, Kovács SJ. MRI determined left ventricular "crescent effect": a consequence of the slight deviation of the contents of the pericardial sack from the constant-volume state. American Journal of Physiology, Heart and Circulatory Physiology., 2005 Feb;288(2):H848-53.
Vuille C, Weyman A. 1994. "Left ventricle I: General considerations, assessment of chamber size and function." In: The principles and practice of echocardiography, edited by AE Weyman. 2nd ed. Philadelphia: Lea & Febiger, 1994, pp.: 575-624.
Chien KR. 1999. Stress pathways and heart failure. Cell 98: 555-8.
D'Cruz I, Shroff S, Janicki J, Jain A, Reddy H, Lakier J. 1989. Differences in the shape of the normal, cardiomyopathic, and volume overloaded human left ventricle. In Journal of the American Society of Echocardiography, pp. 408-14.
Gavazzi A, Demaria R, Renosto G, Moro A, Borgia M, et al. 1993. The Spectrum of Left-Ventricular Size in Dilated Cardiomyopathy - Clinical Correlates and Prognostic Implications. American Heart Journal 125: 410-22.
Jobin J, Heng MK, Martin J, Wyatt HL, Lee PL. 1985. Clinical-Evaluation of Left-Ventricular Function Using the Cardiac Helical Fiber Model - an Echocardiographic Study. American Heart Journal 110: 1226-33.
Wang H, Kadbi M, Kotys M, Ersoy M, Chatzimavroudis GP, Setser RM, Alshaher M, Fischer SE, Amini AA.
2011. Orthogonal CSPAMM (OCSPAMM) MR tagging for imaging ventricular wall motion. Conf Proc IEEE Eng Med Biol Soc. 2011:535-8.
Young AA, Cowan BR. 2012. Evaluation of left ventricular torsion by cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 24;14:49.
Carasso S, Cohen O, Mutlak D, Adler Z, Lessick J, Aronson D, Reisner SA, Rakowski H, Bolotin G, Agmon Y. 2011. Relation of myocardial mechanics in severe aortic stenosis to left ventricular ejection fraction and response to aortic valve replacement. Am J Cardiol. 107(7):1052-7.
Poveda F, Gil D, Martí E, Andaluz A, Ballester M, Carreras F. 2013. Helical structure of the cardiac ventricular anatomy assessed by diffusion tensor magnetic resonance imaging with multiresolution tractography. Rev Esp Cardiol (Engl Ed). 66(10):782-90.
Ingels NB, Hansen DE, Daughters GT, Stinson EB, Alderman EL, Miller DC. 1989. Relation between Longitudinal, Circumferential, and Oblique Shortening and Torsional Deformation in the Left-Ventricle of the Transplanted Human-Heart. Circulation Research 64: 915-27.