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Analise M. Sulentic

Publications and source records attributed to Analise M. Sulentic.

2 recordsLinked to original sources

Geodesic-based Predictive Shape Modeling of the Right Ventricle in Patients with Hypoplastic Left Heart Syndrome

Hypoplastic left heart syndrome (HLHS) is characterized by severe underdevelopment of left ventricle requiring staged surgical reconstruction (stages) to allow the right ventricle (RV) alone to support the circulation. In this setting changes in RV size and shape over time reflect adaptations to single-ventricle physiology, dysfunction of the associated tricuspid valve (TV), and are associated with circulatory failure. As such, an accurate prediction of the RV shape of a patient would inform understanding of both RV and TV failure, as well as clinical prognosis and associated decision making. We present a geodesic-based predictive shape modeling framework applied a cohort of RVs obtained from 15 HLHS patients at three individual time points. Reasonable predictions on stage 1 RV shapes can generated using pre-stage 1 RV shapes and two predictors from prior clinical and demographic measures. Our results demonstrate the future potential for a data-driven method to predict how the morphology of the RV of an individual patient will change in size and shape over time. Future studies will seek to expand the training sample size and integrate more comprehensive demographic and morphological data into the proposed predictive model.

physics.med-ph↗

FEBio FINESSE: An open-source finite element simulation approach to estimate in vivo heart valve strains using shape enforcement

Finite element simulations are an enticing tool to evaluate heart valve function in healthy and diseased patients; however, patient-specific simulations derived from 3D echocardiography are hampered by several technical challenges. In this work, we present an open-source method to enforce matching between finite element simulations and in vivo image-derived heart valve geometry in the absence of patient-specific material properties, leaflet thickness, and chordae tendineae structures. We evaluate FEBio Finite Element Simulations with Shape Enforcement (FINESSE) using three synthetic test cases covering a wide range of model complexity. Our results suggest that FINESSE can be used to not only enforce finite element simulations to match an image-derived surface, but to also estimate the first principal leaflet strains within +/- 0.03 strain. Key FINESSE considerations include: (i) appropriately defining the user-defined penalty, (ii) omitting the leaflet commissures to improve simulation convergence, and (iii) emulating the chordae tendineae behavior via prescribed leaflet free edge motion or a chordae emulating force. We then use FINESSE to estimate the in vivo valve behavior and leaflet strains for three pediatric patients. In all three cases, FINESSE successfully matched the target surface with median errors similar to or less than the smallest voxel dimension. Further analysis revealed valve-specific findings, such as the tricuspid valve leaflet strains of a 2-day old patient with HLHS being larger than those of two 13-year old patients. The development of this open source pipeline will enable future studies to begin linking in vivo leaflet mechanics with patient outcomes

physics.med-ph↗