Sensitivity of Myocardial Stiffness Estimates to Inter-observer Variability in LV Geometric Modelling

Abdallah I. Hasaballa*, Thiranja P. Babarenda Gamage, Vicky Y. Wang, Debbie Zhao, Charlène A. Mauger, Kathleen Gilbert, Zhinuo J. Wang, Bianca Freytag, Jie Jane Cao, Alistair A. Young, Martyn P. Nash

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingConference paperpeer-review

1 Citation (Scopus)


Heart failure is known to be associated with substantial changes in the mechanical properties of the heart muscle. Biomechanical parameters, such as myocardial stiffness, have the potential to help clinicians diagnose and determine and monitor treatment options. The impact of inter-observer variability of geometric modelling on the estimation of passive myocardial stiffness has not yet been systematically investigated. We aimed to examine the sensitivity of myocardial stiffness estimates with respect to inter-observer geometric model variability. Twenty-four subjects (5 controls, 19 patients with heart failure) underwent left heart catheterisation and cardiovascular magnetic resonance (CMR) imaging. Three expert analysts independently constructed three-dimensional geometric models of the left ventricle (LV), which were used to estimate myocardial stiffness using finite element simulations that combined cine CMR data and LV pressure measurements. Bland-Altman analysis was used to assess the inter-observer effects on the reproducibility of myocardial stiffness. The inter-observer variations were ±7.69 mL/m2 and ±9.78 g/m2 for the LV end-diastolic volume and mass indices, respectively. Meanwhile, the variability ranged by up to ±0.51 kPa for inter-observer analysis on the estimated intrinsic myocardial stiffness values. Findings from this pilot study highlight the importance of the accuracy of image-based geometric modelling when estimating myocardial stiffness.

Original languageEnglish
Title of host publicationFunctional Imaging and Modeling of the Heart - 11th International Conference, FIMH 2021, Proceedings
EditorsDaniel B. Ennis, Luigi E. Perotti, Vicky Y. Wang
PublisherSpringer Science and Business Media Deutschland GmbH
Number of pages9
ISBN (Print)9783030787097
Publication statusPublished - 2021
Event11th International Conference on Functional Imaging and Modeling of the Heart, FIMH 2021 - Virtual, Online
Duration: 21 Jun 202125 Jun 2021

Publication series

NameLecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)
Volume12738 LNCS
ISSN (Print)0302-9743
ISSN (Electronic)1611-3349


Conference11th International Conference on Functional Imaging and Modeling of the Heart, FIMH 2021
CityVirtual, Online


  • Cine CMR
  • Finite element analysis
  • Geometric modelling
  • Heart failure
  • Inter-observer variability
  • Myocardial stiffness

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