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Simulating Ventricular Systolic Motion in a Four-chamber Heart Model with Spatially Varying Robin Boundary Conditions to Model the Effect of the Pericardium

Research output: Contribution to journalArticle

Marina Strocchi, Matthias A. F. Gsell, Christoph M. Augustin, Orod Razeghi, Caroline Helen Roney, A. J. Prassl, Edward Vigmond, Jonathan Behar, Justin Gould, Christopher A. Rinaldi, Martin J. Bishop, Gernot Planck, Steven Alexander Niederer

Original languageEnglish
JournalJournal of Biomechanics
Publication statusAccepted/In press - 16 Jan 2020

King's Authors

Abstract

The pericardium affects cardiac motion by limiting epicardial displacement normal to the surface. In computational studies, it is important for the model to replicate realistic motion, as this affects the physiological fidelity of the model. Previous computational studies showed that accounting for the effect of the pericardium allows for a more realistic motion simulation. In this study, we describe the mechanism through which the pericardium causes improved cardiac motion. We simulated electrical activation and contraction of the ventricles on a four-chamber heart in the presence and absence of the effect of the pericardium. We simulated the mechanical constraints imposed by the pericardium by applying normal Robin boundary conditions on the ventricular epicardium. We defined a regional scaling of normal springs stiffness based on image-derived motion from CT images. The presence of the pericardium reduced the error between simulated and image-derived end-systolic configurations from 12.8±4.1mm to 5.7±2.5mm. First, the pericardium prevents the ventricles from spherising during isovolumic contraction, reducing the outward motion of the free walls normal to the surface and the upwards motion of the apex. Second, by restricting the inward motion of the ventricle free and apical walls the pericardium increases atrioventricular plane displacement by four folds during ejection. Our results provide a mechanistic explanation of the importance of the pericardium in physiological simulations of electromechanical cardiac function.

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