Inter-model and inter-modality analysis of left ventricular hemodynamics: Comparative study of two CFD approaches based on echocardiography and magnetic resonance imaging

Abstract

Computational fluid dynamics (CFD) carry the potential to provide detailed insights into intraventricular hemodynamics and complement in vivo flow measurement techniques. A variety of CFD approaches emerged in recent years, mostly building solely on medical image data as patient-specific input. While the utilized medical imaging method and chosen CFD approach both influence the computed hemodynamics, thereto related differences are rarely investigated. The present study addresses this issue with an inter-(imaging)-modality and inter-model comparison of intracardiac flow computations. Magnetic resonance imaging (MRI) and transthoracic echocardiography (TTE) data of a volunteer were acquired and used to reconstruct the anatomical structures. For each modality, the reconstructed shapes were applied in two previously introduced CFD approaches to compute whole-cycle ventricular flow patterns. While both methods involved benefits and challenges, similar valve velocities were computed, being in accordance with in vivo 4D flow MRI and pulsed-wave Doppler velocity measurements (systolic peak velocity: 1.24–1.26 m/s (MRI), 0.9–1.25 m/s (TTE); diastolic peak velocity: 0.54 m/s (MRI), 0.59–0.75 m/s (TTE)). A detailed flow analysis with vortex formation, kinetic energy, and mid-ventricular velocities indicated the computed inter-modality differences to be larger than inter-method ones. Quantitatively, this could be observed in the direct flow rate ($\Delta$ inter-modality: 13$\%$, $\Delta$ inter-method, 3$\%$). These results help to gain trust in CFD approaches to compute intraventricular flow and emphasize the importance of standardized input data. Future studies, however, should consider a broader data base.