Model-based Analysis of Myocardial Strains in Obstructive and Non-obstructive Hypertrophic Cardiomyopathy

The objective of this paper is to propose preliminary results of a study focusing on an integrated cardiovascular model, including the left ventricular outflow tract obstruction (LVOT), to reproduce strain curves in obstructive and non-obstructive HCM patients.Clinical and echocardiography data were extracted from a database of 79 HCM patients enrolled in Rennes University Hospital.Unsupervised clustering was applied on a set of 12 clinical and echocardiography features per patient.Sensitivity analyses were performed to identify the most influential parameters on 6 outputs of the model.Two patients were selected, each associated with the centroid of the two defined clusters representing either a lower or higher proportion of obstructive patients.Then, two virtual patients were identified by adjusting manually model parameters to reproduce longitudinal strain curves as well as their LVOT pressure gradient.A close match was observed between simulated and experimental strains with a mean Root Mean Square Error of 3.75% 1.22 for the C1 centroid (non-obstructive patient) and 3.96% 1.46 for the C2 centroid (obstructive patient).This work demonstrated that the model was able to reproduce longitudinal strain curves and LVOT pressure gradient in both obstructive and non-obstructive HCM patients.