Cardiac Sensitivities to Biomechanical Changes in a Chronic Alcoholic Heart: A Case Study Using 3-Dimensional Electro-Mechanical Heart Modelling

Chronic excessive alcohol consumption impairs cardiac function through altered anatomy, material properties, and pre-/afterload.Understanding these mechanisms may improve diagnosis, patient selection, and therapy monitoring.We propose a multi-scale 3D electro-mechanical cardiac simulator, integrating patient data to identify key biomechanical factors affecting heart function.Patient-specific four-chamber anatomical models were created for a control and an alcoholaffected case, simulating cellular, tissue, and organ scale electrophysiology and mechanics within a closed-loop cardiovascular system.We evaluated the impact of myocardial stiffness, ventricular pressures, and vascular resistance through 100 simulations, employing Latin Hypercube (LH) sampling.Gaussian Process Emulators (GPE) were developed for ejection fraction, maximum ventricular pressures, and left ventricular (LV) enddiastolic volume outputs.Sensitivity analysis revealed LV end-diastolic pressure as the most influential parameter in both models, with LV stiffness significantly impacting right ventricle (RV) ejection fraction in the alcoholaffected model.Systemic resistance had a larger influence than pulmonary resistance, particularly in the alcoholic heart.