Left ventricle modelling: a functional assessment tool combined with a predictive tool for the evaluation of the post-operative mechanical performance

Dilated cardiomyopathy following ischemic disease increases the degree of heart failure and its surgical management remains controversial. The most challenging objective in the clinical decision making for the management of patients with myocardial dysfunction or overt heart failure (HF) is to choose the best option for improving myocardial function and the clinical outcome. Medical versus surgical and, among surgical options, coronary revascularization, myocardial restoration, mitral valve repair, are the proposed solutions for avoiding progression of cardiac dysfunction toward HF. Magnetic resonance imaging (MRI) can provide patient-specific identification of dysfunctioning left ventricular (LV) segments and recognition of not viable myocardium by gadolinium (GAD) late hyperenhancement pattern. Within EU project VPH2 we aimed at developing two software tools for the quantitatively prediction the postoperative mechanical performance of the complex left ventricle: a functional assessment tool (FAT) and a functional predictive tool (FTP). In particular, the former is aimed to the automatic extraction of contours from 4D MRI images and automatic calculation of global and regional parameters (e.g. EF, synchronicity) while the latter is aimed to the prediction of postoperative LV function through mechanical modeling.