Image-Based Computational Hemodynamics Analysis of Systolic Obstruction in Hypertrophic Cardiomyopathy

FIGURE 1. Reconstruction algorithm. Numbers correspond to the steps of Algorithm 1.

FIGURE 2. Computational domain Ω with its outlet section Σout and the endocardial and aortic walls Σwall. ΓMV denotes the mitral valve leaflets.

FIGURE 3. Computational mesh for the patients under investigation. In the box, a zoom showing the local refinement in the LVOT.

FIGURE 4. Reconstructed displacement field of the three patients, at the end of diastole (t = 0 s) and in late systole (t = 0.2 s). LV aligned vertically, with septal wall on the left.

FIGURE 5. Evolution of the reconstructed volume of the LV cavity. Circled points: instants of the MRI segmentation; solid line: spline interpolation on all the times of the simulation.

FIGURE 6. Velocity distributions on a two-dimensional slice of the LV and ascending aorta, orthogonal to the latero-lateral axis of the LV (as shown on the right), at significant times during systole.

FIGURE 7. Q-criterion contours [10 log-spaced values for Q in 2.4 × (104, 106) s– 1] colored by velocity magnitude at significant times during systole.

FIGURE 8. Time evolution of the maximum blood velocity U(t) over the whole aorta. The median Uthr of U(t) over time for each patient is indicated by a dotted line.

FIGURE 9. Distribution of pressure difference Δp = p-pout on a longitudinal slice, at significant times during systole.

FIGURE 10. Distribution of pressure difference with respect to the Valsalva sinuses (left) and wall shear stress (right) along a line on the septum (center), at the instant of maximum pressure gradient: Patient 1, t = 0.08 s; Patient 2, t = 0.16 s; and Patient 3, t = 0.20 s. The distance is normalized with respect to the total length of the line. For each patient, the origin of the line in the right coronary ostium is denoted by 0, while the position of the aortic annulus (point A in the center figure) is indicated by a circle.

FIGURE 11. Wall shear stress distributions at significant times during systole: view from the interventricular septum. In the boxes, WSS distribution on the aortic root wall at the systolic peak (view from the atrial side): Patient 1, t = 0.08 s; Patient 2, t = 0.23 s; and Patient 3, t = 0.20 s.