In the weeks and months following a heart attack, the morphological structure of the left ventricle can change significantly. This process begins with the expansion of the tissue damaged by the infarct, but can gradually have an increasing effect on the surrounding healthy tissue. The shape of the ventricle can continue to change until its entire mechanical and functional properties are altered. This process can lead to a range of complications and can, in itself, be fatal. The way in which the condition develops can vary significantly between patients and is not fully understood. As the blood flow within the ventricle can be affected by the early stages of the remodelling process, it is likely that the flow itself can contribute to the deformation of the morphological structure. By investigating the relationships between ventricular morphology and blood flow, our understanding of the remodelling process Will be greatly increased.
This PhD proposes a framework that allows the relationships between the ventricular morphology and blood flow to be explored. It is based upon the acquisition of in-vivo images of the heart using Cardiovascular Magnetic Resonance imaging. Firstly, a novel imaging strategy is proposed that allows the automatic segmentation of the cardiac structure. This is then followed by the introduction of a new patient specific modelling scheme that permits the creation of detailed statistical models of the left ventricle. Finally, simulation of the blood flow is performed by using Computational Fluid Dynamics. The simulation allows the generation of blood flow patterns at a far higher spatial and temporal resolution than can be physically measured. The results may be compared to the morphological properties of the ventricle to provide a valuable insight into the bio-mechanical and haemodynamic factors involved in the remodelling process.