The importance of the pericardium for cardiac biomechanics: from physiology to computational modeling

The human heart is enclosed in the pericardial cavity. The pericardium consists of a layered thin sac and is separated from the myocardium by a thin film of fluid. It provides a fixture in space and frictionless sliding of the myocardium. The influence of the pericardium is essential for predictive...

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Bibliographic Details
Published in:Biomechanics and modeling in mechanobiology 2019-04, Vol.18 (2), p.503-529
Main Authors: Pfaller, Martin R., Hörmann, Julia M., Weigl, Martina, Nagler, Andreas, Chabiniok, Radomir, Bertoglio, Cristóbal, Wall, Wolfgang A.
Format: Article
Language:English
Subjects:
Approximation
Biological and Medical Physics
Biomechanics
Biomedical Engineering and Bioengineering
Biophysics
Boundary conditions
Computer applications
Computer simulation
Engineering
Epicardium
Heart
Magnetic resonance imaging
Mathematical analysis
Mathematical models
Myocardium
Original Paper
Pericardium
Space life sciences
Stiffness
Theoretical and Applied Mechanics
Thin films
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Summary:The human heart is enclosed in the pericardial cavity. The pericardium consists of a layered thin sac and is separated from the myocardium by a thin film of fluid. It provides a fixture in space and frictionless sliding of the myocardium. The influence of the pericardium is essential for predictive mechanical simulations of the heart. However, there is no consensus on physiologically correct and computationally tractable pericardial boundary conditions. Here, we propose to model the pericardial influence as a parallel spring and dashpot acting in normal direction to the epicardium. Using a four-chamber geometry, we compare a model with pericardial boundary conditions to a model with fixated apex. The influence of pericardial stiffness is demonstrated in a parametric study. Comparing simulation results to measurements from cine magnetic resonance imaging reveals that adding pericardial boundary conditions yields a better approximation with respect to atrioventricular plane displacement, atrial filling, and overall spatial approximation error. We demonstrate that this simple model of pericardial–myocardial interaction can correctly predict the pumping mechanisms of the heart as previously assessed in clinical studies. Utilizing a pericardial model not only can provide much more realistic cardiac mechanics simulations but also allows new insights into pericardial–myocardial interaction which cannot be assessed in clinical measurements yet.
ISSN:1617-7959
1617-7940
DOI:10.1007/s10237-018-1098-4