The Role of Trabeculae Carneae on the Left Ventricular Diastolic and Systolic Functions

Reduced left ventricular (LV) compliance is the hallmark of heart failure with preserved ejection fraction (HFpEF), which is the leading cause of all heart failure hospitalizations. LV stiffness is related to the thickness of the myocardium and the extent of fibrosis as LV hypertrophy develops. LV hypertrophy is also associated with the thickening and fibrosis of the trabeculae carneae. Our recent studies suggested that trabeculae carneae have a noticeable effect on the overall stiffness of LV, and severing free-running trabeculae carneae may help increase the compliance of LV in HFpEF patients. Therefore, it is of clinical interest to better understand the microstructural and material properties and mechanical role of trabeculae carneae in human LV.

Mechanical properties and microstructural characteristics of trabeculae carneae were determined through conducting ex-vivo experiments on explanted human hearts. Knowing these mechanical properties enabled us to develop accurate computational models of LV. MR images were acquired from an explanted human heart and patient-specific model of LV with detailed anatomy of trabeculae carneae was generated. Virtual experiments of severing free-running trabeculae carneae were performed using finite element analysis. The changes in stiffness, diastolic function and systolic function of LV were evaluated. The results from this study will clarify the role of trabeculae carneae in LV function and set a base for developing new treatment for HFpEF patients.