A novel in vivo assessment of fluid dynamics on aortic valve leaflet using epi-aortic echocardiogram.
A novel in vivo assessment of fluid dynamics on aortic valve leaflet using epi-aortic echocardiogram.
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DOI：
10.1111/echo.14596
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发表时间：
2020-02
期刊：
影响因子：
--
通讯作者：
Takayama H
中科院分区：
文献类型：
--
作者：
Hayashi H;Akiyama K;Itatani K;DeRoo S;Sanchez J;Ferrari G;Colombo PC;Takeda K;Wu IY;Kainuma A;Takayama H
由血流引起的机械应力，例如壁切应力（WSS）及其相关参数，是内皮变性的关键调节因子。然而，尚未开发出测量心脏瓣膜上WSS的体内方法。我们开发了一种新的方法，基于向量流映射使用术中主动脉上超声心动图，测量WSS和振荡剪切指数（OSI）的主动脉瓣。我们前瞻性地纳入了15例瓣膜正常的患者，他们接受了冠状动脉旁路移植术。室壁收缩期WSS [2.40 ± 0.44 Pa（1.45-3.00 Pa）]高于纤维壁收缩期WSS [0.33 ± 0.08 Pa（0.14-0.47 Pa），P<0.001]和室壁舒张期WSS [0.18± 0.07 Pa（0.04-0.28 Pa），P<0.001]。纤维瘤的OSI高于脑室（0.29 ± 0.04 [0.24-0.36] vs.0.05 ± 0.03 [0.01-0.12]，P<0.001）。一项涉及两名重度主动脉瓣返流患者的初步研究显示，流体动力学值存在显著差异。采用术中主动脉外膜超声心动图的矢量流标测方法是测量正常主动脉瓣叶WSS和OSI的有效方法，可以更好地了解主动脉瓣疾病的病理生理学。
Mechanical stress caused by blood flow, such as wall shear stress (WSS) and its related parameters, are key moderators of endothelial degeneration. However, an in vivo method to measure WSS on heart valves has not been developed. We developed a novel approach, based on vector flow mapping using intraoperative epi-aortic echocardiogram, to measure WSS and oscillatory shear index (OSI) on the aortic valve. We prospectively enrolled 15 patients with normal valves, who underwent coronary artery bypass graft. Systolic WSS on the ventricularis [2.40 ± 0.44 Pa (1.45–3.00 Pa)] was higher than systolic WSS on the fibrosa [0.33 ± 0.08 Pa (0.14–0.47 Pa), P<0.001] and diastolic WSS on the ventricularis [0.18± 0.07 Pa (0.04–0.28 Pa), P<0.001]. OSI on the fibrosa was higher than on the ventricularis (0.29 ± 0.04 [0.24–0.36] vs. 0.05± 0.03 [0.01–0.12], P<0.001). A pilot study involving two patients with severe aortic regurgitation showed significantly different values in fluid dynamics. Vector flow mapping method using intraoperative epi-aortic echocardiogram is an effective way of measuring WSS and OSI on normal aortic leaflet in vivo, allowing for better understanding of the pathophysiology of aortic valve diseases.
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影响因子：
1.5
作者：
Miyazaki S;Itatani K;Furusawa T;Nishino T;Sugiyama M;Takehara Y;Yasukochi S
通讯作者：
Yasukochi S
DOI：
10.1016/s0735-1097(96)00563-3
发表时间：
1997-03-01
影响因子：
24
作者：
Stewart, BF;Siscovick, D;Otto, CM
通讯作者：
Otto, CM
DOI：
10.1016/j.jtcvs.2007.01.039
发表时间：
2007-05-01
影响因子：
6
作者：
Sievers, Hans-H.;Schmidtke, Claudia
通讯作者：
Schmidtke, Claudia
影响因子：
8.9
作者：
John, Ranjit;Mantz, Katie;May-Newman, Karen
通讯作者：
May-Newman, Karen
DOI：
10.1016/j.echo.2013.07.009
发表时间：
2013-09-01
影响因子：
6.5
作者：
Hahn, Rebecca T.;Abraham, Theodore;Picard, Michael H.
通讯作者：
Picard, Michael H.