A Three-Dimensional Computational Fluid Dynamics Model of Regurgitant Mitral Valve Flow: Validation Against in vitro Standards and 3D Color Doppler Methods.
A Three-Dimensional Computational Fluid Dynamics Model of Regurgitant Mitral Valve Flow: Validation Against in vitro Standards and 3D Color Doppler Methods.
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DOI：
10.1007/s13239-011-0038-6
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发表时间：
2011-06
影响因子：
1.8
通讯作者：
Little, Stephen H
中科院分区：
文献类型：
--
作者：
Quaini, Annalisa;Canic, Suncica;Guidoboni, Giovanna;Glowinski, Roland;Igo, Stephen R;Hartley, Craig J;Zoghbi, William A;Little, Stephen H
3D 彩色多普勒超声心动图最近已用于评估瓣膜反流严重程度的 3D 近端等速表面积 (PISA) 和收缩静脉 (VC) 面积测量值。计算流体动力学 (CFD) 建模可以深入了解用于量化二尖瓣反流 (MR) 的新兴 3D 彩色多普勒应用的优势和局限性。本研究的目的是评估最近开发的在定制血流动力学条件下对二尖瓣反流的 CFD 模拟。使用体外流动环路模拟中度 MR（30 mL/次）和重度 MR（70 mL/次），其中成像室配置为模拟二尖瓣反流。基于纳维-斯托克斯方程的有限元法近似的 3D CFD 模型的新颖应用被用来模拟回流条件。将 CFD 得出的峰值穿孔压力梯度和速度与体外测量标准进行比较。将近端反流事件的 CFD 模拟与 2D 和 3D 彩色多普勒 PISA 和 VC 测量进行比较。与在线流量计参考相比，CFD 模型提供了峰值穿孔流速的准确估计（平均值分别为 459 与 442 m/s；相对误差 5.7%）。与高保真压力传感器相比，CFD 模型提供了峰值穿孔压力梯度的准确估计（分别为平均 90 与 85 mmHg；相对误差 10.4%）。与 3D 彩色多普勒 PISA 测量相比，等速表面积的 CFD 模型更大（相对差异 7-23%）。较高流量条件下误差最大。与实际孔口面积相比，3D 多普勒 VC 面积较大（相对误差为 3-14%），而 CFD VC 面积较小（相对误差为 8-9%），并且与跨瓣血流压缩导致的面积预期减少更为一致。与体外压力和流量测量相比，复杂心内血流事件的 3D CFD 模拟是准确的，并且与最近推出的 3D 超声心动图血流量化方法一致。未来的研究可能会采用经过验证的 CFD 模型来评估新兴 3D 彩色多普勒应用的优势和局限性。
3D color Doppler echocardiography has recently been employed to evaluate 3D proximal isovelocity surface area (PISA) and vena contracta (VC) area measures of regurgitant valve severity. Computational fluid dynamics (CFD) modeling may provide insight into the strengths and limitations of emerging 3D color Doppler applications for the quantification of mitral regurgitation (MR). The objective of this study is to evaluate a recently developed CFD simulation of regurgitant mitral jets under tailored hemodynamic conditions. Moderate MR (30 mL/beat) and severe MR (70 mL/beat) were simulated using anin vitroflow loop with an imaging chamber configured to model a regurgitant mitral orifice. A novel application of a 3D CFD model based on a finite element method approximation of the Navier–Stokes equation was used to simulate the regurgitant flow conditions. The CFD derived peak transorifice pressure gradient and velocity were compared againstin vitromeasurement standards. CFD simulation of proximal regurgitant flow events were compared against 2D and 3D color Doppler PISA and VC measurements. Compared to an in-line flow meter reference, the CFD model provided an accurate estimate of peak transorifice flow velocity (mean 459 vs. 442 m/s, respectively; relative error 5.7%). Compared to high-fidelity pressure transducers, the CFD model provided accurate estimates of peak transorifice pressure gradient (mean 90 vs. 85 mmHg, respectively; relative error 10.4%). Compared to 3D color Doppler PISA measures, the CFD model of isovelocity surface area was larger (relative difference 7–23%). The error was greatest for higher flow conditions. When compared to the actual orifice area, the 3D Doppler VC area was larger (3–14% relative error), whereas the CFD VC area was smaller (8–9% relative error) and more consistent with the expected reduction in area due to transvalvular flow compression. 3D CFD simulations of complex intracardiac flow events are accurate when compared toin vitropressure and flow measures and are consistent with recently introduced 3D echocardiographic flow quantification methods. Future studies may employ validated CFD models to assess the strengths and limitations of emerging 3D color Doppler applications.