Platelet activation of mechanical versus bioprosthetic heart valves during systole
Platelet activation of mechanical versus bioprosthetic heart valves during systole
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DOI：
10.1016/j.jbiomech.2017.03.002
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发表时间：
2017-05-03
影响因子：
2.4
通讯作者：
Borazjani, Iman
中科院分区：
文献类型：
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作者：
Hedayat, Mohammadali;Asgharzadeh, Hafez;Borazjani, Iman
血栓形成是机械心脏瓣膜（mhv）受者的一个主要问题，这需要他们在余生中服用抗凝药物。生物人工心脏瓣膜（bhv）不需要终身抗凝治疗，但在10-15年后会恶化。血栓形成是由血小板活化引起的，而血小板活化被认为主要是由mhv中通过铰链的流动和舒张期的泄漏流动产生的。然而，我们的研究结果表明，收缩期大流量的激活可能也起着重要的作用。这是基于我们通过比较MHV和BHV（作为对照）在完全相同条件下剪切诱导血小板激活方面的血栓形成性能而获得的结果。通过对直主动脉MHV和BHV在相同生理血流条件下的血流模拟，我们测试了三种不同的数学激活模型，包括线性激活水平、损伤积累和Soares模型，以量化收合期血小板激活。结果表明，收缩期开始时MHV的血小板活化程度略低于BHV。然而，在收收期结束时，MHV的大流量对血小板的激活比所有测试的血小板激活模型的BHV高几倍（分别为1.41、5.12和2.81，分别为线性激活水平、损伤积累和Soares模型）。(C) 2017 Elsevier Ltd.版权所有。
Thrombus formation is a major concern for recipients of mechanical heart valves (MHVs), which requires them to take anticoagulant drugs for the rest of their lives. Bioprosthetic heart valves (BHVs) do not require life-long anticoagulant therapy but deteriorate after 10-15 years. The thrombus formation is initiated by the platelet activation which is thought to be mainly generated in MHVs by the flow through the hinge and the leakage flow during the diastole. However, our results show that the activation in the bulk flow during the systole phase might play an essential role as well. This is based on our results obtained by comparing the thrombogenic performance of a MHV and a BHV (as control) in terms of shear induced platelet activation under exactly the same conditions. Three different mathematical activation models including linear level of activation, damage accumulation, and Soares model are tested to quantify the platelet activation during systole using the previous simulations of the flow through MHV and BHV in a straight aorta under the same physiologic flow conditions. Results indicate that the platelet activation in the MHV at the beginning of the systole phase is slightly less than the BHV. However, at the end of the systole phase the platelet activation by the bulk flow for the MHV is several folds (1.41, 5.12, and 2.81 for linear level of activation, damage accumulation, and Soares model, respectively) higher than the BHV for all tested platelet activation models. (C) 2017 Elsevier Ltd. All rights reserved.