Fluid-Structure Interactions of the Mitral Valve and Left Heart: Comprehensive Strategies, Past, Present and Future.
Fluid-Structure Interactions of the Mitral Valve and Left Heart: Comprehensive Strategies, Past, Present and Future.
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DOI：
10.1002/cnm.1280
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发表时间：
2010-03
影响因子：
2.9
通讯作者：
Ratcliffe MB
中科院分区：
文献类型：
--
作者：
Einstein DR;Del Pin F;Jiao X;Kuprat AP;Carson JP;Kunzelman KS;Cochran RP;Guccione JM;Ratcliffe MB
后外侧心肌梗死后发生的重构可通过在二尖瓣环和后内侧乳头肌中产生构象异常来改变二尖瓣功能，从而导致二尖瓣返流（MR）。一般认为，这种重塑是由容积负荷引起的，并由舒张期壁应力的增加介导。因此，二尖瓣返流可能是异常心脏应激环境的原因和结果。缺血性MR及其手术矫正的计算建模很有吸引力，因为它可以检查给定的干预是否以异常组织应力为代价来解决反流（液体流动）的矫正。这是重要的，因为由于干预而增加的壁应力的负面影响仅随着时间的推移而明显。然而，一个有意义的流体-结构相互作用模型的左心脏是不平凡的;它需要体内心脏几何形状的仔细表征、通过逆分析的组织参数化、处理收缩拉格朗日界面的鲁棒耦合求解器、能够精确离散心脏几何形状的自动网格生成算法、图像分析的创新胜任和有效的本构模型和组织微观结构的空间组织的理解。在这篇手稿中，我们通过回顾我们的早期工作，介绍我们目前的工作，并在四个大类中列出我们未来的工作：数据收集，几何形状，流体结构相互作用和验证，概述了我们对左心的综合流体结构相互作用模型的工作。
The remodeling that occurs after a posterolateral myocardial infarction can alter mitral valve function by creating conformational abnormalities in the mitral annulus and in the posteromedial papillary muscle, leading to mitral regurgitation (MR). It is generally assumed that this remodeling is caused by a volume load and is mediated by an increase in diastolic wall stress. Thus, mitral regurgitation can be both the cause and effect of an abnormal cardiac stress environment. Computational modeling of ischemic MR and its surgical correction is attractive because it enables an examination of whether a given intervention addresses the correction of regurgitation (fluid-flow) at the cost of abnormal tissue stress. This is significant because the negative effects of an increased wall stress due to the intervention will only be evident over time. However, a meaningful fluid-structure interaction model of the left heart is not trivial; it requires a careful characterization of the in-vivo cardiac geometry, tissue parameterization though inverse analysis, a robust coupled solver that handles collapsing Lagrangian interfaces, automatic grid-generation algorithms that are capable of accurately discretizing the cardiac geometry, innovations in image analysis, competent and efficient constitutive models and an understanding of the spatial organization of tissue microstructure. In this manuscript, we profile our work toward a comprehensive fluid-structure interaction model of the left heart by reviewing our early work, presenting our current work and laying out our future work in four broad categories: data collection, geometry, fluid-structure interaction and validation.
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