Significance of aortoseptal angle anomalies to left ventricular hemodynamics and subaortic stenosis: A numerical study.
Significance of aortoseptal angle anomalies to left ventricular hemodynamics and subaortic stenosis: A numerical study.
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主动脉膜角度异常对左心室血流动力学和亚电狭窄的意义：一项数值研究。
DOI：
10.1016/j.compbiomed.2022.105613
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发表时间：
2022-07
影响因子：
7.7
通讯作者：
中科院分区：
文献类型：
--
作者：
离散性主动脉瓣下狭窄（DSS）是由左心室（LV）流出道（LVOT）中的膜性病变引起的阻塞性心脏病。尽管其病因尚不清楚，但在具有陡峭横隔角（AoSA）的LVOT解剖结构中，DSS的患病率较高，表明血流动力学可能起作用。因此，本研究的目的是量化AoSA陡峭化对LV壁三维（3D）血流动力学应力环境的影响。根据心脏电影-磁共振成像重建的3D LV模型连接到跨越临床AoSA范围（115°-160°）的四种LVOT几何变化。LV血流动力学应力的特征在于周期平均压力，时间剪切幅度（TSM）和振荡剪切指数。通过计算壁面剪应力矢量场的标度散度，进一步分析了壁面剪应力的拓扑骨架。AoSA变陡导致主动脉下血流扰动增加，以LVOT血流偏斜和复杂的3D二次流模式为标志。这些干扰在下LVOT壁上产生WSS过载（TSM与160°模型相比增加> 45%），并在易于形成DSS膜的区域增加WSS收缩（WSS发散与160°模型相比减少> 66%）。AoSA变陡在LVOT区域产生大量的血流动力学应力异常，易于DSS形成。需要进一步的研究来评估这种机械异常对组织和细胞反应的可能影响。
Discrete subaortic stenosis (DSS) is an obstructive cardiac disease caused by a membranous lesion in the left ventricular (LV) outflow tract (LVOT). Although its etiology is unknown, the higher prevalence of DSS in LVOT anatomies featuring a steep aortoseptal angle (AoSA) suggests a potential role for hemodynamics. Therefore, the objective of this study was to quantify the impact of AoSA steepening on the LV wall three-dimensional (3D) hemodynamic stress environment. A 3D LV model reconstructed from cardiac cine-magnetic resonance imaging was connected to four LVOT geometrical variations spanning the clinical AoSA range (115°-160°). LV hemodynamic stresses were characterized in terms of cycle-averaged pressure, temporal shear magnitude (TSM), and oscillatory shear index. The wall shear stress (WSS) topological skeleton was further analyzed by computing the scaled divergence of the WSS vector field. AoSA steepening caused an increasingly perturbed subaortic flow marked by LVOT flow skewness and complex 3D secondary flow patterns. These disturbances generated WSS overloads (> 45% increase in TSM vs. 160° model) on the inferior LVOT wall, and increased WSS contraction (> 66% decrease in WSS divergence vs. 160° model) in regions prone to DSS membrane formation. AoSA steepening generated substantial hemodynamic stress abnormalities in LVOT regions prone to DSS formation. Further studies are needed to assess the possible impact of such mechanical abnormalities on the tissue and cellular responses.
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影响因子：
2.4
作者：
Jacot JG;Martin JC;Hunt DL
通讯作者：
Hunt DL
影响因子：
2.6
作者：
Donald, Julia S.;Naimo, Phillip S.;Konstantinov, Igor E.
通讯作者：
Konstantinov, Igor E.
DOI：
10.1177/2150135113485760
发表时间：
2013-07-01
影响因子：
0.9
作者：
Barboza, Laura A.;de Maria Garcia, Flor;Castaneda, Aldo R.
通讯作者：
Castaneda, Aldo R.
DOI：
10.1016/0735-1097(93)90563-g
发表时间：
1993-11-01
影响因子：
24
作者：
KLEINERT, S;GEVA, T
通讯作者：
GEVA, T
影响因子：
1.9
作者：
Atkins, Samantha K.;Moore, Alison N.;Sucosky, Philippe
通讯作者：
Sucosky, Philippe