Can Computational Simulation Quantitatively Determine Mitral Valve Abnormalities?
Can Computational Simulation Quantitatively Determine Mitral Valve Abnormalities?
复制标题
计算模拟可以定量确定二尖瓣异常吗？
DOI：
10.1016/j.jcmg.2014.09.011
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Kim,Hyunggun
中科院分区：
文献类型：
--
作者：
Rim,Yonghoon;Chandran,KrishnanB;Laing,SusanT;Kee,Patrick;McPherson,DavidD;Kim,Hyunggun
二尖瓣 (MV) 装置的各种病理包括瓣环过度扩张、腱索伸长、腱索破裂和小叶组织增大，这些都会导致二尖瓣反流 (MR)(1)。对于这些伴有严重 MR 的 MV 病理，推荐的治疗方法是 MV 重建，这已被证明可以提高无事件生存率 (2)。超声心动图是提供 MV 病理信息和考虑 MV 修复的适当时机的主要成像方式 (3)。在最近一期中，我们演示了 MV 函数计算评估的 4 个案例 (4)。在这里，我们扩展了针对患者的计算 MV 评估研究，以定量确定涉及严重环形扩张的 MV 功能的生物力学和生理特征。招募了 5 名 MV 正常的患者和 5 名伴有 MR 的严重环形扩张患者，并进行了 3 维（3D）经食管超声心动图（TEE）。患者特定的 3D TEE 数据被转换为计算 MV 模型，然后进行动态模拟以评估 MV 功能 (5)。在收缩峰值时确定二尖瓣小叶的应力和接触压力分布。计算并比较正常和病理 MV 组之间接合的小叶面积与整个后小叶面积的比率。正常 MV 清楚地显示整个心动周期中鞍形环形形态的 3D 循环变形。与正常 MV 相比，表现出严重 MR 的病理 MV 显示出更大的环形尺寸和更少的椭圆形环形形态。收缩期峰值时二尖瓣小叶的代表性应力分布如图所示
Various pathologies of the mitral valve (MV) apparatus include excessive annular dilation, chordal elongation, chordal rupture, and leaflet tissue enlargement, which lead to mitral regurgitation (MR)(1). The recommended treatment for these MV pathologies accompanied by severe MR is MV reconstruction, which has been shown to improve event-free survival (2). Echocardiography is the primary imaging modality to provide MV pathological information and the proper timing for consideration of MV repair (3). In a recent issue, we demonstrated 4 cases of computational evaluation of MV function (4). Here we extend our patient-specific computational MV evaluation studies to quantitatively determine the biomechanical and physiological characteristics of MV function involving severe annular dilation. Five patients with normal MV and 5 patients with severe annular dilation accompanied by MR were recruited, and 3-dimensional (3D) transesophageal echocardiography (TEE) was performed. Patient-specific 3D TEE data were converted into computational MV models followed by dynamic simulations to evaluate MV function (5). Stress and contact pressure distributions across the mitral leaflets were determined at peak systole. A ratio of the coapted leaflet area to the entire posterior leaflet area was calculated and compared between the normal and pathological MV groups. The normal MVs clearly showed 3D cyclic deformation of the saddle-shaped annular morphology across the cardiac cycle. The pathological MVs displaying severe MR revealed larger annular sizes and less elliptical annular morphology compared with the normal MVs. Representative stress distributions across the mitral leaflets at peak systole are demonstrated in
我们如何使用影像学来帮助考虑对严重二尖瓣反流患者进行干预？
影响因子：
3.1
作者：
Randolph P. Martin
通讯作者：
Randolph P. Martin
DOI：
10.1053/j.semtcvs.2007.04.003
发表时间：
2007-06-01
影响因子：
2.5
作者：
Filsoufi, Farzan;Carpentier, Alain
通讯作者：
Carpentier, Alain
影响因子：
2.4
作者：
Rim Y;McPherson DD;Chandran KB;Kim H
通讯作者：
Kim H