Anterior mitral leaflet curvature during the cardiac cycle in the normal ovine heart.
Anterior mitral leaflet curvature during the cardiac cycle in the normal ovine heart.
复制标题
正常羊心脏心动周期中二尖瓣前叶的曲率。
DOI：
10.1161/circulationaha.110.961243
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发表时间：
2010-10-26
期刊：
影响因子：
37.8
通讯作者：
Miller DC
中科院分区：
文献类型：
--
作者：
Kvitting JP;Bothe W;Göktepe S;Rausch MK;Swanson JC;Kuhl E;Ingels NB Jr;Miller DC
二尖瓣前叶（AML）曲率的动态变化对最佳左心室（LV）充盈和排空至关重要，但其特征并不完全。将16个不透射线标记缝合到11只绵羊的AML，并使用双平面视频荧光透视采集4-D标记坐标。应用曲面细分算法计算收缩中期和最大瓣膜开度时AML的曲率。分别沿着SL AML（MSL）和CC AML（MCC）子午线计算间隔-外侧（SL）和连合-连合（CC）曲率曲线，正曲率向左心房凹陷。在收缩中期，二尖瓣环附近的MSL是凹的，从凹到凸穿过腹部，并且沿着自由边缘是凸的。在最大瓣膜开度时，瓣环附近的MSL是平坦的，腹部从轻微凹到凸，并朝向自由边缘变平。相比之下，在收缩中期，MCC在两个连合处附近是凹形的，在腹部是凸形的，但在最大瓣膜开口处，MCC在两个连合处附近是凸形的，在腹部是凹形的。虽然AML沿着MSL的SL曲率在收缩中期和舒张早期跨腹部区域相似，但AML沿着MCC的CC曲率翻转，其中腹部在收缩中期向左心房凸出，在最大瓣膜打开时凹入。这些曲率方向表明AML的最佳LV流入和流出形状，在导管或手术干预期间应予以保留。
The dynamic changes of anterior mitral leaflet (AML) curvature are of primary importance for optimal left ventricular (LV) filling and emptying, but are incompletely characterized. Sixteen radiopaque markers were sutured to the AML in 11 sheep, and 4-D marker coordinates were acquired using biplane videofluoroscopy. A surface subdivision algorithm was applied to compute the curvature across the AML at mid-systole and at maximal valve opening. Septal-lateral (SL) and commissure-commissure (CC) curvature profiles were calculated along the SL AML (MSL)and CC AML (MCC) meridians, respectively, with positive curvature being concave towards the left atrium. At mid-systole, the MSL was concave near the mitral annulus, turned from concave to convex across the belly, and was convex along the free edge. At maximal valve opening, the MSL was flat near the annulus, turned from slightly concave to convex across the belly and flattened towards the free edge. In contrast, the MCC was concave near both commissures and convex at the belly at mid-systole, but convex near both commissures and concave at the belly at maximal valve opening. While the SL curvature of the AML along the MSL is similar across the belly region at mid-systole and early diastole, the CC curvature of the AML along the MCC flips with the belly being convex to the left atrium at mid-systole and concave at maximal valve opening. These curvature orientations suggest optimal LV inflow and outflow shapes of the AML and should be preserved during catheter or surgical interventions.