The effect of patient-specific annular motion on dynamic simulation of mitral valve function.
The effect of patient-specific annular motion on dynamic simulation of mitral valve function.
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DOI：
10.1016/j.jbiomech.2013.01.014
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发表时间：
2013-04-05
影响因子：
2.4
通讯作者：
Kim H
中科院分区：
文献类型：
--
作者：
Rim Y;McPherson DD;Chandran KB;Kim H
大多数二尖瓣反流（MR）患者的外科手术都侧重于优化二尖瓣环的尺寸和形状，利用环成形术来恢复正常的环几何形状，增加小叶的覆盖，减少反流。通过结合临床成像方式（如超声心动图）的患者特异性二尖瓣仪器几何形状，计算研究可以深入了解环形运动对二尖瓣（MV）功能的影响。在本研究中，我们开发了一种新的算法来模拟患者在心脏周期内的特定环形运动，以进一步改进我们的虚拟MV建模和仿真策略。利用患者舒张末和收缩期的三维超声心动图数据，确定包括小叶、环和乳头肌尖的位置在内的中压装置，并将其转换为虚拟中压模型。动态环运动通过结合心电图门控时变尺度环位移在心脏周期建模。我们对两组关于mr存在的患者数据进行了动态有限元（FE）模拟，确定了环形形态，小叶和环上的应力分布以及接触应力分布，以评估环形运动对MV功能和小叶适应的影响。动态环形运动的影响清楚地表明减少了具有大应力值的区域，并提高了确定不适当的小叶适应位置的准确性。这种策略有可能更好地量化病理性中压的程度，并更好地评估中压修复后的功能恢复。
Most surgical procedures for patients with mitral regurgitation (MR) focus on optimization of annular dimension and shape utilizing ring annuloplasty to restore normal annular geometry, increase leaflet coaptation, and reduce regurgitation. Computational studies may provide insight on the effect of annular motion on mitral valve (MV) function through the incorporation of patient-specific MV apparatus geometry from clinical imaging modalities such as echocardiography. In the present study, we have developed a novel algorithm for modeling patient-specific annular motion across the cardiac cycle to further improve our virtual MV modeling and simulation strategy. The MV apparatus including the leaflets, annulus, and location of papillary muscle tips was identified using patient 3D echocardiography data at end diastole and peak systole and converted to virtual MV model. Dynamic annular motion was modeled by incorporating the ECG-gated time-varying scaled annular displacement across the cardiac cycle. We performed dynamic finite element (FE) simulation of two sets of patient data with respect to the presence of MR. Annular morphology, stress distribution across the leaflets and annulus, and contact stress distribution were determined to assess the effect of annular motion on MV function and leaflet coaptation. The effect of dynamic annular motion clearly demonstrated reduced regions with large stress values and provided an improved accuracy in determining the location of improper leaflet coaptation. This strategy has the potential to better quantitate the extent of pathologic MV and better evaluate functional restoration following MV repair.
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影响因子：
3.8
作者：
Rausch, Manuel K.;Bothe, Wolfgang;Kvitting, John-Peder Escobar;Swanson, Julia C.;Miller, D. Craig;Kuhl, Ellen
通讯作者：
Kuhl, Ellen
DOI：
10.1115/1.4000107
发表时间：
2009-12-01
影响因子：
1.7
作者：
Stevanella, Marco;Votta, Emiliano;Redaelli, Alberto
通讯作者：
Redaelli, Alberto
DOI：
10.1152/ajpheart.1995.269.4.h1319
发表时间：
1995-10-01
影响因子：
4.8
作者：
MAYNEWMAN, K;YIN, FCP
通讯作者：
YIN, FCP
影响因子：
3.8
作者：
Rausch, Manuel K.;Bothe, Wolfgang;Kuhl, Ellen
通讯作者：
Kuhl, Ellen
影响因子：
3.8
作者：
Jensen, MOJ;Fontaine, AA;Yoganathan, AP
通讯作者：
Yoganathan, AP