Characterization of Mitral Valve Annular Dynamics in the Beating Heart
Characterization of Mitral Valve Annular Dynamics in the Beating Heart
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DOI：
10.1007/s10439-011-0272-y
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发表时间：
2011-06-01
影响因子：
3.8
通讯作者：
Kuhl, Ellen
中科院分区：
文献类型：
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作者：
Rausch, Manuel K.;Bothe, Wolfgang;Kuhl, Ellen
本研究的目的是建立二尖瓣环的数学表征，以便对跳动心脏中的瓣环动力学进行精确的定性和定量评估。我们通过缝在55只绵羊的瓣环上的16个微型标记来定义瓣环几何形状。使用双平面视频透视，我们记录标记物在体内的坐标。通过分段三次样条逼近这16个标记坐标，我们生成了55个二尖瓣环的平滑数学表示。我们将这55个瓣环表示与特征血流动力学时间点进行时间对齐，以生成平均基线瓣环表示。为了表征瓣环生理学，我们提取了整个心动周期中瓣环形式和功能的经典临床指标。为了表征环形动力学，我们计算位移，应变和曲率的离散数学表示。为了说明这种方法的潜在未来应用，我们在特征血流动力学时间点创建平均二尖瓣环的快速原型。总之，本研究引入了一种新的数学模型，使我们能够识别表征二尖瓣环形状和功能的临床和力学指标的时间、区域和受试者间变化。最终，该模型可以作为一个有价值的工具，以优化旨在恢复二尖瓣功能的手术和介入方法。
The objective of this study is to establish a mathematical characterization of the mitral valve annulus that allows a precise qualitative and quantitative assessment of annular dynamics in the beating heart. We define annular geometry through 16 miniature markers sewn onto the annuli of 55 sheep. Using biplane videofluoroscopy, we record marker coordinates in vivo. By approximating these 16 marker coordinates through piecewise cubic splines, we generate a smooth mathematical representation of the 55 mitral annuli. We time-align these 55 annulus representations with respect to characteristic hemodynamic time points to generate an averaged baseline annulus representation. To characterize annular physiology, we extract classical clinical metrics of annular form and function throughout the cardiac cycle. To characterize annular dynamics, we calculate displacements, strains, and curvature from the discrete mathematical representations. To illustrate potential future applications of this approach, we create rapid prototypes of the averaged mitral annulus at characteristic hemodynamic time points. In summary, this study introduces a novel mathematical model that allows us to identify temporal, regional, and inter-subject variations of clinical and mechanical metrics that characterize mitral annular form and function. Ultimately, this model can serve as a valuable tool to optimize both surgical and interventional approaches that aim at restoring mitral valve competence.