Collaborative Research: Advancing the Diagnosis and Quantification of Mitral Valve Regurgitation with Mathematical Modeling

合作研究：通过数学建模推进二尖瓣反流的诊断和量化

• 批准号: 1263572
• 负责人: Suncica Canic
• 金额: $ 35.71万
• 依托单位: University of Houston
• 依托单位国家: 美国
• 项目类别: Continuing Grant
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-10-01 至 2017-09-30
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1263572&HistoricalAwards=false
• 关键词: Collaborative; Research; Advancing; Diagnosis; Quantification

Mitral regurgitation (MR) is a valvular disease in which the mitral valve does not close properly, thereby allowing blood to flow backward from the left ventricle to the left atrium of the heart. MR is among the most prevalent valve problems in the Western world. Doppler echocardiography has recently emerged as the method of choice for the non-invasive detection and evaluation of MR severity. However, due to the various color Doppler limitations, the accurate quantification of MR remains one of the major challenges in modern echocardiography. This is particularly the case with eccentric, wall-hugging regurgitant jets, known as the Coanda effect. This form of MR is currently very difficult to quantify and may lead to gross under-estimation of regurgitant volume by inexperienced cardiovascular observers. Using mathematical modeling, bifurcation analysis, and numerical simulations, combined with the in vitro experimental modeling of MR, and clinical experience, the investigators are developing a state-of-the-art tool for accurate non-invasive assessment of mitral regurgitation. The mathematical approach utilizes the most recent advances in fluid-structure interaction, modeling the flow of an incompressible, viscous fluid, coupled with the motion of an elastic regurgitant orifice simulating the regurgitant valve. A bifurcation diagram providing the information about different types of MR is being developed. The in vitro model is based on a pulsatile flow loop incorporating a mock imaging chamber, which contains a regurgitant orifice simulating the flow conditions encountered in patients with MR.This is an exciting, new study, addressing a significant problem in the development of non-invasive diagnostic tools for the quantification of valvular regurgitation. The interdisciplinary team of investigators is developing sophisticated novel mathematics, high performance computing, and in vitro experimental tools, which, when used together, provide novel information about the severity of mitral valve regurgitation, that could not be obtained by using each individual approach separately. Based on this collaborative endeavor, detailed information about the blood flow conditions in patient regurgitant valves will be obtained, that could not be obtained by using classical 2D or even 3D echocardiography. This information will be used to quantify the severity of MR, which is the fundamental data on which surgical interventions are decided. The complementary mathematical tools, combined with the echocardiographic images, and clinical experience, support the next step in the evolution of modern 3D echocardiography for non-invasive diagnosis of pathological complex intra-cardiac flows. The broader impacts will be achieved through student education via interdisciplinary training and interdisciplinary course preparation. Two of the investigators are women, and active recruitment of women and minorities will continue. This project contributes toward building a strong partnership between academia (University of Houston) and health/medical industry (The Methodist Hospital).

二尖瓣返流(MR)是一种瓣膜疾病，二尖瓣关闭不正确，从而使血液从左心室倒流到心脏的左心房。MR是西方世界最普遍的瓣膜问题之一。近年来，多普勒超声心动图已成为非侵入性检测和评估MR严重程度的首选方法。然而，由于各种彩色多普勒的局限性，MR的准确定量仍然是现代超声心动图的主要挑战之一。这种奇特的紧贴墙壁的回流喷流尤其如此，也就是所谓的科安达效应。这种形式的MR目前很难量化，并可能导致缺乏经验的心血管观察者对返流量的严重低估。利用数学建模、分叉分析和数值模拟，结合MR的体外实验建模和临床经验，研究人员正在开发一种最先进的工具，用于准确地非侵入性评估二尖瓣反流。该数学方法利用了流体-结构相互作用的最新进展，模拟了不可压缩、粘性流体的流动，并结合了模拟反流阀的弹性回流孔的运动。提供有关不同类型MR的信息的分叉图正在开发中。体外模型是建立在脉动血流回路的基础上的，其中包含一个模拟返流孔的模拟成像腔。这是一项令人兴奋的新研究，解决了瓣膜返流定量的非侵入性诊断工具开发中的一个重要问题。跨学科的研究团队正在开发复杂的新型数学、高性能计算和体外实验工具，当这些工具结合使用时，可以提供有关二尖瓣反流严重程度的新信息，而这些信息不能单独使用单独的方法获得。在这种合作努力的基础上，将获得有关患者返流瓣膜中血液流动状况的详细信息，这些信息是经典的2D甚至3D超声心动图无法获得的。这些信息将被用来量化MR的严重程度，这是决定手术干预的基本数据。互补的数学工具，结合超声心动图图像和临床经验，支持现代三维超声心动图发展的下一步，用于非侵入性诊断病理性复杂的心内血流。通过跨学科培训和跨学科课程准备的学生教育将产生更广泛的影响。其中两名调查员是女性，将继续积极招募妇女和少数族裔。该项目有助于在学术界(休斯顿大学)和卫生/医疗行业(卫理公会医院)之间建立强有力的伙伴关系。