Computational fluid dynamics in Fontan patients to evaluate power loss during simulated exercise
Computational fluid dynamics in Fontan patients to evaluate power loss during simulated exercise
复制标题
DOI：
10.1136/heartjnl-2013-304969
复制
发表时间：
2014-05-01
期刊：
影响因子：
5.7
通讯作者：
Helbing, Willem A.
中科院分区：
文献类型：
--
作者：
Bossers, Sjoerd S. M.;Cibis, Merih;Helbing, Willem A.
目的全腔静脉吻合术（TCPC）患者运动不耐症较为常见。已经表明TCPC内的功率损失（Ploss）在降低的运动表现中起作用。我们的目标是建立的作用，在增加流量的TCPC内的Ploss，模拟运动在patient-specific way.Methods心脏MRI（CMR）被用来获得从腔静脉在休息和增加流量，模拟运动与多巴酚丁胺的流速。使用CMR数据创建TCPC的3D重建。进行计算流体动力学（CFD）模拟，以计算TCPC结构内部的Ploss，用于静止和应力条件。为了反映运动时的血流分布，增加了下腔静脉（IVC）血流比静息时增加2倍的条件。29例TCPC患者（15例为房内侧通道（ILT），14例为心外管道（ECC））。结果静息时的平均Ploss分别为1.36 ± 0.94（ILT）和3.20 ± 1.26（ECC）mW/m2（P < 0.01）。
Objective Exercise intolerance is common in total cavopulmonary connection (TCPC) patients. It has been suggested that power loss (Ploss) inside the TCPC plays a role in reduced exercise performance. Our objective is to establish the role of Ploss inside the TCPC during increased flow, simulating exercise in a patient-specific way.Methods Cardiac MRI (CMR) was used to obtain flow rates from the caval veins during rest and increased flow, simulating exercise with dobutamine. A 3D reconstruction of the TCPC was created using CMR data. Computational fluid dynamics (CFD) simulations were performed to calculate Ploss inside the TCPC structure for rest and stress conditions. To reflect the flow distribution during exercise, a condition where inferior caval vein (IVC) flow was increased twofold compared with rest was added.29 TCPC patients (15 intra-atrial lateral tunnel (ILT) and 14 extracardiac conduit (ECC)) were included.Results Mean Ploss at rest was 1.36+/-0.94 (ILT) and 3.20+/-1.26 (ECC) mW/m(2) (p