Simplified Bernoulli's Method Significantly Underestimates Pulmonary Transvalvular Pressure Drop
Simplified Bernoulli's Method Significantly Underestimates Pulmonary Transvalvular Pressure Drop
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DOI：
10.1002/jmri.25097
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发表时间：
2016-06-01
影响因子：
4.4
通讯作者：
Kheradvar, Arash
中科院分区：
文献类型：
--
作者：
Falahatpisheh, Ahmad;Rickers, Carsten;Kheradvar, Arash
目的：探讨在简化伯努利方程中忽略血流不稳定性是否会显著影响肺经瓣压降的估计。材料与方法：对4名健康志愿者、7例修复性法洛四联症患者和13例经动脉开关修复的大动脉转位患者进行3.0T磁共振成像（MRI） 4D速度成像。肺经瓣压降的估计基于两种方法：一般伯努利方程（General Bernoulli’s Equation， GBE），即最完整形式；和简化伯努利方程（SBE），称为4V(2)。使用了2300多个单独的压降测量值来比较简化伯努利方法和一般伯努利方法。采用线性混合效应模型进行统计分析，充分考虑了方法和收缩期之间观察结果的聚类。结果：简化伯努利法与普通伯努利法相比，系统地低估了整个收缩期的压降（P < 0.05），包括收缩期的峰值，平均δ P (SBE)/ δ P (GBE) = 78%。结论：简化伯努利法低估了所有研究对象所有收缩期的压降。因此，为了更准确地估计压降，有必要考虑流动的不稳定性。
Purpose: To determine whether neglecting the flow unsteadiness in simplified Bernoulli's equation significantly affects the pulmonary transvalvular pressure drop estimation.Materials and Methods: 3.0T magnetic resonance imaging (MRI) 4D velocity mapping was performed on four healthy volunteers, seven patients with repaired tetralogy of Fallot, and thirteen patients with transposition of the great arteries repaired by arterial switch. Pulmonary transvalvular pressure drop was estimated based on two methods: General Bernoulli's Equation (GBE), ie, the most complete form; and Simplified Bernoulli's Equation (SBE), known as 4V(2). More than 2300 individual pressure drop measurements were used to compare the simplified and the general Bernoulli's methods. A linear mixed-effects model was employed for statistical analyses, fully accounting for clustering of observations among the methods and systolic phases.Results: The simplified Bernoulli's method systematically underestimated the pressure drop compared to general Bernoulli's method during the entire systolic phase (P < 0.05), including the peak systole, where on average Delta p(SBE)/Delta p(GBE) = 78%.Conclusion: The simplified Bernoulli method underestimated the pressure drop during all systolic phases in all the studied subjects. Therefore, it is necessary to take into account the flow unsteadiness for more accurate estimation of the pressure drop.