Influence of Mitral Valve Anterior Leaflet in vivo Shape on Left Ventricular Ejection

Dimasi, Annalisa; Cattarinuzzi, Emanuele; Stevanella, Marco; Conti, Carlo; Votta, Emiliano; Maffessanti, Francesco; Ingels, Neil B.; Redaelli, Alberto

doi:10.1007/s13239-012-0105-7

Cited by 11 publications

(8 citation statements)

References 51 publications

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“…In diastole, the maximum specific energy dissipation in the MR cases appears during early diastole, whereas in the non-MR cases, it is visible in diastasis. By taking the volume integral of the energy dissipation, a power loss can be calculated ( 30 ). The application of a time integral over the cardiac cycle can then reveal the cyclic power loss.…”

Section: Resultsmentioning

confidence: 99%

“…To get a hold of the energetic loss, the dissipation function Φ is used. It is defined as the double-dot product of the stress tensor σ and the gradient of the velocity vector ∇ v ( 30 , 59 ) as shown in Equation 9.…”

Section: Methodsmentioning

confidence: 99%

“…Image-based CFD approaches are for example used to investigate intraventricular flow patterns and diastolic vortex formation ( 25 – 28 ) as well as loss of kinetic energy and pressure gradients in LVs ( 29 ). In contrast to medical imaging techniques, CFD allows to analyze wall shear stress at high spatio-temporal resolutions ( 30 ) and to model post-operative states, e.g., after MV treatment ( 12 , 31 ) or surgical ventricular restoration ( 32 ). CFD furthermore enables the creation of synthetic cases, for example, LVs via statistical shape models ( 33 ) or different incorporated MV shapes in mitral regurgitation (MR) ( 34 ).…”

Section: Introductionmentioning

confidence: 99%

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CT-Based Simulation of Left Ventricular Hemodynamics: A Pilot Study in Mitral Regurgitation and Left Ventricle Aneurysm Patients

Obermeier

Vellguth

Schlief

et al. 2022

Front. Cardiovasc. Med.

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BackgroundCardiac CT (CCT) is well suited for a detailed analysis of heart structures due to its high spatial resolution, but in contrast to MRI and echocardiography, CCT does not allow an assessment of intracardiac flow. Computational fluid dynamics (CFD) can complement this shortcoming. It enables the computation of hemodynamics at a high spatio-temporal resolution based on medical images. The aim of this proposed study is to establish a CCT-based CFD methodology for the analysis of left ventricle (LV) hemodynamics and to assess the usability of the computational framework for clinical practice.Materials and MethodsThe methodology is demonstrated by means of four cases selected from a cohort of 125 multiphase CCT examinations of heart failure patients. These cases represent subcohorts of patients with and without LV aneurysm and with severe and no mitral regurgitation (MR). All selected LVs are dilated and characterized by a reduced ejection fraction (EF). End-diastolic and end-systolic image data was used to reconstruct LV geometries with 2D valves as well as the ventricular movement. The intraventricular hemodynamics were computed with a prescribed-motion CFD approach and evaluated in terms of large-scale flow patterns, energetic behavior, and intraventricular washout.ResultsIn the MR patients, a disrupted E-wave jet, a fragmentary diastolic vortex formation and an increased specific energy dissipation in systole are observed. In all cases, regions with an impaired washout are visible. The results furthermore indicate that considering several cycles might provide a more detailed view of the washout process. The pre-processing times and computational expenses are in reach of clinical feasibility.ConclusionThe proposed CCT-based CFD method allows to compute patient-specific intraventricular hemodynamics and thus complements the informative value of CCT. The method can be applied to any CCT data of common quality and represents a fair balance between model accuracy and overall expenses. With further model enhancements, the computational framework has the potential to be embedded in clinical routine workflows, to support clinical decision making and treatment planning.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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CT-Based Simulation of Left Ventricular Hemodynamics: A Pilot Study in Mitral Regurgitation and Left Ventricle Aneurysm Patients

Obermeier

Vellguth

Schlief

et al. 2022

Front. Cardiovasc. Med.

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“…Although the orifice openings are not exactly circular in shape, care was taken to ensure that the effective orifice area would agree with the obtained transmitral jet velocity from PW Doppler. It is evident that the inlet geometry (Lancellotti et al, 2010) and dynamics of the valves (Dimasi et al, 2012) would indeed affect the transmitral velocity and shape of the overall 3D vortex, yet limitations in non invasive imaging did not allow estimating geometrical details of such. Values of the orifice areas are reported in Table 1, which may differ from sizes based on the annulus edges that contain the valvular effective opening.…”

Section: Flow Imaging Proceduresmentioning

confidence: 99%

Comparative numerical study on left ventricular fluid dynamics after dilated cardiomyopathy

Mangual

Kraigher‐Krainer

Luca

et al. 2013

Journal of Biomechanics

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Results: The flow in DCM exhibited qualitative differences due to the weakness of the formed vortices in the large LV chamber. DCM and healthy subjects show significant volumetric differences; these also reflect inflow properties like the vortex formation time, energy dissipation, and sub-volumes describing flow transit. Proper normalization permitted to define purely fluid dynamics indicators that are not influenced by volumetric measures. Conclusion: Cardiac fluid mechanics can be evaluated by a combination of imaging and numerical simulation. This pilot study on pathological changes in LV blood motion identified intraventricular flow indicators based on pure fluid mechanics that could potentially be integrated with existing indicators of cardiac mechanics in the evaluation of disease progression.

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“…In many studies, the valve's leaflets are either ignored or simplified using an on-off approach where the switch between the on and off configuration occurs instantaneously without any intermediate positions 32,33,34,15 . Dimasi et al 35 reconstructed the MV and AV from cardiac magnetic resonance (CMR) images. Their study was limited to systole (MV always closed).…”

Section: Introductionmentioning

confidence: 99%

A hybrid echocardiography-computational fluid dynamics framework for ventricular flow simulations

Hedayat,

Patel,

Belohlavek

et al. 2019

Preprint

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Image-based computational fluid dynamics (CFD) has emerged as a powerful tool to study cardiovascular flows while 2D echocardiography (echo) is the most widely used non-invasive imaging modality for diagnosis of heart disease. Here, echo is combined with CFD, i.e., an echo-CFD framework, to study ventricular flows. To achieve this, our previous 3D reconstruction from multiple 2D-echo at standard cross-sections is extended by 1) reconstructing valves (aortic and mitral valves) from 2D-echo images and the superior wall; 2) optimizing the location and orientation of the surfaces to incorporate the physiological assumption of fixed apex as a reference (fixed) point for reconstruction; and 3) incorporating several smoothing algorithms to remove the nonphysical oscillations (ringing) near the basal section observed in our previous study. The main parameters of the reconstructed left ventricle (LV) are all within the physiologic range. Our results show that the mitral valve can significantly change the flow pattern inside the LV during the diastole phase in terms of ring vortex formation/propagation as well as the flow circulation. In addition, the abnormal shape of unhealthy LV can drastically change the flow field during the diastole phase. Furthermore, the hemodynamic energy loss, as an indicator of the LV pumping performance, for different test cases is calculated which shows a larger energy loss for unhealthy LV compared to the healthy one.

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Influence of Mitral Valve Anterior Leaflet in vivo Shape on Left Ventricular Ejection

Cited by 11 publications

References 51 publications

CT-Based Simulation of Left Ventricular Hemodynamics: A Pilot Study in Mitral Regurgitation and Left Ventricle Aneurysm Patients

CT-Based Simulation of Left Ventricular Hemodynamics: A Pilot Study in Mitral Regurgitation and Left Ventricle Aneurysm Patients

Comparative numerical study on left ventricular fluid dynamics after dilated cardiomyopathy

A hybrid echocardiography-computational fluid dynamics framework for ventricular flow simulations

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