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Fluid-structure interaction simulation of pathological mitral valve dynamics in a coupled mitral valve-left ventricle model

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智慧医学(英文) 2023年第2期3卷 104-114页

作者： Li Cai Tong Zhao Yongheng Wang Xiaoyu Luo Hao Gao NPU-UoG International Cooperative Lab for Computation and Application in Cardiology School of Mathematics and StatisticsNorthwestern Polytechnical UniversityXi’anShaanxi 710129China Xi’an Key Laboratory of Scientific Computation and Applied Statistics Xi’anShaanxi 710129China School of Mathematics and Statistics University of GlasgowGlasgowG128QQUnited Kingdom

Background Understanding the interaction between the mitral valve(MV)and the left ventricle(LV)is very important in assessing cardiac pump function,especially when the MV is *** dysfunction is a major medical problem owing to the essential role of the MV in cardiac pump *** modelling can provide new approaches to gain insight into the functions of the MV and *** In this study,a previously developed LV-MV model was used to study cardiac dynamics of MV leaflets under normal and pathological conditions,including hypertrophic cardiomyopathy(HOCM)and calcification of the *** coupled LV-MV model was implemented using a hybrid immersed boundary/finite element method to enable assessment of MV haemodynamic *** parameters of the HOCM and calcified valves were inversely determined from published experimental *** LV compensation mechanism was further studied in the case of the calcified *** Our results showed that MV dynamics and LV pump function could be greatly affected by MV *** example,the HOCM case showed bulged MV leaflets at the systole owing to low stiffness,and the calcified MV was associated with impaired diastolic filling and much-reduced stroke *** further demonstrated that either increasing the LV filling pressure or increasing myocardial contractility could enable a calcified valve to achieve near-normal pump *** The modelling approach developed in this study may deepen our understanding of the interactions between the MV and the LV and help in risk stratification of heart valve disease and in silico treatment planning by exploring intrinsic compensation mechanisms.

关键词： Mitral valve Left ventricle valve disease Hybrid immersed boundary/finite element method Calcification Hypertrophic cardiomyopathy

Risk Factors for Prognosis after the Maze Ⅳ Procedure in Patients with Atrial Fibrillation Undergoing valve Surgery

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Cardiovascular Innovations and Applications 2022年第1期 135-145页

作者： Hui Yang Pu Zou Yuhu He Lingzhi Huang Xinmin Zhou Liming Liu Zhenjiang Liu Shenghua Zhou Department of Cardiology The Second Xiangya HospitalCentral South UniversityChangshaHunanChina Department of Cardiovascular Surgery The Second Xiangya HospitalCentral South UniversityChangshaHunanChina

The present study evaluated risk factors related to persistent atrial fibrillation(AF)at discharge(AF-d)and recurrent atrial fibrillation(rAF)and all-cause death after the maze IV *** hundred nineteen patients(63 female,aged 52.5±8.8 years)with valve disease and persistent AF undergoing valve surgery and the maze IV procedure in our center between 2015 and 2016 were *** demographic and clinical data were obtained by review of medical *** median follow-up period was 27 months(interquartile range 21-34 months)in our patient *** primary end point was all-cause *** secondary end point was AF-d or *** is defined as AF recurrence at 3 months or later after the ***-eight patients(12.8%)died during *** logistic regression analysis showed that thrombocytopenia,elevated serum total bilirubin level,a larger right atrium,AF-d,and rAF were independent determinants for all-cause death after the maze IV procedure after adjustment for age,sex,and clinical covariates,including New York Heart Association class III/IV disease,hypertension,and aortic regurgitation,while valvular disease duration and left atrial diameter greater than 80.5 mm were independent determinants for AF-d,and thrombocytopenia,elevated serum total bilirubin level,higher mean pulmonary artery pressure,and AF-d were independent predictors for *** conclusion,thrombocytopenia,elevated serum total bilirubin level,an enlarged right atrium,AF-d,and rAF are independent predictors of all-cause death in patients undergoing the maze IV procedure.

关键词： Atrial fibrillation maze IV valve disease thrombocytopenia

Accuracy of the Logistic EuroSCORE in Predicting Long-Term Survival Following Isolated Aortic valve Replacement

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World Journal of Cardiovascular Surgery 2022年第3期12卷 28-38页

作者： Fatemeh Hedayat Antony H. Walker School of Medicine and Dentistry University of Central Lancashire Lancaster UK Department of Cardiothoracic Surgery Lancashire Cardiac Centre Blackpool Victoria Hospital NHS Blackpool UK

Objective: To assess the ability of the logistic EuroSCORE to predict long- term mortality of patients undergoing isolated Surgical Aortic valve Replacement (SAVR). Methods: A retrospective review of all patients undergoing SAVR between September 1999, and March 2018 was done. Results: 2018 patients were eligible for inclusion in the study. Patients were grouped according to risk: low (n = 506), intermediate (n = 609), and high-risk (n = 903) depending on their logistic EuroSCORE values. The 30-day mortality of the low- risk group was 0.47%. The one-, five-, 10-, 15-, and 20-year mortality was 1.66%, 4.9%, 14.9%, 24.3%, and 43.8%, respectively. Intermediate-risk group 30-day mortality was 0.66%. The one-, five-, 10-, 15-, and 20-year mortality was 3.28%, 11.9%, 32%, 54.8%, and 82.6%, respectively. The 30-day mortality of the high- risk group was 3.99%. The one-, five-, 10-, 15-, and 20-year mortality was 8.2%, 27%, 55.4%, 78.6%, and 87%, respectively. Conclusion: Our results confirm that the lES is accurate in predicting long-term mortality outcomes of SAVR. This real-world data provides evidence of the potential usefulness of the EuroSCORE to help the heart team and patients decide on appropriate interventions for aortic stenosis.

关键词： Aortic Stenosis TAVR SAVR valve disease

Exercise stress echocardiography:Where are we now?

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World Journal of Cardiology 2022年第2期14卷 64-82页

作者： Carlos Alberto Cotrim Hugo Café Isabel João Nuno Cotrim Jorge Guardado Pedro Cordeiro Hortense Cotrim Luis Baquero Heart Center Hospital da Cruz Vermelha PortuguesaLisboa 1549-008Portugal Faculdade de Medicina Algarve UniversityFaro 8005-139Portugal Department of Cardiology Garcia de Orta HospitalAlmada 2805-267Portugal Department of Medicine Garcia de Orta HospitalAlmada 2805-267Portugal Cardiovascular Unit UCARDIOCentro ClinicoRiachos 2350-325Portugal Department of Cardiology Hospital Particular do AlgarveFaro 8005-226Portugal

Exercise stress echocardiography(ESE)is a widely used diagnostic test in cardiology *** is mainly used to study patients with coronary artery disease;however,it has increasingly been used in other clinical scenarios including valve pathology,congenital heart disease,hypertrophic and dilated cardiomyopathies,athlete evaluations,diastolic function evaluation,and pulmonary circulation *** our laboratories,we use an established methodology in which cardiac function is evaluated while exercising on a *** completing the exercise regimen,patients remain in a standing position or lie down on the left lateral decubitus,depending on the clinical questions to be answered for further *** method increases the quality and quantity of information ***,we present the various methods of exercise stress echocardiography and our experience in many clinical arenas in *** also present alternatives to ESE that may be used and their advantages and *** review recent advances in ESE and future directions for this established method in the study of cardiac patients and underline the advantage of using a diagnostic tool that is radiation-free.

关键词： Exercise stress echocardiography Coronary artery disease valve disease Athletes Intraventricular gradients Children

Preoperative echocardiographic predictors for 1-year mortality in patients treated with standard endovascular aneurysm repair for abdominal aortic aneurysm

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World Journal of Cardiovascular diseases 2013年第3期3卷 268-274页

作者： Tomas Ohrlander Magnus Dencker Stefan Acosta Department of Surgery Eksjo County HospitalEksjoSweden Department of Clinical Physiology and Nuclear Medicine Vascular CenterMalmoSweden Lund and Skane University Hospital MalmoSweden

Background: Abdominal aortic aneurysm (AAA) and cardiovascular disease are intimately associated, the latter representing the most common cause of death in Sweden. Cardiac complications are held responsible for the majority of perioperative morbidity and mortality in patients undergoing repair of AAA. The importance of preoperative thorough cardiac assessment is therefore obvious. The aim of this study was to evaluate the prognostic significance of preoperative echocardiographic findings for 1-year mortality after elective endovascular aneurysm repair (EVAR) of infrarenal AAA. Design: Retrospective analysis. Methods: The 505 patients were identified in a prospective database for endovascular interventions between 1998 and 2011, and data were retrieved from patient records. Preoperative echocardiography reports in 380 patients were reviewed and findings were notified according to a predefined protocol. Results: The 1-year mortality rate was 6.7%. Severe valve disease was present in 8.7% of the patients, aortic valve stenosis being the leading cause of valve pathology. Severe valve disease (OR 3.5, 95% CI [1.2 - 10.7];p = 0.025) and chronic kidney disease grade ≥ 3 (OR 7.5, 95% CI [2.1 - 26.1];p = 0.002) were the only independent risk factors for increased mortality rate at 1-year. Conclusion: Echocardiography should be a part of the preoperative workup in AAA patients. Finding of severe valve disease should be further evaluated by a cardiologist prior to EVAR.

关键词： Echocardiography EVAR Abdominal Aortic Aneurysm valve disease Aortic valve Stenosis