دورية أكاديمية
Patient-Specific Quantitative In-Vivo Assessment of Human Mitral Valve Leaflet Strain Before and After MitraClip Repair.
العنوان: | Patient-Specific Quantitative In-Vivo Assessment of Human Mitral Valve Leaflet Strain Before and After MitraClip Repair. |
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المؤلفون: | Simonian NT; James T. Willerson Center for Cardiovascular Modeling and Simulation, The Oden Institute for Computational Engineering and Sciences and the Department of Biomedical Engineering, The University of Texas at Austin , 201 East 24th St., Stop C0200, Austin, TX, 78712-1229, USA., Liu H; James T. Willerson Center for Cardiovascular Modeling and Simulation, The Oden Institute for Computational Engineering and Sciences and the Department of Biomedical Engineering, The University of Texas at Austin , 201 East 24th St., Stop C0200, Austin, TX, 78712-1229, USA., Vakamudi S; Ascension Texas Cardiovascular & Division of Cardiology, Department of Internal Medicine, Dell Medical School, University of Texas, Austin, TX, USA., Pirwitz MJ; Ascension Texas Cardiovascular & Division of Cardiology, Department of Internal Medicine, Dell Medical School, University of Texas, Austin, TX, USA., Pouch AM; Gorman Cardiovascular Research Group, Smilow Center for Translational Research, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Gorman JH 3rd; Gorman Cardiovascular Research Group, Smilow Center for Translational Research, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Gorman RC; Gorman Cardiovascular Research Group, Smilow Center for Translational Research, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Sacks MS; James T. Willerson Center for Cardiovascular Modeling and Simulation, The Oden Institute for Computational Engineering and Sciences and the Department of Biomedical Engineering, The University of Texas at Austin , 201 East 24th St., Stop C0200, Austin, TX, 78712-1229, USA. msacks@oden.utexas.edu. |
المصدر: | Cardiovascular engineering and technology [Cardiovasc Eng Technol] 2023 Oct; Vol. 14 (5), pp. 677-693. Date of Electronic Publication: 2023 Sep 05. |
نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 101531846 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1869-4098 (Electronic) Linking ISSN: 1869408X NLM ISO Abbreviation: Cardiovasc Eng Technol Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: New York, NY : Springer |
مواضيع طبية MeSH: | Echocardiography, Three-Dimensional* , Mitral Valve Insufficiency*/diagnostic imaging , Mitral Valve Insufficiency*/surgery , Heart Valve Prosthesis Implantation*/adverse effects, Humans ; Mitral Valve/diagnostic imaging ; Mitral Valve/surgery ; Echocardiography ; Treatment Outcome |
مستخلص: | Purpose: Mitral regurgitation (MR) is a highly prevalent and deadly cardiac disease characterized by improper mitral valve (MV) leaflet coaptation. Among the plethora of available treatment strategies, the MitraClip is an especially safe option, but optimizing its long-term efficacy remains an urgent challenge. Methods: We applied our noninvasive image-based strain computation pipeline [1] to intraoperative transesophageal echocardiography datasets taken from ten patients undergoing MitraClip repair, spanning a range of MR etiologies and MitraClip configurations. We then analyzed MV leaflet strains before and after MitraClip implementation to develop a better understanding of (1) the pre-operative state of human regurgitant MV, and (2) the MitraClip's impact on the MV leaflet deformations. Results: The MV pre-operative strain fields were highly variable, underscoring both the heterogeneity of the MR in the patient population and the need for patient-specific treatment approaches. Similarly, there were no consistent overall post-operative strain patterns, although the average A2 segment radial strain difference between pre- and post-operative states was consistently positive. In contrast, the post-operative strain fields were better correlated to their respective pre-operative strain fields than to the inter-patient post-operative strain fields. This quantitative result implies that the patient specific pre-operative state of the MV guides its post-operative deformation, which suggests that the post-operative state can be predicted using pre-operative data-derived modelling alone. Conclusions: The pre-operative MV leaflet strain patterns varied considerably across the range of MR disease states and after MitraClip repair. Despite large inter-patient heterogeneity, the post-operative deformation appears principally dictated by the pre-operative deformation state. This novel finding suggests that though the variation in MR functional state and MitraClip-induced deformation were substantial, the post-operative state can be predicted from the pre-operative data alone. This study suggests that, with use of larger patient cohort and corresponding long-term outcomes, quantitative predictive factors of MitraClip durability can be identified. (© 2023. The Author(s) under exclusive licence to Biomedical Engineering Society.) |
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معلومات مُعتمدة: | R01 HL073021 United States NH NIH HHS |
فهرسة مساهمة: | Keywords: Computational modelling; Echocardiography; MitraClip; Mitral regurgitation; Mitral valve; Patient-specific |
تواريخ الأحداث: | Date Created: 20230905 Date Completed: 20231030 Latest Revision: 20240806 |
رمز التحديث: | 20240806 |
DOI: | 10.1007/s13239-023-00680-4 |
PMID: | 37670097 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1869-4098 |
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DOI: | 10.1007/s13239-023-00680-4 |