Non-invasive determination of transcatheter pressure gradient in stenotic aortic valves: An analytical model

Keshavarz‐Motamed, Zahra; Motamed, Pouyan K.; Maftoon, Nima

doi:10.1016/j.medengphy.2015.01.003

Cited by 5 publications

(7 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Its clinical management may be compromised by the adoption of the simplified Bernoulli equation used for echocardiography, which does not account for the pressure recovery effect [4,6]. Beyond that, engineering research has focused almost exclusively on aortic stenosis [7][8][9], neglecting the wide spectrum of diseases that may cause VOT obstruction. Thus, we developed a mathematical model to correlate the degree of R/LVOT obstruction to the Δp and the cardiac output.…”

Section: Resultsmentioning

confidence: 99%

“…ii) To the best of our knowledge, currently engineering research has focused its attention almost exclusively to aortic valve stenosis [7][8][9]. The physical and mathematical-numerical models that have been proposed over the years to describe aortic transvalvular hemodynamics are numerous, and with varying degrees of detail e.g., from bulk flow parameters to local flow kinematic and dynamics, from rigid valve geometry to time dependent geometry, calcification modelling, and so on [8][9][10][11][12]. Modelling of obstructive diseases other than aortic stenosis has been only sporadic and limited to the adult population.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ventricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients

et al. 2021

View full text Add to dashboard Cite

Background Right (R) or left (L) ventricular outflow tract (VOT) obstruction can be either a dynamic phenomenon or a congenital anatomic lesion, which requires a prompt and optimal timing of treatment to avoid a pathological ventricular remodelling. Objective To develop a simple and reliable numerical tool able to relate the R/L obstruction size with the pressure gradient and the cardiac output. To provide indication of the obstruction severity and be of help in the clinical management of patients and designing the surgical treatment for obstruction mitigation. Methods Blood flow across the obstruction is described according to the classical theory of one-dimensional flow, with the obstruction uniquely characterized by its size. Hemodynamics of complete circulation is simulated according to the lumped parameter approach. The case of a 2 years-old baby is reproduced, with the occlusion placed in either the R/ or the L/VOT. Conditions from wide open to almost complete obstruction are reproduced. Results Both R/LVOT obstruction in the in-silico model resulted in an increased pressure gradient and a decreased cardiac output, proportional to the severity of the VOT obstruction and dependent on the R/L location of the obstruction itself, as it is clinically observed. Conclusion The in-silico model of ventricular obstruction which simulates pressure gradient and/or cardiac output agrees with clinical data, and is a first step towards the creation of a tool that can support the clinical management of patients from diagnosis to surgical treatments.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ventricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients

et al. 2021

View full text Add to dashboard Cite

show abstract

“…1A) incorporated the left ventricle, aortic valve, extent of aortic regurgitation, and systemic circulation. Each sub-model was validated with in vivo cardiac catheterization and MRI data (27)(28)(29). All input parameters were obtained as patient-specific echocardiographic measurements.…”

Section: Lumped Parameter Model and Left Ventricle Stroke Work Calculmentioning

confidence: 99%

“…Values are presented as means ± SD. Hypertensive response after TAVR was defined as systolic BP > 140 mmHg or diastolic BP > 90 mmHg 30 days after TAVR not present at baseline (28).…”

Section: Table 3 Changes In Sw LV and Vascular Impedance Metrics In P...mentioning

confidence: 99%

See 1 more Smart Citation

Ventricular stroke work and vascular impedance refine the characterization of patients with aortic stenosis

et al. 2019

Self Cite

View full text Add to dashboard Cite

Aortic stenosis (AS) management is classically guided by symptoms and valvular metrics. However, the natural history of AS is dictated by coupling of the left ventricle, aortic valve, and vascular system. We investigated whether metrics of ventricular and vascular state add to the appreciation of AS state above valve gradient alone. Seventy patients with severe symptomatic AS were prospectively followed from baseline to 30 days after transcatheter aortic valve replacement (TAVR). Quality of life (QOL) was assessed using the Kansas City Cardiomyopathy Questionnaire. Left ventricular stroke work (SWLV) and vascular impedance spectrums were calculated noninvasively using in-house models based on central blood pressure waveforms, along with hemodynamic parameters from echocardiograms. Patients with higher preprocedural SWLV and lower vascular impedance were more likely to experience improved QOL after TAVR. Patients fell into two categories: those who did and those who did not exhibit increase in blood pressure after TAVR. In patients who developed hypertension (19%), vascular impedance increased and SWLV remained unchanged (impedance at zeroth harmonic: Z0, from 3964.4 to 4851.8 dyne·s/cm3, P = 0.039; characteristic impedance: Zc, from 376.2 to 603.2 dyne·s/cm3, P = 0.033). SWLV dropped only in patients who did not develop new hypertension after TAVR (from 1.58 to 1.26 J; P < 0.001). Reduction in valvular pressure gradient after TAVR did not predict change in SWLV (r = 0.213; P = 0.129). Reduction of SWLV after TAVR may be an important metric in management of AS, rather than relying solely on the elimination of transvalvular pressure gradients.

show abstract

An ultrasound-exclusive non-invasive computational diagnostic framework for personalized cardiology of aortic valve stenosis

Bahadormanesh

Tomka

Kadem

et al. 2023

Medical Image Analysis

View full text Add to dashboard Cite

Non-invasive determination of transcatheter pressure gradient in stenotic aortic valves: An analytical model

Cited by 5 publications

References 12 publications

Ventricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients

Ventricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients

Ventricular stroke work and vascular impedance refine the characterization of patients with aortic stenosis

An ultrasound-exclusive non-invasive computational diagnostic framework for personalized cardiology of aortic valve stenosis

Contact Info

Product

Resources

About