Analysis of Energy and Pressure in the Sinus with Different Blood Pressures after Bioprosthetic Aortic Valve Replacement

IF 3 2区 医学 Q3 ENGINEERING, BIOMEDICAL
Brennan Vogl, Agata Sularz, Sunyoung Ahn, Rajat Gadhave, Scott Lilly, Vinod Thourani, Brian Lindman, Mohamad Alkhouli, Hoda Hatoum
{"title":"Analysis of Energy and Pressure in the Sinus with Different Blood Pressures after Bioprosthetic Aortic Valve Replacement","authors":"Brennan Vogl,&nbsp;Agata Sularz,&nbsp;Sunyoung Ahn,&nbsp;Rajat Gadhave,&nbsp;Scott Lilly,&nbsp;Vinod Thourani,&nbsp;Brian Lindman,&nbsp;Mohamad Alkhouli,&nbsp;Hoda Hatoum","doi":"10.1007/s10439-024-03587-w","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the effect of changing systolic and diastolic blood pressures (SBP and DBP, respectively) on sinus flow and valvular and epicardial coronary flow dynamics after TAVR and SAVR.</p><h3>Methods</h3><p>SAPIEN 3 and Magna valves were deployed in an idealized aortic root model as part of a pulse duplicating left heart flow loop simulator. Different combinations of SBP and DBP were applied to the test setup and the resulting change in total coronary flow from baseline (120/60 mmHg), effective orifice area (EOA), and left ventricular (LV) workload, with each combination, was assessed. In addition, particle image velocimetry was used to assess the Laplacian of pressure (<span>\\({\\nabla }^{2}\\text{P}\\)</span>) in the sinus, coronary and main flow velocities, the energy dissipation rate (EDR) in the sinus and the LV workload.</p><h3>Results</h3><p>This study shows that under an elevated SBP, there is an increase in the total coronary flow, EOA, LV workload, peak velocities downstream of the valve, <span>\\({\\nabla }^{2}\\text{P}\\)</span>, and EDR. With an elevated DBP, there was an increase in the total coronary flow and <span>\\({\\nabla }^{2}\\text{P}\\)</span>. However, EOA and LV workload decreased with an increase in DBP, and EDR increased with a decrease in DBP.</p><h3>Conclusions</h3><p>Blood pressure alters the hemodynamics in the sinus and downstream flow following aortic valve replacement, potentially influencing outcomes in some patients.</p></div>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":"52 12","pages":"3228 - 3239"},"PeriodicalIF":3.0000,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Biomedical Engineering","FirstCategoryId":"5","ListUrlMain":"https://link.springer.com/article/10.1007/s10439-024-03587-w","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose

To investigate the effect of changing systolic and diastolic blood pressures (SBP and DBP, respectively) on sinus flow and valvular and epicardial coronary flow dynamics after TAVR and SAVR.

Methods

SAPIEN 3 and Magna valves were deployed in an idealized aortic root model as part of a pulse duplicating left heart flow loop simulator. Different combinations of SBP and DBP were applied to the test setup and the resulting change in total coronary flow from baseline (120/60 mmHg), effective orifice area (EOA), and left ventricular (LV) workload, with each combination, was assessed. In addition, particle image velocimetry was used to assess the Laplacian of pressure (\({\nabla }^{2}\text{P}\)) in the sinus, coronary and main flow velocities, the energy dissipation rate (EDR) in the sinus and the LV workload.

Results

This study shows that under an elevated SBP, there is an increase in the total coronary flow, EOA, LV workload, peak velocities downstream of the valve, \({\nabla }^{2}\text{P}\), and EDR. With an elevated DBP, there was an increase in the total coronary flow and \({\nabla }^{2}\text{P}\). However, EOA and LV workload decreased with an increase in DBP, and EDR increased with a decrease in DBP.

Conclusions

Blood pressure alters the hemodynamics in the sinus and downstream flow following aortic valve replacement, potentially influencing outcomes in some patients.

Abstract Image

Abstract Image

生物修复主动脉瓣置换术后不同血压下窦道能量和压力分析
目的:研究收缩压和舒张压(分别为 SBP 和 DBP)变化对 TAVR 和 SAVR 后窦血流以及瓣膜和心外膜冠状动脉血流动力学的影响:将 SAPIEN 3 和 Magna 瓣膜部署在理想化的主动脉根部模型中,作为脉冲复制左心流环模拟器的一部分。将不同的 SBP 和 DBP 组合应用于测试装置,并评估每种组合导致的总冠脉流量与基线(120/60 mmHg)、有效孔面积(EOA)和左心室(LV)工作量的变化。此外,还使用粒子图像测速仪评估了窦内压力的拉普拉卡方(∇ 2 P)、冠状动脉和主血流速度、窦内能量耗散率(EDR)和左心室工作量:该研究表明,在 SBP 升高的情况下,冠状动脉总流量、EOA、左心室工作量、瓣膜下游峰值速度、∇ 2 P 和 EDR 都会增加。DBP 升高时,冠状动脉总流量和∇ 2 P 增加。然而,EOA 和 LV 工作负荷随着 DBP 的升高而降低,EDR 则随着 DBP 的降低而升高:结论:血压会改变主动脉瓣置换术后窦道和下游血流的血流动力学,可能会影响部分患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Annals of Biomedical Engineering
Annals of Biomedical Engineering 工程技术-工程:生物医学
CiteScore
7.50
自引率
15.80%
发文量
212
审稿时长
3 months
期刊介绍: Annals of Biomedical Engineering is an official journal of the Biomedical Engineering Society, publishing original articles in the major fields of bioengineering and biomedical engineering. The Annals is an interdisciplinary and international journal with the aim to highlight integrated approaches to the solutions of biological and biomedical problems.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信