Elizabeth W Thompson, Anindro Bhattacharya, Fengling Hu, Russell T Shinohara, Paris Perdikaris, Kevin K Whitehead, Elizabeth Goldmuntz, Mark A Fogel, Walter R Witschey
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引用次数: 0
Abstract
Purpose: Right ventricular (RV) remodeling in repaired tetralogy of Fallot (rToF) is a multifactorial process that may be affected by downstream hemodynamics. We therefore sought to characterize hemodynamics in the pulmonary arteries (PAs) of rToF patients using cardiovascular magnetic resonance (CMR)-derived computational fluid dynamics (CFD) and to study these variables in association with RV measurements at follow-up.
Methods: We selected patients with two CMRs who had magnetic resonance angiography (MRA) performed at baseline. The PA was segmented from the main PA (MPA) through the first bifurcation of the left PA (LPA) and right PA (RPA). Both steady and pulsatile simulations were performed. For each vessel, we calculated curvature, tortuosity, and both average (avg) and peak steady WSS (WSSsteady), time-averaged WSS (taWSS), WSS in systole (WSSsystole), and WSS in diastole (WSSdiastole), as well as oscillatory shear index (OSI). We studied these variables in association with RV metrics at follow-up including: RV end-diastolic volume index (RVEDVi), RV end-systolic volume index (RVESVi), RV stroke volume index (RVSVi), and RV ejection fraction (RVEF), as well as the outcome of pulmonic valve replacement (PVR).
Results: 22 patients met the inclusion criteria. Several focal hemodynamic metrics in the main and branch PAs, including WSSsteady, taWSS, WSSsystole, WSSdiastole, and OSI were associated with RV measurements at follow-up, including RVEDVi, RVESVi, and RVSVi. LPA WSSsteady,avg, RPA WSSsteady,peak, whole vessel OSIavg, and MPA OSIavg were associated with likelihood of PVR.
Conclusion: CFD-derived hemodynamic variables in the PAs of rToF patients are associated with both PVR and RV remodeling.
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.
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