Cardiovascular Engineering and Technology最新文献

{"title":"Enhancing Stroke Prevention in Transcatheter Aortic Valve Replacement: The Role of F2, a Novel Neuroprotection Device.","authors":"Mahsa Ghovvati, Taichiro Imahori, Nina Fukui, Kenichi Sakuta, Yoshiki Hanaoka, Lea Guo, Amir M Molaie, Aryan M Gajjar, Satoshi Tateshima, Gary Duckwiler, Naoki Kaneko","doi":"10.1007/s13239-025-00806-w","DOIUrl":"https://doi.org/10.1007/s13239-025-00806-w","url":null,"abstract":"<p><strong>Purpose: </strong>Transcatheter aortic valve replacement (TAVR) is an established treatment for severe aortic stenosis; however, it carries the risk of periprocedural strokes. Current cerebral embolic protection (CEP) devices, such as the Sentinel, provide partial protection but are limited by inadequate anatomical coverage and inability to capture smaller emboli effectively. This study aimed to evaluate the effectiveness of a novel CEP device, the F2 filter with a 28 μm pore size and full cervical vessel coverage, in preventing emboli from entering the cerebral circulation.</p><p><strong>Methods: </strong>The Sentinel and F2 filter were evaluated for the ability to prevent embolic particles of various sizes (45-300 µm) from entering cerebral arteries using two in vitro flow models, incorporating standard and tortuous aortic anatomies. Additionally flow rates were also measured to confirm that normal perfusion was maintained while the devices were in place.</p><p><strong>Results: </strong>The F2 filter maintained normal cerebral arterial flow and significantly reduced the number of particles across all sizes compared to the Sentinel and control groups. This reduction was observed in all four cerebral branches and across both standard and tortuous aorta models.</p><p><strong>Conclusions: </strong>The F2 filter showed superior neuroprotective effectiveness to prevent embolic debris from entering the cerebral circulation in the in vitro models. By offering comprehensive coverage to all cervical arteries and with a smaller mesh size, this filter has the potential to improve cerebral protection during TAVR.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a Mathematical Model of Arterial Wall Mechanics with Drug Induced Vasoconstriction Against Ex Vivo Measurements.","authors":"Sara Costa Faya, Callan Wesley, Marina Vidrascu, Miguel A Fernández, Pieter-Jan Guns, Damiano Lombardi","doi":"10.1007/s13239-025-00796-9","DOIUrl":"https://doi.org/10.1007/s13239-025-00796-9","url":null,"abstract":"<p><strong>Purpose: </strong>In this work we investigate a mathematical model in order to reproduce experimental data of arterial compliance under the action of vasoconstrictors and vasodilators related to pharmacological studies.</p><p><strong>Methods: </strong>The considered model is a 3D-shell with active fibers. Model parameters are identified by means of an optimization procedure.</p><p><strong>Results: </strong>The resulting model was able to reproduce the experimental data and predict the system behavior in scenarios other than those used for the parameter estimation. This enables the assessment of different scenarios concerning the impact of the molecules on the active or passive contributions of the arterial wall.</p><p><strong>Conclusion: </strong>The results suggest that smooth muscle cell contraction modulates stiffness through direct fiber-induced regulation of vascular tone, while parameters related to the passive arterial wall component remain relatively stable across different vasoactive scenarios.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical Properties of the Myocardium Post-Alcohol Ablation in Transcatheter Mitral Valve Implantation.","authors":"Steven Said, Mina Shafiei, Dong Qiu, Ali N Azadani","doi":"10.1007/s13239-025-00807-9","DOIUrl":"https://doi.org/10.1007/s13239-025-00807-9","url":null,"abstract":"<p><strong>Purpose: </strong>Alcohol septal ablation (ASA) has become a minimally invasive alternative to septal myectomy for treating left ventricular outflow tract (LVOT) obstructions. ASA has gained popularity, especially among patients undergoing transcatheter mitral valve replacement (TMVR). This study aimed to determine the effect of ASA on the mechanical properties of myocardial tissue.</p><p><strong>Methods: </strong>Twenty-four square samples were excised from the septal regions of fresh-frozen swine hearts. Mechanical testing was conducted using a biaxial tester. Half of the samples underwent 3-minute ablation, while the other half underwent 5-minute ablation.</p><p><strong>Results: </strong>All samples exhibited a nonlinear response to strain in the fiber and cross-fiber directions. After 3 min of ablation, the mean force required to achieve 20% displacement increased from 182.08-mN to 347.42-mN (true stress from 11.0-KPa to 24.1-KPa) in the fiber direction and from 66.83-mN to 110.75-mN (true stress from 4.3-KPa to 8.2-KPa) in the cross-fiber direction. Following 5 min of ablation, mean force values rose from 178.0-mN to 452.8-mN (true stress from 11.0-KPa to 32.4-KPa) in the fiber direction, and from 70.0-mN to 154.8-mN (true stress from 4.8-KPa to 12.0-KPa) in the cross-fiber direction. All changes were statistically significant (p ≤ 0.002). Histological analysis also revealed that alcohol ablation progressively disrupted myocardial architecture.</p><p><strong>Conclusion: </strong>This study demonstrates that ASA significantly alters the passive mechanical properties of the myocardium, increasing tissue stiffness in the septal region over the short term. The extent of stiffening is directly proportional to the duration of ablation, with longer ablation times causing greater stiffness, necessitating careful selection of ablation time before TMVR procedures.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Impact of Downsampled ECGs and Alternative Loss Functions in Multi-Label Classification of 12-Lead ECGs.","authors":"Bjørn-Jostein Singstad, Eraraya Morenzo Muten","doi":"10.1007/s13239-025-00797-8","DOIUrl":"https://doi.org/10.1007/s13239-025-00797-8","url":null,"abstract":"<p><strong>Background: </strong>The electrocardiogram (ECG) is an almost universally accessible diagnostic tool for heart disease. An ECG is measured by using an electrocardiograph, and today's electrocardiographs use built-in software to interpret the ECGs automatically after they are recorded. However, these algorithms exhibit limited performance, and therefore, clinicians usually have to manually interpret the ECG, regardless of whether an algorithm has interpreted it or not. Manual interpretation of the ECG can be time-consuming and requires specific skills. Therefore, better algorithms are clearly needed to make correct ECG interpretations more accessible and time-efficient. Algorithms based on artificial intelligence (AI) have demonstrated promising performance in various fields, including ECG interpretation, over the past few years and may represent an alternative to manual ECG interpretation by doctors.</p><p><strong>Results: </strong>We trained and validated a convolutional neural network with an Inception architecture on a dataset with 88253 12-lead ECGs, and classified 30 of the most frequent annotated cardiac conditions in the dataset. We assessed two different loss functions and different ECG sampling rates and the best-performing model used double soft F1-loss and ECGs downsampled to 75Hz. This model achieved an F1-score of <math><mrow><mn>0.420</mn> <mo>±</mo> <mn>0.017</mn></mrow> </math> , accuracy <math><mrow><mo>=</mo> <mn>0.954</mn> <mo>±</mo> <mn>0.002</mn></mrow> </math> , and an AUROC score of <math><mrow><mn>0.832</mn> <mo>±</mo> <mn>0.019</mn></mrow> </math> . An aggregated saliency map, showing the global importance of all 12 ECG leads for the 30 cardiac conditions, was generated using Local Interpretable Model-Agnostic Explanations (LIME). The global saliency map showed that the Inception model paid the most attention to the limb leads and the augmented leads and less importance to the precordial leads.</p><p><strong>Conclusions: </strong>One of the more significant contributions that emerge from this study is the use of aggregated saliency maps to obtain global ECG lead importance for different cardiac conditions. In addition, we emphasized the relevance of evaluating different loss functions, and in this specific case, we found double soft F1-loss to be slightly better than binary cross-entropy (BCE). Finally, we found it somewhat surprising that drastic downsampling of the ECG led to higher performance than higher sampling frequencies, such as 500Hz. These findings contribute in several ways to our understanding of the artificial intelligence-based interpretation of ECGs, but further studies should be carried out to validate these findings in other datasets from other patient cohorts.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Advancing Myocardial Infarction Treatment: Harnessing Multi-Layered Recellularized Cardiac Patches with Fetal Myocardial Scaffolds and Acellular Amniotic Membrane\".","authors":"Burak Bozkurt","doi":"10.1007/s13239-025-00805-x","DOIUrl":"https://doi.org/10.1007/s13239-025-00805-x","url":null,"abstract":"","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Comment on \"Effect of Transcatheter Edge-to-Edge Repair on Left Ventricular Flow Features\".","authors":"Xinyi He, Shuyi Feng, Fan Wu, Hongping Wang, Shizhao Wang, Xiangbin Pan","doi":"10.1007/s13239-025-00804-y","DOIUrl":"https://doi.org/10.1007/s13239-025-00804-y","url":null,"abstract":"","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Simulation-Based Comparison of Human, Porcine and Ovine Pulmonary Artery Hemodynamics. Evaluating the Suitability of Large Animal Models for Endopulmonary Device Evaluation from a Hemodynamics Point of View.","authors":"Pavlo Yevtushenko, Titus Kuehne, Jan Bruening, Leonid Goubergrits","doi":"10.1007/s13239-025-00803-z","DOIUrl":"https://doi.org/10.1007/s13239-025-00803-z","url":null,"abstract":"<p><p>In the field of cardiovascular device development, new devices such as heart valves, stents or pressure probes for long term heart failure monitoring are subject to animal trials to evaluate their safety and efficacy. For such applications, swine and sheep are the animal models of choice owed to their similarities to humans with regards to heart size, weight and ventricular kinetics. However, clinical aspects regarding the choice of animal model revolve mainly around anatomical similarities as well as the ability to induce the desired pathology. In the case of pulmonary artery pressure sensors, both swine and sheep appear to be suitable candidates for animal trials since both animals have been used for pre-clinical evaluation. Hemodynamic aspects however, although equally important for device performance, appear rather underrepresented in current research and it remains uncertain whether anatomical similarities between humans and animal model in the region of interest translate to hemodynamic similarities. To provide insight whether pulmonary artery hemodynamics in large animal models are indeed comparable to those in humans, this work presents a computational fluid dynamics-based study on pulmonary artery hemodynamics for humans, swine and sheep. A total of 28 human, 41 porcine and 14 ovine transient simulations of pulmonary artery hemodynamics were performed based on subject-specific geometries reconstructed from computed tomography data. The distributions of wall shear stress (WSS) and oscillatory shear index (OSI) within the cohorts were then compared to assess hemodynamic similarity. Distributions of time averaged WSS were found to be similar between humans and sheep (median 1.2 vs. 1.5 Pa, interquartile range (IQR) 0.8 Pa vs. 0.6 Pa, Wilcoxon rank sum test p = 0.42) but were significantly different for swine (median 1.7, IQR 0.5, p < 0.05), whereas OSI was significantly different for sheep and swine (0.17 ± 0.04 vs. 0.14 ± 0.03 and 0.09 ± 0.02). between sheep and humans. In summary, pulmonary artery vessel wall stresses of both animal models appear broadly similar to humans, however, sheep seem to have a notable edge over swine in our study.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Credibility Assessment of the Patient-Specific Modeling of the Aneurysmal Ascending Thoracic Aorta: Verification, Validation and Uncertainty Quantification.","authors":"Roberta Scuoppo, Chiara Catalano, Fabrizio Crascì, Salvatore Pasta","doi":"10.1007/s13239-025-00801-1","DOIUrl":"https://doi.org/10.1007/s13239-025-00801-1","url":null,"abstract":"<p><strong>Purpose: </strong>Computational modeling holds promise in predicting patient-specific outcomes and guiding clinical decision-making. The patient-specific model forming the basis of a digital twin can be considered biomedical software, thereby necessitating trust in its predictive accuracy.</p><p><strong>Methods: </strong>This study applies the ASME V&V40 framework to demonstrate the credibility of patient-specific models of aneurysmal thoracic ascending aorta (ATAA) biomechanics. A comprehensive verification, validation, and uncertainty quantification process was performed to evaluate the accuracy of the patient-specific ATAA model.</p><p><strong>Results: </strong>After implementing the ASME V&V40 standard, the verification errors on the model inputs (i.e., material parameters and hemodynamic variables) resulted in relative errors (RE) < 1%. Validation and its uncertainty quantification of the output aneurysm diameter response showed area metric errors below 5% in the majority of cases, highlighting the accuracy of the patient-specific ATAA model against the clinical comparator. Uncertainties in wall stress predictions due to model inputs were also quantified by probability density functions. Sensitivity analysis revealed that the unknown value of aneurysm wall thickness drives the model output at the highest extent.</p><p><strong>Conclusions: </strong>These findings contribute to a standardized methodology for evaluating the credibility of patient-specific models, enhancing their utility in computer-based clinical decision support systems for managing patients with ATAAs.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision Unveiled in Unborn: A Cutting-Edge Hybrid Machine Learning Approach for Fetal Health State Classification.","authors":"Prachi, Pooja Sabherwal, Monika Agrawal, Anupam Sharma","doi":"10.1007/s13239-025-00800-2","DOIUrl":"https://doi.org/10.1007/s13239-025-00800-2","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding and categorizing fetal health is an influential field of research that profoundly impacts the well-being of both mother and child. The primary desire to precisely examine and cure fetal disorders during pregnancy to enhance fetal and maternal outcomes is the driving force behind the classification of fetal health. Fetal cardiac abnormalities (structural or functional) need immediate doctor attention, and their early identification and detection in all stages of pregnancy can help doctors with the timely treatment of the mother and the unborn child by enabling appropriate prenatal counseling and management. By knowing about fetal health and taking necessary precautions for fetal health, the rate of fetal mortality can be decreased. Advancements in machine learning (ML) algorithms have revolutionized the analysis of fetal electrocardiogram (ECG) signals. Machine Learning and Deep Learning algorithms automate the fetal monitoring process and decisions in emergencies, save time, and enable telemonitoring.</p><p><strong>Methods: </strong>This paper introduces a new hybrid approach to enhance fetal health classification using an intelligent and dynamic combination of Random Forest (RF) and AdaBoost machine learning algorithms. The proposed work includes a detailed review of existing models and the challenges in handling fetal health data, setting the foundation for the design of advanced hybrid models. The implemented algorithm effectively integrates the strengths of RF and AdaBoost to enhance fetal health monitoring and classification performance. The RF algorithm is widely established for its capacity to manage large and highly dimensional data sets, whereas AdaBoost focuses on enhancing classification accuracy by correcting for mistakes in the RF models' predictions.</p><p><strong>Results: </strong>The proposed hybrid model is tested on a recognized benchmark CTG dataset, where it attained a classification accuracy of 95.98%, a precision of 92.88%, a recall of 92.78% and an F1 score of 92.70%. Achieved results demonstrate the potential of our novel approach in real-world applications, offering a promising tool for early detection of fetal anomalies, which is crucial for both fetal and maternal health.</p><p><strong>Conclusions: </strong>Fetal health classification and timely prediction of fetal diseases seem to be a critical step throughout pregnancy. So, to deal with this problem, an attempt has been made to propose an accurate, reliable, and novel hybrid approach for enhancing fetal health classification. By combining the strengths of two algorithms, named RF and AdaBoost, superior classification accuracy, precision, F1 score, and recall have been achieved, and much better robustness compared to standalone models. We have strived to make a noteworthy impact on the health sector by developing this hybrid model for the timely evaluation and prediction of fetal-maternal health.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Similarities and Differences between Biatrial Remodeling Through Electro-Anatomic Mapping in Patients with Atrial Fibrillation.","authors":"Yue-Yue Feng, Bing Han","doi":"10.1007/s13239-025-00802-0","DOIUrl":"https://doi.org/10.1007/s13239-025-00802-0","url":null,"abstract":"<p><strong>Background: </strong>This study aims to explore the association between LA and RA remodeling and their influences on ablation efficacy in AF patients.</p><p><strong>Methods: </strong>The study involved AF patients undergoing their first catheter ablation using CARTO 3 system. After isolating pulmonary veins, three-dimensional electro-anatomical mapping (3D-EAM) of LA and RA was conducted during sinus rhythm. Low voltage area (LVA) was defined as regions with bipolar voltage < 0.5 mv. If LVA constituted ≥ 10% of the total area of the ipsilateral atrium, it was considered an extensive LVA (ELVA).</p><p><strong>Results: </strong>A total of 271 patients (male 58.3%, median age 63 years) were enrolled. Biatrial 3D-EAM found that the RA had a larger volume and volume index, longer total activation time, and higher maximum voltage than the LA (P < 0.001). The presence of LVAs, especially ELVAs, was more common in LA (LVAs: 47 patients (17.3%) vs. 29 patients (10.7%), P = 0.011; ELVAs: 26 patients (9.6%) vs. 7 patients (2.6%), P < 0.001). The multivariate logistic analysis revealed that older age, female gender, persistent AF, and LA enlargement were independent predictors of LA LVAs, while female gender and AF duration were associated with RA LVAs. Strong associations were found between variables reflecting the LA and the RA remodeling. Multivariate Cox regression indicated that ELVA in the LA was the only independent predictor of post-ablation recurrence.</p><p><strong>Conclusions: </strong>AF patients had different characteristics and intrinsic correlations between LA and RA remodeling. The LVAs, especially the ELVAs, were more prevalent in the LA than in the RA. There were distinctions in related factors and impacts on ablation efficacy between the LA LVAs and the RA LVAs.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}