Cardiovascular Engineering and Technology最新文献

{"title":"Comparative Evaluation of Power-Law and Viscoelastic Hemolysis Models in the FDA Nozzle Benchmark Geometry.","authors":"Alberto Girelli, Giulia Giantesio, Adélia Sequeira, Tomáš Bodnár","doi":"10.1007/s13239-026-00862-w","DOIUrl":"https://doi.org/10.1007/s13239-026-00862-w","url":null,"abstract":"<p><strong>Purpose: </strong>The mechanical damage of red blood cells (hemolysis) remains a key challenge in the design of blood-contacting medical devices. This study aims to compare the predictive performance of the empirical power-law model and the physiologically motivated viscoelastic model in the FDA nozzle benchmark geometry, with a focus on how model parameters and shear stress definitions influence hemolysis predictions.</p><p><strong>Methods: </strong>Computational fluid dynamics (CFD) simulations were performed using a finite volume framework to resolve flow fields and shear stresses in the FDA nozzle. Both hemolysis models were implemented under identical geometry, mesh and boundary conditions. A parametric analysis was conducted by varying key model parameters, including the viscoelastic constants A, <math><msub><mi>T</mi> <mn>1</mn></msub> </math> , <math><msub><mi>T</mi> <mn>2</mn></msub> </math> , the shear stress threshold <math><msub><mi>τ</mi> <mi>S</mi></msub> </math> , and the power-law parameters. Predictions were evaluated using both total shear stress and turbulent viscous shear stress (TVSS) formulations, and compared against experimental data.</p><p><strong>Conclusion: </strong>The viscoelastic model demonstrated strong sensitivity to the relaxation time <math><msub><mi>T</mi> <mn>2</mn></msub> </math> and to the choice of stress definition. A quasi-linear dependence on parameter A was identified, enabling calibration with experimental results. In contrast, the power-law model was less sensitive to stress definitions but strongly dependent on parameter fitting. The effect of <math><msub><mi>τ</mi> <mi>S</mi></msub> </math> differed between the two models: it reduced hemolysis in the power-law case but increased it in the viscoelastic formulation.</p><p><strong>Background: </strong>The viscoelastic model offers a more mechanistic description of hemolysis but requires careful parameter calibration and is highly sensitive to stress definitions. The power-law model remains computationally efficient and easier to implement, though empirical by nature. Future research should refine parameter estimation and extend validation to more complex flow regimes, considering feedback effects of hemolysis on viscosity. Ultimately, CFD prediction of hemolysis remains a challenging unsolved problem.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208174","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 Beginner's Guide to Cardiac Optical Mapping.","authors":"Katy A Trampel, Binjie Li, Sharon A George, Igor R Efimov","doi":"10.1007/s13239-026-00863-9","DOIUrl":"https://doi.org/10.1007/s13239-026-00863-9","url":null,"abstract":"<p><p>Optical mapping is a high spatiotemporal resolution imaging technique used to study cardiac electrophysiology by recording fluorescent signals that correspond to changes in transmembrane potential, intracellular calcium, and metabolic activity. This review provides a comprehensive guide for beginners, covering the fundamentals of optical mapping system components, including dye selection, optical filters and mirrors, camera specifications, and system configurations. A range of tissue preparations, from single cells to whole hearts, is described, with attention to how preparation type affects experimental design, perfusion methods, and system setup. Pharmacological and computational strategies to reduce motion artifacts are discussed. Electrical stimulation protocols, such as pacing and restitution mapping, are described in the context of arrhythmia induction and rate dependent electrophysiological properties. Technical considerations including system maintenance and troubleshooting are also addressed. Finally, the review outlines current limitations, including dye cytotoxicity, tissue viability, and photobleaching, and explores future directions such as genetically encoded indicators and oxygen-enriched perfusates. This guide aims to equip new users with the foundational knowledge needed to design, perform, and interpret optical mapping experiments.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197535","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":"Biventricular Assist Devices Versus Total Artificial Heart as Bridge-to-Transplantation Strategies: A Systematic Review and Meta-analysis.","authors":"Obay J I Ahmed, Moaz J I Ahmed, Moustafa Mahmoud Aboutabl, Mariam Mohammed, Mohamed Elserougi, Khaled Ashraf Mohamed, Tamer Ghazy, Diyar Saeed, Ahmed Abdelsamad","doi":"10.1007/s13239-026-00864-8","DOIUrl":"https://doi.org/10.1007/s13239-026-00864-8","url":null,"abstract":"<p><strong>Purpose: </strong>Biventricular assist devices (BiVADs) and total artificial heart (TAH) are the principal bridge-to-transplantation strategies for patients with advanced biventricular heart failure awaiting heart transplantation, but their comparative effectiveness and safety remain uncertain. This systematic review and meta-analysis compared pretransplant outcomes between the two approaches.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Scopus, Web of Science, and Cochrane Library were searched from inception through January 2026 for studies comparing BiVADs and TAH as bridge-to-transplantation strategies. Study quality was assessed using the Newcastle-Ottawa Scale, and certainty of evidence was evaluated using the GRADE framework. Random-effects models were used to compare survival to transplantation, mortality during support, support-related complications, and duration of support.</p><p><strong>Results: </strong>Ten retrospective studies involving 2,242 patients met the inclusion criteria. The overall analysis showed no significant difference in survival to transplantation between patients supported with BiVADs and TAH (RR = 0.97, 95% CI (0.84, 1.13), P = 0.74). However, after excluding potentially overlapping cohorts, sensitivity analysis showed a higher rate of survival to transplantation in those supported with TAH (RR = 0.88, 95% CI (0.80, 0.97), P = 0.01). No significant difference was observed in mortality during support in the overall analysis (RR = 1.19, 95% CI (0.88, 1.61), P = 0.26) or after excluding potentially overlapping cohorts (RR = 0.98, 95% CI (0.79, 1.21), P = 0.84). BiVADs were associated with higher rates of bleeding and stroke (RR = 2.79, 95% CI (1.70, 4.59), P < 0.0001 and RR = 2.31, 95% CI (1.53, 3.50), P < 0.0001, respectively), whereas infection did not differ significantly between the two groups (RR = 1.18, 95% CI (0.50, 2.78), P = 0.70). Sensitivity analysis for stroke after excluding potentially overlapping cohorts showed a similarly higher rate in patients supported with BiVADs (RR = 2.39, 95% CI (1.46, 3.93), P = 0.0006). Duration of support did not differ significantly between both groups in the overall analysis (MD = 2.25 days, 95% CI (- 16.46, 20.96), P = 0.81) or after excluding potentially overlapping cohorts (MD = - 0.90 days, 95% CI (- 24.26, 22.46), P = 0.94).</p><p><strong>Conclusion: </strong>TAH may be associated with higher rates of survival to transplantation after excluding potentially overlapping cohorts, while BiVAD support may be associated with higher rates of bleeding and stroke. However, all included studies were retrospective, and the certainty of evidence was low for most outcomes. These findings should therefore be interpreted with caution and require confirmation in prospective multicenter studies.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186147","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":"Characterization of Turbulent Kinetic Energy and Shear Layers in Sudden Expansion Flows: A Physics-Informed Machine Learning Approach.","authors":"Suleyman Sisman","doi":"10.1007/s13239-026-00865-7","DOIUrl":"https://doi.org/10.1007/s13239-026-00865-7","url":null,"abstract":"<p><strong>Purpose: </strong>Traditional Computational Fluid Dynamics (CFD) methods used in the hydrodynamic design of blood-contacting medical devices create a bottleneck in optimization processes due to their heavy dependence on mesh structure and high computational costs.</p><p><strong>Methods: </strong>In this study, using a mesh-free Physics-Informed Neural Network (PINN) approach, complex flow fields and Turbulent Kinetic Energy (TKE) distributions in FDA reference nozzle geometries were mapped with high resolution. Unlike artificial intelligence algorithms that merely fit data, the proposed model directly integrates the axisymmetric mass conservation equation into the loss function as a mathematical constraint. The model was trained on experimental PIV/LDV data over a wide range covering laminar, transitional, and fully turbulent regimes ( <math><mrow><mi>R</mi> <mi>e</mi> <mo>=</mo> <mn>500</mn> <mo>-</mo> <mn>6500</mn></mrow> </math> ).</p><p><strong>Results: </strong>The model predicted sharp velocity gradients in the shear layers with high accuracy. Additionally, a practical empirical correlation for peak TKE was derived within the investigated conditions, serving as a rapid hydrodynamic indicator.</p><p><strong>Conclusion: </strong>The findings demonstrate that this physics-constrained approach reduces the need for mesh generation and offers a computationally lightweight framework for the continuity-constrained reconstruction and regularization of complex and inherently noisy experimental flow fields.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186120","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 Novel Femoral Artery Compression Device Compared with Manual Compression for Hemostasis After Femoral Artery Access in Coronary Artery Catheterizations.","authors":"Sathienwit Rowsathien, Muenpetch Muenkaew, Ramez Vessawan, Wiroj Limtrakarn","doi":"10.1007/s13239-026-00861-x","DOIUrl":"https://doi.org/10.1007/s13239-026-00861-x","url":null,"abstract":"<p><strong>Background: </strong>Femoral arterial access remains widely used in contemporary coronary catheterization procedures. Following the removal of the femoral sheath, hand compression is commonly employed to achieve hemostasis. Nevertheless, this method is time-consuming and imposes a burden on both the operator and the patient.</p><p><strong>Objective: </strong>This study aims to investigate the hemostatic efficacy of the novel external femoral artery compression device (the TU device).</p><p><strong>Materials and methods: </strong>Patients enrolled in this study were randomly assigned in a 1:1 ratio to either the TU device (with a 3-2-1 protocol for compression) or the conventional hand compression group. The primary efficacy outcome was the time to achieve hemostasis within 15 minutes, and the safety outcomes were major vascular complications. Other secondary outcomes included minor vascular complications, time to hospital discharge, reports of vasovagal symptoms, discomfort levels, as well as user and patient satisfaction.</p><p><strong>Results: </strong>A total of 52 patients were included in this study (TU device, n = 26 vs. hand compression, n = 26). The baseline characteristics of the groups were mostly similar. We found that achieving hemostasis within 15 minutes was successful in the TU device group more than in the hand compression group (84.6% vs. 46.2%, p = 0.004). Small hematomas were reported more frequently in the device group (34.6% vs. 7.7%, p = 0.017). Interestingly, there was an absence of any vasovagal response in patients using the device (0% vs. 15.4%, p = 0.037). There were no significant differences in major vascular complications, time to hospital discharge, patient discomfort, and satisfaction scores between the groups.</p><p><strong>Conclusions: </strong>The TU device is effective for achieving femoral artery hemostasis with an acceptable rate of access site complications compared to conventional hand compression.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082845","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":"What Determines the Three-Dimensional Trajectory of Chronic Total Occlusion (CTO) Guidewires? An Engineering Study of the Principles of CTO-guidewire Control.","authors":"Shimpei Watanabe, Osamu Katoh, Kenya Nasu, Tomoki Ichikawa, Shumpei Yoshitake, Sho Sanami","doi":"10.1007/s13239-026-00858-6","DOIUrl":"https://doi.org/10.1007/s13239-026-00858-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study was performed to establish the equivalence between the differential-geometry osculating plane of the chronic total occlusion (CTO)-guidewire (GW-Although GW is typically used as an abbreviation for guidewire, in this paper it is used specifically as the abbreviation for CTO-guidewire) trajectory and the GW osculating plane-defined as the plane spanned by the direction vectors of the GW tip-shaft and the GW tip-and to clarify the operating principles of GW manipulation by demonstrating that the GW osculating plane prescribes the three-dimensional GW trajectory.</p><p><strong>Methods: </strong>A GW was manually advanced into a CTO model through controlled rotation and pushing. At an arbitrary point A, the GW tip and tip-shaft were imaged using a cardiovascular X-ray system. Using vectors derived from two angiographic images taken at different view angles, the normalized direction vectors of the GW tip and tip-shaft were obtained to calculate the normalized normal vector of the GW osculating plane. The approximation function of the three-dimensional GW trajectory near point A was derived from X-ray images, and the tangent and principal normal vectors at A were calculated to determine the normalized normal vector of the differential-geometry osculating plane. Thirty experiments were conducted to statistically evaluate the equivalence of the normal vectors of both osculating planes.</p><p><strong>Results: </strong>In all 30 experiments, the normals of the GW osculating plane and the differential-geometry osculating plane were statistically equivalent.</p><p><strong>Conclusion: </strong>These findings provide strong evidence that the GW osculating plane coincides with the differential-geometry osculating plane under the tested conditions, supporting their interchangeability for predicting the three-dimensional GW trajectory.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992356","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":"Cardiovascular Disease and Androgens: Clinical Trends, Potential Mechanisms, and Considerations for Engineering Solutions.","authors":"Madeline N Monroe, Alexander L Curylo, Farshad Amirkhosravi, Eric I Garcia Huitron, George I Ezeokeke, Inioluwa G Ojediran, Jessica K Wang, Sawyer E Cremer, K Jane Grande-Allen","doi":"10.1007/s13239-026-00859-5","DOIUrl":"https://doi.org/10.1007/s13239-026-00859-5","url":null,"abstract":"<p><p>This review summarizes the current understanding of androgen physiology, relationships between androgens and cardiovascular (CV) diseases, and novel engineering approaches to study the effect of androgens on CV system. Testosterone (T), the primary sex hormone in biological males and a potent sex hormone in females, is the androgen of focus for this review. In the cardiovascular system, T signaling is seen through varying genomic and non-genomic mechanisms, which are further detailed in this review. Varying androgen levels in aging adults can significantly impact CVD outcomes, particularly for males. We also consider the implication of exogenous T treatment and androgen deprivation treatments on CVD. Furthermore, androgen-related trends in different CVD processes such as cardiac hypertrophy, congestive heart failure, atherosclerosis, calcific aortic valve disease, and aneurysms are explored. To that end, we present opportunities for novel tissue engineered approaches to discovering mechanisms and potential therapeutic pathways for androgen-related CV conditions.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992302","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":"Human and Porcine Marginal Chordal Forces in a Vacuum Based Physiological In Vitro Mitral Valve Model.","authors":"Mads V Ancker, Sam E Stephens, Justin T Jack, Neil B Ingels, Jonathan F Wenk, Søren N Skov, Surendra K Chawla, Ajit P Yoganathan, Morten O Jensen","doi":"10.1007/s13239-026-00857-7","DOIUrl":"https://doi.org/10.1007/s13239-026-00857-7","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to quantitatively investigate the role of marginal chordae of the mitral valve during static closure by analyzing the force within these chordae and its potential correlation with the transvalvular pressure.</p><p><strong>Materials and methods: </strong>Porcine (n = 10) and human (n = 4) mitral valves were mounted in a saddle-shaped annulus clamp, while an in vitro system was utilized to replicate a physiological systolic blood pressure by vacuum pressure applied to the atrial side of the valve. A Millar pressure catheter and force transducers (\"C-gauges\") were used to acquire the data. Strut chordal force was recorded simultaneously with the marginal chordal force, to serve as a verification of the employed equipment.</p><p><strong>Results: </strong>The marginal chordal force in porcine and human averaged to 0.012 N ± 0.008 N and 0.006 N ± 0.008 N respectively at peak systolic pressure of 120 mmHg. Additionally, a simplified finite element study was conducted and supports low marginal forces relative to intermediary chords.</p><p><strong>Discussion & conclusion: </strong>This low force calls into question the traditionally-described role of the marginal chordae in preventing mitral prolapse at closure. The chords do, however, still show signs of assisting with the leaflets' positioning. The relationship between marginal chordal forces and transvalvular pressure varies significantly across experiments, further obfuscating their role in normal valvular function.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889432","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 Translational Paradigm for Univentricular Heart Disease: Single-Stage Neonatal Repair with Adaptive Control of Cavopulmonary Flow.","authors":"Paulo Cesar Duarte Junior, Martin Poulsen Kessler, Alessandro Cavalcanti Lianza, Shirley Ferraz Crispilho, Rudolf Huebner, Hemerson Donizete Pinheiro, Aron José Pazin de Andrade","doi":"10.1007/s13239-026-00856-8","DOIUrl":"https://doi.org/10.1007/s13239-026-00856-8","url":null,"abstract":"<p><strong>Background: </strong>Univentricular heart defects remain one of the greatest challenges in pediatric cardiovascular surgery. Although well-established, the traditional approach consisting of three serial palliative procedures (Norwood, Glenn, and Fontan) entails cumulative risks, repeated hospitalizations, high healthcare costs, and significant psychosocial impact. This study proposes a single-stage neonatal surgical strategy integrating a tissue-engineered vascular graft and a differential flow control valve to enable adaptive and gradual modulation of cavopulmonary flow, avoiding abrupt physiological transitions. To evaluate the hemodynamic feasibility of the proposed concept, a three-dimensional computational fluid dynamics model was developed and analyzed under controlled flow conditions.</p><p><strong>Methods: </strong>A three-dimensional model of the total cavopulmonary connection was developed to evaluate the hemodynamic feasibility of the surgical proposal. The fenestration diameter was reduced from 14 to 0 mm, representing progressive hemodynamic conditions. Computational fluid dynamics simulations were conducted under standardized physiological conditions, with neonatal pulmonary vascular resistance represented by porous zones. Flow distributions, pressure gradients, and hemodynamic equilibrium points were evaluated.</p><p><strong>Results: </strong>Progressive reduction of fenestration diameter from 14 to 0 mm promoted gradual redistribution of venous flow from predominant right atrial diversion to predominant pulmonary perfusion. Systemic venous pressure increased from 4.2 to 10.6 mmHg as fenestration diameter decreased. An intermediate functional range between 5 and 6 mm provided a balanced distribution between pulmonary perfusion and right atrial diversion, consistent with an intermediate cavopulmonary flow condition.</p><p><strong>Conclusion: </strong>Within the assumptions of this proof-of-concept computational model, the proposed strategy demonstrated hemodynamic feasibility for progressive cavopulmonary flow modulation. By integrating tissue engineering, adaptive flow control, and computational modeling, the proposed concept provides a foundation for future patient-specific, experimental, and translational investigations in the treatment of univentricular heart defects.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801665","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":"The Reverse Calcification Technique (RCT): A Quantitative Parametric Model of Aortic Stenosis Progression.","authors":"Maya Sharon, Omer Tal, Ashraf Hamdan, Adi Morany, Danny Bluestein, Rami Haj-Ali","doi":"10.1007/s13239-026-00854-w","DOIUrl":"https://doi.org/10.1007/s13239-026-00854-w","url":null,"abstract":"<p><strong>Introduction: </strong>Aortic stenosis (AS) develops from calcific aortic valve disease (CAVD), which narrows the aortic valve opening as leaflet stiffness increases due to calcium deposition. This study extends the Reverse Calcification Technique (RCT) by incorporating a time dimension to develop a quantitative parametric model for patient-specific prediction of CAVD progression from sequential CT scans.</p><p><strong>Methods: </strong>Seventeen pre-transcatheter aortic valve replacement (TAVR) patients underwent sequential CT scans (1.2-6.5 years); baseline aortic valve calcification (AVC) volumes: <math><mo>≈</mo></math> 250 to <math><mo>≈</mo></math> 1,600 mm³ (cohort mean <math><mo>≈</mo></math>  730 mm³ at the first scan and <math><mo>≈</mo></math> 920 mm³ at the follow-up scan). A parametric model was developed using two approaches: forward prediction (mild to severe stages) and backward reconstruction (from severe to moderate stages). 34 test cases were assessed through alternating calibration and verification, with performance evaluated using Bland-Altman analysis, paired t-tests, and relative error calculations.</p><p><strong>Results: </strong>For scan intervals under 3 years, forward prediction achieved a mean absolute error of 77 mm³ (7.0% relative to a mean target volume of 918 mm³) and backward reconstruction achieved 53 mm³ (8.4% relative to 542 mm³) within the inherent CT measurement uncertainty of 8-12%. For longer intervals (> 3 years), relative errors increased to 16.8-21.6%. Individual errors ranged from 0.02% to 36.8%, with no systematic bias detected.</p><p><strong>Conclusion: </strong>The quantitative parametric RCT model demonstrates feasibility for patient-specific estimation of CAVD progression and shows promise for optimizing follow-up intervals. External validation in larger independent cohorts and incorporation of patient-specific risk factors are required before clinical implementation.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702655","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}