Cardiovascular Engineering and Technology最新文献

{"title":"Design and Validation of a High-Fidelity Left Atrial Cardiac Simulator for the Study and Advancement of Left Atrial Appendage Occlusion.","authors":"Keegan Mendez, Manisha Singh, Patrick Willoughby, Beatrice Ncho, Aileen Liao, Susan Su, Megan Lim, Elijah Lee, Mohamad Alkhouli, Hasan Alarouri, Ellen T Roche","doi":"10.1007/s13239-025-00773-2","DOIUrl":"10.1007/s13239-025-00773-2","url":null,"abstract":"<p><strong>Purpose: </strong>Atrial fibrillation (AF) is the most common chronic cardiac arrhythmia that increases the risk of stroke, primarily due to thrombus formation in the left atrial appendage (LAA). Left atrial appendage occlusion (LAAO) devices offer an alternative to oral anticoagulation for stroke prevention. However, the complex and variable anatomy of the LAA presents significant challenges to device design and deployment. Current benchtop models fail to replicate both anatomical variability and physiological hemodynamics, limiting their utility. This study introduces a novel left atrial cardiac simulator that incorporates patient-derived LAA models within a benchtop circulatory flow loop, enabling high-fidelity LAAO device testing and development.</p><p><strong>Methods: </strong>A rigid, patient-derived left atrium (LA) model was 3D printed from segmented MRI data and modified to accommodate attachment of patient-specific LAA models. A library of LAA geometries was fabricated using silicone casting techniques to replicate the mechanical properties of native tissue. The LA-LAA model was integrated into a circulatory flow loop equipped with a pulsatile pump, pressure sensors, and flow probes, allowing real-time hemodynamic analysis. System tunability was demonstrated by varying heart rate, stroke volume, resistance, and compliance to simulate physiological and pathological conditions.</p><p><strong>Results: </strong>The simulator accurately replicated LA pressure and flow waveforms, closely approximating physiological conditions. Changes in heart rate, stroke volume, and compliance effectively modulated LAP and LA inflow before and after LAAO. Distinct pressure and flow waveforms were observed with different LAA geometries. Hemodynamic analysis revealed increased left atrial pulse pressure after occlusion, with the greatest increase occurring after complete exclusion of the LAA. The simulator facilitated the evaluation of LAAO device performance, including metrics such as seal and PDL, and served as an effective training tool for iterative device deployment and recapture with visual and imaging-guided feedback.</p><p><strong>Conclusions: </strong>The left atrial cardiac simulator offers a highly tunable and realistic platform for testing and developing LAAO devices. It also serves as an effective procedural training tool, allowing for the simulation of patient-specific anatomical and hemodynamic conditions. By enabling these advanced simulations, the simulator enhances pre-procedural planning, device sizing, and placement. This innovation represents a significant step toward advancing personalized medicine in atrial fibrillation management and improving LAAO outcomes.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"279-295"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated Coronary Artery Segmentation with 3D PSPNET using Global Processing and Patch Based Methods on CCTA Images.","authors":"Kavita Chachadi, S R Nirmala, Pavan G Netrakar","doi":"10.1007/s13239-025-00775-0","DOIUrl":"10.1007/s13239-025-00775-0","url":null,"abstract":"<p><p>The prevalence of coronary artery disease (CAD) has become the major cause of death across the world in recent years. The accurate segmentation of coronary artery is important in clinical diagnosis and treatment of coronary artery disease (CAD) such as stenosis detection and plaque analysis. Deep learning techniques have been shown to assist medical experts in diagnosing diseases using biomedical imaging. There are many methods which employ 2D DL models for medical image segmentation. The 2D Pyramid Scene Parsing Neural Network (PSPNet) has potential in this domain but not explored for the segmentation of coronary arteries from 3D Coronary Computed Tomography Angiography (CCTA) images. The contribution of present research work is to propose the modification of 2D PSPNet into 3D PSPNet for segmenting the coronary arteries from 3D CCTA images. The innovative factor is to evaluate the network performance by employing Global processing and Patch based processing methods. The experimental results achieved a Dice Similarity Coefficient (DSC) of 0.76 for Global process method and 0.73 for Patch based method using a subset of 200 images from the ImageCAS dataset.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"307-321"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469998","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":"Temporary Pacing for Electric Cardiac Stimulation and Neuromodulatory Cardiovascular Therapy.","authors":"Charles Stark, Pavan Bhat, Eric Rytkin, Igor R Efimov","doi":"10.1007/s13239-025-00780-3","DOIUrl":"10.1007/s13239-025-00780-3","url":null,"abstract":"<p><p>The widespread prevalence and significant consequences of cardiac arrhythmias have been addressed by adopting cardiac stimulation and neuromodulation implantable devices. The oldest, most commonly employed, and most well-known technology is the permanent transvenous cardiac pacemaker. However, in select emergent clinical scenarios and transient pathologies, temporary pacing is preferred. More recently, neuromodulatory vagal nerve stimulation has emerged to address neurologic, psychiatric, and nociceptive pathologies, generating significant clinical and scientific interest in the invention of temporary corollary devices for a subset of indications of nociceptive origin. The dominance of particular implant approaches and anatomic targets in both temporary pacing and neuromodulation in the clinic is owed to capabilities and limitations present in the current technological landscape. However, recent innovations in industry and academia may lead to a fundamental shift in how temporary pacing and neuromodulation are delivered in terms of procedural approach and patient outcomes. In this review, we present an overview of contemporary temporary pacemakers, neuromodulatory therapies, and devices, highlighting novel temporary pacing technologies from the clinic, industry, and academia, such as temporary permanent pacemakers, innovations in non-blood-contacting devices, bioresorbable pacemakers, and advances in neuromodulatory approaches.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"363-375"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Peripheral Vascular Motion on Acute Drug Retention of Intravascular Devices.","authors":"Trey Ursillo, Kayla Lowry, Catherine Allred, Mollie Phillips, Linda B Liu, Danyi Chen, Saami K Yazdani","doi":"10.1007/s13239-025-00776-z","DOIUrl":"10.1007/s13239-025-00776-z","url":null,"abstract":"<p><strong>Purpose: </strong>This goal of this study was to determine the impact of vascular motion on acute drug transfer and retention of drug-coated balloons (DCB) or drug-eluting stents (DES).</p><p><strong>Methods: </strong>Commercially available paclitaxel DCBs (Lutonix & IN.PACT) and a paclitaxel DES (Zilver) were subjected to physiological flow and vascular motion conditions using a peripheral-simulating benchtop bioreactor system. Each DCB- or DES-treated artery was subjected to three sets of movement parameters including pulsatile flow with no twisting/bending (P1), pulsatile flow with 16.8° twist, 25° bend and 3.2 mm compression (P2), and pulsatile flow with 68° twist, 35° bend, 21 mm compression (P3). After 24 h, the treated segments were removed and paclitaxel concentrations were measured using pharmacokinetic analysis.</p><p><strong>Results: </strong>In the group of arteries treated with the Lutonix DCB, there was a significant decrease in arterial paclitaxel concentrations between the P1 and both the P2 and P3 moving parameters (P1 = 404 ± 195 ng/mg, P2 = 14.9 ± 9.92 ng/mg, P3 = 19.2 ± 15.4 ng/mg; P1-P2 p = 0.007, P1-P3 p = 0.005). For the IN.PACT DCB group, no differences in the mean arterial paclitaxel concentrations were observed for the various movements (p = 0.55). Lastly, in the Zilver DES group, differences were only measured between the P2 and P3 moving parameters (P2 = 84.8 ± 32.7 ng/mg, P3 = 0.11 ± 0.06 ng/mg; P2-P3 p = 0.01).</p><p><strong>Conclusion: </strong>Acute retention of arterial paclitaxel levels can be adversely impacted by vascular movement in both DES- and DCB- treated arteries.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"322-332"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Theoretical and Practical Aspects of the Nonlinear Dynamics' Methods of Heart Rate Variability Analyses in Tachyarrhythmia Patients Underwent Radiofrequency Catheter Ablation.","authors":"Andrey Ardashev, Alexander Loskutov, Rod Passman, Evgeny Zhelyakov, Eric Rytkin, Igor Efimov","doi":"10.1007/s13239-024-00766-7","DOIUrl":"10.1007/s13239-024-00766-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study explores the use of heart rate variability (HRV) analysis, a noninvasive technique for assessing the autonomic nervous system, by applying nonlinear dynamics and chaos theory to detect chaotic behavior in RR intervals and assess cardiovascular health.</p><p><strong>Methods: </strong>Employing the \"System Analysis of Heart Rate Dynamics\" (SADR) program, this research combines chaos analysis with the short-time Fourier transform to assess nonlinear dynamic parameters in HRV. It includes constructing phase portraits in Takens space and calculating measures of chaos to identify deterministic chaos indicators.</p><p><strong>Results: </strong>The analysis identifies distinct chaos indicators in the cardiac rhythm of healthy volunteers compared to tachyarrhythmia patients, both before and after catheter treatment. Post-radiofrequency ablation (RFA) analysis shows promise as a predictive tool for arrhythmia recurrence.</p><p><strong>Conclusions: </strong>The findings suggest that HRV analysis, through nonlinear dynamics, can be an effective noninvasive method for predicting arrhythmia recurrence following treatments like catheter ablation. This approach has the potential for early and precise detection of arrhythmia, pending further validation.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":"16 2","pages":"190-201"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694403","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":"Performance Comparison of Centered and Tilted Blunt and Lighthouse Tip Cannulae for Drainage in Extracorporeal Life Support.","authors":"Federico Rorro, Lars Mikael Broman, Lisa Prahl Wittberg","doi":"10.1007/s13239-024-00770-x","DOIUrl":"10.1007/s13239-024-00770-x","url":null,"abstract":"<p><strong>Introduction: </strong>Extracorporeal membrane oxygenation is a lifesaving treatment for patients with refractory acute respiratory, circulatory, or combined cardiopulmonary failure. The patient is cannulated with one or two cannulae for drainage and reinfusion of blood. Blood is drained from the patient, pumped through a membrane lung for oxygenation and returned to the patient. Treatment efficiency depends on correct cannula positioning and interactions between drainage and reinfusion cannula.</p><p><strong>Methods: </strong>An experimental setup was built to study the isolated drainage performance of 24 Fr rigid models of a blunt and lighthouse tip cannula, both when centered and when tilted towards the vessel wall. Planar particle image velocimetry was used to investigate the flow field with water as the fluid medium.</p><p><strong>Results: </strong>For similar flow configuration, higher shear stresses were recorded in the blunt tip rather than lighthouse tip cannula. Moreover, in the lighthouse tip cannula, side-holes furthest from the tip (proximal side-holes) had the highest drainage. Results did not change substantially when the cannula was tilted towards the vessel wall.</p><p><strong>Conclusions: </strong>The effective drainage point of the lighthouse tip cannula was located near the proximal side-holes. Lower shear stresses were recorded in the lighthouse tip cannula when compared with the blunt tip cannula, for all considered flow rate ratios and cannula positions.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"238-250"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Cardiovascular Multiscale Modeling using a Functional Mock-up Interface.","authors":"Ellen E Garven, Ethan Kung, Randy M Stevens, Amy L Throckmorton","doi":"10.1007/s13239-024-00767-6","DOIUrl":"10.1007/s13239-024-00767-6","url":null,"abstract":"<p><strong>Purpose: </strong>Computational models of the cardiovascular system continue to increase in complexity. As more elements of the physiology are captured in multiscale models, there is a need to efficiently integrate subsystems. The objective of this study is to demonstrate the effectiveness of a coupling methodology, called functional mock-up interface (FMI), as applied to multiscale cardiovascular modeling.</p><p><strong>Methods: </strong>The multiscale model is composed of two subsystems: a computational fluid dynamics (CFD) model coupled to a lumped parameter model (LPM). The LPM is packaged using the FMI standard and imported into the CFD subsystem using an FMI co-simulation architecture. The functionality of an FMI coupling was demonstrated in a univentricular parallel circulation by means of compatible tools, including ANSYS CFX and Python. Predicted pressures and flows were evaluated in comparison with clinical data and a previously developed computational model.</p><p><strong>Results: </strong>The two models exchanged pressure and flow data between their boundaries at each timestep, demonstrating sufficient inter-subsystem communication. The models recreated pressures and flows from clinical measurements and a patient-specific model previously published.</p><p><strong>Conclusion: </strong>FMI integrated with ANSYS CFX is an effective approach for interfacing cardiovascular multiscale models as demonstrated by the presented univentricular circulatory model. FMI offers a modular approach towards tool integration and is an advantageous strategy for modeling complex systems.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":"16 2","pages":"202-210"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Transcatheter Posterior Ventricular Anchoring Neochordoplasty Mitral Valve Repair Device.","authors":"Matthew H Park, Annabel M Imbrie-Moore, Michael J Paulsen, Yuanjia Zhu, John W MacArthur, Y Joseph Woo","doi":"10.1007/s13239-024-00764-9","DOIUrl":"10.1007/s13239-024-00764-9","url":null,"abstract":"<p><strong>Purpose: </strong>Advancements in minimally invasive technologies to decrease postoperative morbidity and recovery times represent a large opportunity for mitral valve repair operations. However, current technologies are unable to replicate gold standard surgical neochord implantation.</p><p><strong>Methods: </strong>We developed a novel neochordal repair device, Minimally Invasive Ventricular Anchoring Neochordoplasty (MIVAN), which operates via transcatheter, trans-septal anchoring to the posterior ventricular wall. We evaluated MIVAN in an ex vivo heart simulator and compared it with surgical neochordal repair and MitraClip using a prolapse model.</p><p><strong>Results: </strong>Upon MIVAN repair of the model (n = 5), regurgitant fraction was reduced from 19.46 ± 1.77% to 7.30 ± 0.99% (p = 0.01). Surgical neochordal repair reduced regurgitant fraction to 5.65 ± 0.66%, but there was no significant difference between MIVAN and surgical repair (p = 0.22). Unpaired MitraClip repair had significantly higher regurgitant fraction of 11.9 ± 1.40%, compared with those of neochord (p < 0.01) and MIVAN (p = 0.03) repairs.</p><p><strong>Conclusions: </strong>MIVAN represents a high-value opportunity for minimally invasive mitral valve repair. The benefits of the percutaneous, trans-septal approach for implantation on the posterior ventricular wall necessitate the expanded exploration of this device as a treatment alternative.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"251-257"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and Prototyping of a Novel Triple Lumen Photo-Angioplasty Device: Lumi-Solve-T.","authors":"Aldous Tria, Anak Dharma, Loren Spiegel, Andrew E Rodda, Asvini Allada, Pavel Sluka, Amarnath Sangeetha Menon, Ethan Prabaharan, Pulasthi V Wettesinghe, Justin W Adams, Manfred Spanger, Anthony E Dear","doi":"10.1007/s13239-024-00768-5","DOIUrl":"10.1007/s13239-024-00768-5","url":null,"abstract":"<p><strong>Purpose: </strong>A triple lumen iteration of the novel photo-angioplasty drug eluting balloon catheter (DEBc) Lumi-Solve may be compromised by guidewire shadow (GWS)-mediated attenuation of balloon surface drug activation. The current study aimed to design and evaluate a novel triple lumen prototype, designated Lumi-Solve-T, to circumvent these issues.</p><p><strong>Methods: </strong>Effects of guidewire shadowing (GWS) on vascular smooth muscle cell (VSMC) proliferation was evaluated using the MTT assay. In-silico modelling of GWS in the novel triple lumen design was conducted. Computer-aided design (CAD) and finite element analysis (FEA) contributed to development of a novel triple lumen catheter. 3D printing of rudimentary and refined prototypes of the catheter together with assembly of a novel fibre-optic (FO) complex and ex-vivo evaluation of the triple lumen device, Lumi-Solve T, was also performed.</p><p><strong>Results: </strong>GW insertion in a parallel triple lumen FO: GW port orientation demonstrated significantly reduced inhibition of VSMC proliferation after 7 days confirming the need for an alternative triple lumen design. In-silico analysis identified a multi-fibre FO sleeve design supported uniform, radial and uninterrupted UV365nm light transmission to the angioplasty balloon surface. FEA confirmed a multi-fibre FO ribbon design afforded a practical method of FO sleeve generation and facilitated a novel hub configuration able to afford a FO ribbon to sleeve transition. 3D printed prototypes demonstrated the utility of the novel design.</p><p><strong>Conclusions: </strong>A dedicated third port and lumen for the Lumi-Solve FO is required for optimal balloon surface photo-activation. A novel triple lumen design, Lumi-Solve-T, incorporating a ribbon to sleeve FO transition and novel hub design offers a realistic solution to current device limitations.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"211-221"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873471","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":"Investigating the Shortcomings of the Flow Convergence Method for Quantification of Mitral Regurgitation in a Pulsatile In-Vitro Environment and with Computational Fluid Dynamics.","authors":"Robin Leister, Roger Karl, Lubov Stroh, Derliz Mereles, Matthias Eden, Luis Neff, Raffaele de Simone, Gabriele Romano, Jochen Kriegseis, Matthias Karck, Christoph Lichtenstern, Norbert Frey, Bettina Frohnapfel, Alexander Stroh, Sandy Engelhardt","doi":"10.1007/s13239-024-00763-w","DOIUrl":"10.1007/s13239-024-00763-w","url":null,"abstract":"<p><p>The flow convergence method includes calculation of the proximal isovelocity surface area (PISA) and is widely used to classify mitral regurgitation (MR) with echocardiography. It constitutes a primary decision factor for determination of treatment and should therefore be a robust quantification method. However, it is known for its tendency to underestimate MR and its dependence on user expertise. The present work systematically compares different pulsatile flow profiles arising from different regurgitation orifices using transesophageal echocardiographic (TEE) probe and particle image velocimetry (PIV) as a reference in an in-vitro environment. It is found that the inter-observer variability using echocardiography is small compared to the systematic underestimation of the regurgitation volume for large orifice areas (up to 52%) where a violation of the flow convergence method assumptions occurs. From a flow perspective, a starting vortex was found as a dominant flow pattern in the regurgant jet for all orifice shapes and sizes. A series of simplified computational fluid dynamics (CFD) simulations indicate that selecting a suboptimal aliasing velocity during echocardiography measurements might be a primary source of potential underestimation in MR characterization via the PISA-based method, reaching up to 40%. In this study, it has been noted in clinical observations that physicians often select an aliasing velocity higher than necessary for optimal estimation in diagnostic procedures.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":"16 2","pages":"155-170"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}