主动脉瓣狭窄对左心血流动力学影响的流体-结构-电生理研究
Effects of stenotic aortic valve on the left heart hemodynamics: a fluid-structure-electrophysiology approach
摘要：
主动脉瓣是一种三叶被动结构，由左心室和主动脉之间的压差驱动，在心跳期间打开和关闭，以确保正确的流向和流速。在老年人中或由于特定的病理，瓣膜小叶可能会损害瓣膜功能，进而损害心脏的泵送效率。利用考虑电生理、心肌主动收缩、血流动力学和相关流体-结构相互作用的多物理场左心模型，研究了不同严重程度主动脉瓣狭窄的血流特征变化。我们已经发现，除了跨瓣压降和收缩期射流速度的增加之外，狭窄的主动脉瓣显著地改变了壁剪切应力及其在主动脉弓和瓣叶上的空间分布，这可能引起心室肌的重构过程。多物理场模型的数值结果与临床经验完全一致，从而进一步为计算工程辅助医学诊断开辟了道路。
英文摘要：
The aortic valve is a three-leaflet passive structure that, driven by pressure differences between the left ventricle and the aorta, opens and closes during the heartbeat to ensure the correct stream direction and flow rate. In elderly individuals or because of particular pathologies, the valve leaflets can stiffen thus impairing the valve functioning and, in turn, the pumping efficiency of the heart. Using a multi-physics left heart model accounting for the electrophysiology, the active contraction of the myocardium, the hemodynamics and the related fluid-structure-interaction, we have investigated the changes in the flow features for different severities of the aortic valve stenosis. We have found that, in addition to the increase of the transvalvular pressure drop and of the systolic jet velocity, a stenotic aortic valve significantly alters the wall shear stresses and their spatial distribution over the aortic arch and valve leaflets, which may induce a remodelling process of the ventricular myocardium. The numerical results from the multi-physics model are fully consistent with the clinical experience, thus further opening the way for computational engineering aided medical diagnostic.
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