基于开源软件的房室瓣建模计算框架
A Computational Framework for Atrioventricular Valve Modeling using Open-Source Software
摘要：
房室瓣返流是后天性和先天性心脏瓣膜病患者发病和死亡的重要原因。房室瓣的图像衍生计算建模在过去十年中取得了很大进展，并且特别有希望为小型和异质人群提供瓣膜修复信息，这些人群不太可能通过经验性临床应用进行优化。虽然大量的计算生物力学研究已经调查了成人二尖瓣和三尖瓣疾病，但很少有研究调查了脆弱的儿童和先天性心脏病人群的应用。此外，迄今为止，研究人员主要依赖于一系列商业应用程序，这些应用程序既不是为心脏瓣膜的图像衍生建模而设计的，也不是免费提供的，以促进透明和可再现的瓣膜科学。为了解决这一缺陷，我们的目标是建立一个开源的计算框架，用于房室瓣的图像衍生生物力学分析。在目前的工作中，我们集成了一个开源的瓣膜建模平台，SlicerHeart，和一个开源的生物力学有限元建模软件，FEBio，以促进图像衍生的房室瓣模型创建和有限元分析。我们提出了详细的验证和敏感性分析，以证明该建模应用于3D超声心动图衍生的小儿二尖瓣和三尖瓣模型的保真度。我们的分析取得了很好的协议与文献报道。因此，这种不断发展的计算框架为瓣膜力学的未来发展和研究提供了一个有希望的初步基础，特别是针对先天性心脏病儿童改进修复的合作努力。
英文摘要：
Atrioventricular valve regurgitation is a significant cause of morbidity and mortality in patients with acquired and congenital cardiac valve disease. Image-derived computational modeling of atrioventricular valves has advanced substantially over the last decade and holds particular promise to inform valve repair in small and heterogeneous populations which are less likely to be optimized through empiric clinical application. While an abundance of computational biomechanics studies have investigated mitral and tricuspid valve disease in adults, few studies have investigated application to vulnerable pediatric and congenital heart populations. Further, to date, investigators have primarily relied upon a series of commercial applications that are neither designed for image-derived modeling of cardiac valves, nor freely available to facilitate transparent and reproducible valve science. To address this deficiency, we aimed to build an open-source computational framework for the image-derived biomechanical analysis of atrioventricular valves. In the present work, we integrated an open-source valve modeling platform, SlicerHeart, and an open-source biomechanics finite element modeling software, FEBio, to facilitate image-derived atrioventricular valve model creation and finite element analysis. We present a detailed verification and sensitivity analysis to demonstrate the fidelity of this modeling in application to 3D echocardiography-derived pediatric mitral and tricuspid valve models. Our analyses achieved excellent agreement with those reported in the literature. As such, this evolving computational framework offers a promising initial foundation for future development and investigation of valve mechanics, in particular collaborative efforts targeting the development of improved repairs for children with congenital heart disease.
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