The Korean Journal of Physiology and Pharmacology

  • 제23권1호
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  • Pages.63-70
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  • 2019
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  • 1226-4512(pISSN)
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  • 2093-3827(eISSN)
대한약리학회 (The Korean Society of Pharmacology)
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Computational analysis of the electromechanical performance of mitral valve cerclage annuloplasty using a patient-specific ventricular model

  • Lee, Kyung Eun (Department of Mechanical and Biomedical Engineering, Kangwon National University) ;
  • Kim, Ki Tae (Department of Mechanical and Biomedical Engineering, Kangwon National University) ;
  • Lee, Jong Ho (Department of Mechanical and Biomedical Engineering, Kangwon National University) ;
  • Jung, Sujin (Department of Cardiology, College of Medicine, Pusan National University) ;
  • Kim, June-Hong (Department of Cardiology, College of Medicine, Pusan National University) ;
  • Shim, Eun Bo (Department of Mechanical and Biomedical Engineering, Kangwon National University)
  • 투고 : 2018.09.05
  • 심사 : 2018.10.18
  • 발행 : 2019.01.01
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초록

We aimed to propose a novel computational approach to predict the electromechanical performance of pre- and post-mitral valve cerclage annuloplasty (MVCA). Furthermore, we tested a virtual estimation method to optimize the left ventricular basement tightening scheme using a pre-MVCA computer model. The present model combines the three-dimensional (3D) electromechanics of the ventricles with the vascular hemodynamics implemented in a lumped parameter model. 3D models of pre- and post-MVCA were reconstructed from the computed tomography (CT) images of two patients and simulated by solving the electromechanical-governing equations with the finite element method. Computed results indicate that reduction of the dilated heart chambers volume (reverse remodeling) appears to be dependent on ventricular stress distribution. Reduced ventricular stresses in the basement after MVCA treatment were observed in the patients who showed reverse remodeling of heart during follow up over 6 months. In the case who failed to show reverse remodeling after MVCA, more virtual tightening of the ventricular basement diameter than the actual model can induce stress unloading, aiding in heart recovery. The simulation result that virtual tightening of the ventricular basement resulted in a marked increase of myocardial stress unloading provides in silico evidence for a functional impact of MVCA treatment on cardiac mechanics and post-operative heart recovery. This technique contributes to establishing a pre-operative virtual rehearsal procedure before MVCA treatment by using patient-specific cardiac electromechanical modeling of pre-MVCA.

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참고문헌

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