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结合计算机建模和心脏成像技术理解右心室泵功能。

Combining computer modelling and cardiac imaging to understand right ventricular pump function.

机构信息

CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands.

Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

Cardiovasc Res. 2017 Oct 1;113(12):1486-1498. doi: 10.1093/cvr/cvx154.

Abstract

Right ventricular (RV) dysfunction is a strong predictor of outcome in heart failure and is a key determinant of exercise capacity. Despite these crucial findings, the RV remains understudied in the clinical, experimental, and computer modelling literature. This review outlines how recent advances in using computer modelling and cardiac imaging synergistically help to understand RV function in health and disease. We begin by highlighting the complexity of interactions that make modelling the RV both challenging and necessary, and then summarize the multiscale modelling approaches used to date to simulate RV pump function in the context of these interactions. We go on to demonstrate how these modelling approaches in combination with cardiac imaging have improved understanding of RV pump function in pulmonary arterial hypertension, arrhythmogenic right ventricular cardiomyopathy, dyssynchronous heart failure and cardiac resynchronization therapy, hypoplastic left heart syndrome, and repaired tetralogy of Fallot. We conclude with a perspective on key issues to be addressed by computational models of the RV in the near future.

摘要

右心室(RV)功能障碍是心力衰竭预后的强有力预测因子,也是运动能力的关键决定因素。尽管有这些重要发现,但 RV 在临床、实验和计算机建模文献中的研究仍不够充分。本综述概述了如何利用计算机建模和心脏成像的最新进展协同工作,以帮助理解健康和疾病状态下的 RV 功能。我们首先强调了使 RV 建模具有挑战性和必要性的相互作用的复杂性,然后总结了迄今为止用于模拟 RV 泵功能的多尺度建模方法,这些方法考虑了这些相互作用。接着,我们展示了这些建模方法与心脏成像相结合如何提高对肺动脉高压、致心律失常性右心室心肌病、不同步心力衰竭和心脏再同步治疗、左心发育不全综合征以及法洛四联症修复后 RV 泵功能的理解。最后,我们对 RV 计算模型在不久的将来需要解决的关键问题进行了展望。

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