Thomas J D, Weyman A E
Noninvasive Cardiac Laboratory, Massachusetts General Hospital, Boston 02114.
J Am Coll Cardiol. 1989 Jan;13(1):221-33. doi: 10.1016/0735-1097(89)90575-5.
A lumped variable fluid dynamics model of mitral valve blood flow is described that is applicable to both Doppler echocardiography and invasive hemodynamic measurement. Given left atrial and ventricular compliance, initial pressures and mitral valve impedance, the model predicts the time course of mitral flow and atrial and ventricular pressure. The predictions of this mathematic formulation have been tested in an in vitro analog of the left heart in which mitral valve area and atrial and ventricular compliance can be accurately controlled. For the situation of constant chamber compliance, transmitral gradient is predicted to decay as a parabolic curve, and this has been confirmed in the in vitro model with r greater than 0.99 in all cases for a range of orifice area from 0.3 to 3.0 cm2, initial pressure gradient from 2.4 to 14.2 mm Hg and net chamber compliance from 16 to 29 cc/mm Hg. This mathematic formulation of transmitral flow should help to unify the Doppler echocardiographic and catheterization assessment of mitral stenosis and left ventricular diastolic dysfunction.
描述了一种二尖瓣血流的集总变量流体动力学模型，该模型适用于多普勒超声心动图和有创血流动力学测量。给定左心房和心室的顺应性、初始压力和二尖瓣阻抗，该模型可预测二尖瓣血流以及心房和心室压力随时间的变化过程。此数学公式的预测结果已在左心的体外模拟模型中得到验证，在该模型中，二尖瓣面积以及心房和心室的顺应性均可精确控制。对于腔室顺应性恒定的情况，预测跨二尖瓣梯度将呈抛物线形衰减，并且在体外模型中已得到证实，对于一系列不同参数：瓣口面积从0.3至3.0平方厘米、初始压力梯度从2.4至14.2毫米汞柱以及净腔室顺应性从16至29立方厘米/毫米汞柱，所有情况下相关系数r均大于0.99。这种跨二尖瓣血流的数学公式应有助于统一二尖瓣狭窄和左心室舒张功能障碍的多普勒超声心动图评估和心导管检查评估。
