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短期左心室辅助装置对心力衰竭患者特异性主动脉模型血流动力学的影响:一项计算流体动力学研究。

Effects of a Short-Term Left Ventricular Assist Device on Hemodynamics in a Heart Failure Patient-Specific Aorta Model: A CFD Study.

作者信息

Wang Yu, Wang Junwei, Peng Jing, Huo Mingming, Yang Zhiqiang, Giridharan Guruprasad A, Luan Yong, Qin Kairong

机构信息

School of Optoelectronic Engineering and Instrumentation Science, Dalian University of Technology, Dalian, China.

Department of Cardiovascular Computed Tomography (CT) Examination, The First Affiliated Hospital of Dalian Medical University, Dalian, China.

出版信息

Front Physiol. 2021 Sep 21;12:733464. doi: 10.3389/fphys.2021.733464. eCollection 2021.

Abstract

Patients with heart failure (HF) or undergoing cardiogenic shock and percutaneous coronary intervention require short-term cardiac support. Short-term cardiac support using a left ventricular assist device (LVAD) alters the pressure and flows of the vasculature by enhancing perfusion and improving the hemodynamic performance for the HF patients. However, due to the position of the inflow and outflow of the LVAD, the local hemodynamics within the aorta is altered with the LVAD support. Specifically, blood velocity, wall shear stress, and pressure difference are altered within the aorta. In this study, computational fluid dynamics (CFD) was used to elucidate the effects of a short-term LVAD for hemodynamic performance in a patient-specific aorta model. The three-dimensional (3D) geometric models of a patient-specific aorta and a short-term LVAD, Impella CP, were created. Velocity, wall shear stress, and pressure difference in the patient-specific aorta model with the Impella CP assistance were calculated and compared with the baseline values of the aorta without Impella CP support. Impella CP support augmented cardiac output, blood velocity, wall shear stress, and pressure difference in the aorta. The proposed CFD study could analyze the quantitative changes in the important hemodynamic parameters while considering the effects of Impella CP, and provide a scientific basis for further predicting and assessing the effects of these hemodynamic signals on the aorta.

摘要

心力衰竭(HF)患者或正在经历心源性休克并接受经皮冠状动脉介入治疗的患者需要短期心脏支持。使用左心室辅助装置(LVAD)进行短期心脏支持可通过增强灌注和改善HF患者的血流动力学性能来改变血管系统的压力和血流。然而,由于LVAD流入和流出的位置,在LVAD支持下主动脉内的局部血流动力学发生改变。具体而言,主动脉内的血流速度、壁面剪应力和压力差会发生改变。在本研究中,使用计算流体动力学(CFD)来阐明短期LVAD对特定患者主动脉模型中血流动力学性能的影响。创建了特定患者主动脉和短期LVAD(Impella CP)的三维(3D)几何模型。计算了在Impella CP辅助下特定患者主动脉模型中的速度、壁面剪应力和压力差,并与没有Impella CP支持时主动脉的基线值进行比较。Impella CP支持增加了主动脉的心输出量、血流速度、壁面剪应力和压力差。所提出的CFD研究可以在考虑Impella CP影响的同时分析重要血流动力学参数的定量变化,并为进一步预测和评估这些血流动力学信号对主动脉的影响提供科学依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0da3/8491745/08ebeec652fe/fphys-12-733464-g0001.jpg

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