School of Biomedical Engineering, University of Western Ontario, London, Canada.
Department of Mechanical and Materials Engineering, Faculty of Engineering, University of Western Ontario, London, Canada.
Ann Biomed Eng. 2023 Sep;51(9):2070-2085. doi: 10.1007/s10439-023-03235-9. Epub 2023 May 25.
Commotio cordis is one of the leading causes of sudden cardiac death in youth baseball. Currently, there are chest protector regulations regarding the prevention of Commotio cordis in baseball and lacrosse; however, they are not fully optimized. For the advancement of Commotio cordis safety, it is vital to include various age groups and a variety of impact angles in the testing process. This study employed finite element models and simulated Commotio cordis-inducing baseball collisions for different velocities, impact angles, and age groups. Commotio cordis risk response was characterized in terms of left ventricular strain and pressure, chest band and rib deformation, and force from impact. Normalized rib and chest band deformation when correlated with left ventricular strain resulted in R = 0.72, and R = 0.76, while left ventricular pressure resulted in R = 0.77, R = 0.68 across all velocities and impact angles in the child models. By contrast, the resultant reaction force risk metric as used by the National Operating Committee on Standards for Athletic Equipment (NOCSAE) demonstrated a correlation of R = 0.20 in the child models to ventricular strain, while illustrating a correlation to pressure of R = 0.74. When exploring future revisions to Commotio cordis safety requirements, the inclusion of deformation-related risk metrics at the level of the left ventricle should be considered.
心震是导致青少年棒球运动中心脏性猝死的主要原因之一。目前，棒球和长曲棍球中已有针对心震预防的护胸器规定，但这些规定还没有得到充分优化。为了提高心震安全性，测试过程中必须纳入各种年龄段和各种撞击角度。本研究采用有限元模型，模拟了不同速度、撞击角度和年龄段的引发心震的棒球撞击。心震风险反应的特征是左心室应变和压力、胸带和肋骨变形以及撞击力。正常化的肋骨和胸带变形与左心室应变相关，得出 R=0.72 和 R=0.76，而左心室压力则得出 R=0.77 和 R=0.68，这是在儿童模型中所有速度和撞击角度下的结果。相比之下，国家运动器材标准委员会（NOCSAE）使用的合成反应力风险指标在儿童模型中与心室应变的相关性为 R=0.20，而与压力的相关性为 R=0.74。在探索心震安全要求的未来修订时，应考虑纳入左心室水平的与变形相关的风险指标。
