Rizkallah Ann, Deer Ashley, Katkic Mitchell, Millard Jonathan A
Edward Via College of Osteopathic Medicine, Blacksburg, VA, USA.
Department of Biomedical Sciences, Edward Via College of Osteopathic Medicine, Blacksburg, VA, USA.
Surg Radiol Anat. 2025 Apr 3;47(1):114. doi: 10.1007/s00276-025-03617-9.
The pulmonary valve comprises three leaflets which attach to the wall of the right ventricle via the annulus. The purpose of this study is to describe the leaflet attachment pattern of the pulmonary valve using landmark-based geometric morphometric techniques and explore the relationship between shape variables and size.
A total of 28 pulmonary valves were harvested from anatomical donors. The valves were opened and photographed in a standardized manner. A geometric morphometric landmark protocol was digitally applied to each photograph. Generalized Procrustes superimposition and an ordination analysis were used to assess valve shape. The relationship between major components of valve shape and centroid size were investigated. Ten valves were repinned and photographed by another researcher to evaluate the role of error in the results.
The principal component analysis (PCA) revealed several patterns in pulmonary valve leaflet attachment. Principal component 1 (PC1) accounted for 40.6% of the variation in the sample; its major axis of variation reflects a curvature in the ends of the open outflow tract which corresponds with natural variability in the circumference of the tract between the level of the annulus and sinotubular junction. Principal component 2 accounted for 19.2% of the variation in the sample and was associated with asymmetry in peak leaflet attachment. Uniform variation in sinus depth was seen along PC3 (12.7%). Principal component 4 was associated with non-uniform asymmetric variation in sinus depth and accounted for 7.5% of the variation in the sample. No association was found between the size and shape of the valve. Error study results demonstrated the process of pinning and photographing had a marginal effect shape outcomes.
Our results show notable variability in pulmonary valve leaflet attachment pattern. Shape variables had no relationship with valve centroid size. More nuanced morphologic analyses may stimulate physiologic questions aimed at assessing the relationship between valve morphology and performance.
肺动脉瓣由三个瓣叶组成，通过瓣环附着于右心室壁。本研究的目的是使用基于地标点的几何形态测量技术描述肺动脉瓣瓣叶的附着模式，并探讨形状变量与大小之间的关系。
从解剖学供体中获取了28个肺动脉瓣。以标准化方式打开瓣膜并拍照。将几何形态测量地标方案数字应用于每张照片。使用广义普罗克拉斯提斯叠加法和排序分析来评估瓣膜形状。研究了瓣膜形状的主要组成部分与质心大小之间的关系。由另一位研究人员重新固定并拍摄了10个瓣膜，以评估误差对结果的影响。
主成分分析（PCA）揭示了肺动脉瓣瓣叶附着的几种模式。主成分1（PC1）占样本变异的40.6%；其主要变异轴反映了开放流出道末端的曲率，这与瓣环水平和窦管交界之间管道周长的自然变异性相对应。主成分2占样本变异的19.2%，与瓣叶附着峰值的不对称性有关。沿主成分3（PC3，占12.7%）观察到窦深度的均匀变化。主成分4与窦深度的非均匀不对称变化有关，占样本变异的7.5%。未发现瓣膜大小与形状之间存在关联。误差研究结果表明，固定和拍照过程对形状结果的影响很小。
我们的结果显示肺动脉瓣瓣叶附着模式存在显著变异性。形状变量与瓣膜质心大小无关。更细致的形态学分析可能会引发旨在评估瓣膜形态与性能之间关系的生理学问题。
