经导管缘对缘修复对左心室血流特征的影响。
Effect of Transcatheter Edge-to-Edge Repair on Left Ventricular Flow Features.
作者信息
He Xinyi, Feng Shuyi, Wu Fan, Wang Hongping, Wang Shizhao, Pan Xiangbin
机构信息
The State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing, 100190, China.
School of Engineering Science, University of Chinese Academy of Sciences, Beijing, 100049, China.
出版信息
Cardiovasc Eng Technol. 2025 Apr 3. doi: 10.1007/s13239-025-00781-2.
PURPOSE
This study aims to investigate the effects of transcatheter edge-to-edge repair (TEER) on left ventricular hemodynamics and its potential implications for patient health.
METHODS
An in vitro experimental platform was designed to replicate the anatomical and functional characteristics of the left ventricle (LV). This platform integrates native porcine mitral and aortic valves with a patient-specific 3D-printed silicone LV. The LV hemodynamics after TEER is assessed using echocardiography and particle image velocimetry, focusing on critical indices such as vorticity, Reynolds shear stress (RSS), viscous shear stress (VSS), and energy dissipation rate (ε).
RESULTS
TEER effectively reduces the degree of mitral regurgitation (MR); however, it significantly increases RSS, VSS, and ε due to the formation of numerous small-scale vortices in the LV.
CONCLUSION
These hemodynamic changes may lead to adverse left ventricular remodeling, red blood cell damage, and reduced cardiac pumping efficiency, which have to be taken into consideration to optimize the TEER procedure and improve patient outcomes.
目的
本研究旨在探讨经导管缘对缘修复术（TEER）对左心室血流动力学的影响及其对患者健康的潜在影响。
方法
设计了一个体外实验平台，以复制左心室（LV）的解剖和功能特征。该平台将天然猪二尖瓣和主动脉瓣与患者特异性3D打印硅胶左心室整合在一起。使用超声心动图和粒子图像测速技术评估TEER术后的左心室血流动力学，重点关注诸如涡度、雷诺剪切应力（RSS）、粘性剪切应力（VSS）和能量耗散率（ε）等关键指标。
结果
TEER有效降低二尖瓣反流（MR）程度；然而，由于左心室内形成大量小尺度涡旋，它会显著增加RSS、VSS和ε。
结论
这些血流动力学变化可能导致不良的左心室重构、红细胞损伤和心脏泵血效率降低，在优化TEER手术和改善患者预后时必须考虑到这些因素。
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