A novel in vivo assessment of fluid dynamics on aortic valve leaflet using epi‐aortic echocardiogram
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- Hideyuki Hayashi
- Division of Cardiothoracic Surgery Department of Surgery Columbia University Medical Center New York NY USA
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- Koichi Akiyama
- Department of Anesthesiology Yodogawa Christian Hospital Osaka Japan
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- Keiichi Itatani
- Department of Cardiovascular Surgery Kyoto Prefectural University of Medicine Kyoto Japan
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- Scott DeRoo
- Division of Cardiothoracic Surgery Department of Surgery Columbia University Medical Center New York NY USA
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- Joseph Sanchez
- Division of Cardiothoracic Surgery Department of Surgery Columbia University Medical Center New York NY USA
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- Giovanni Ferrari
- Department of Surgery and Biomedical Engineering Columbia University Medical New York NY USA
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- Paolo C. Colombo
- Division of Cardiology Department of Medicine Columbia University Medical Center New York NY USA
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- Koji Takeda
- Division of Cardiothoracic Surgery Department of Surgery Columbia University Medical Center New York NY USA
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- Isaac Y. Wu
- Department of Anesthesiology Columbia University Medical Center New York NY USA
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- Atsushi Kainuma
- Division of Cardiothoracic Surgery Department of Surgery Columbia University Medical Center New York NY USA
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- Hiroo Takayama
- Division of Cardiothoracic Surgery Department of Surgery Columbia University Medical Center New York NY USA
説明
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Mechanical stress caused by blood flow, such as wall shear stress (WSS) and its related parameters, is key moderator of endothelial degeneration. However, an in vivo method to measure WSS on heart valves has not been developed.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We developed a novel approach, based on vector flow mapping using intraoperative epi‐aortic echocardiogram, to measure WSS and oscillatory shear index (OSI) on the aortic valve. We prospectively enrolled 15 patients with normal valves, who underwent coronary artery bypass graft.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Systolic WSS on the ventricularis (2.40 ± 0.44 Pa [1.45‐3.00 Pa]) was higher than systolic WSS on the fibrosa (0.33 ± 0.08 Pa [0.14‐0.47 Pa], <jats:italic>P</jats:italic> < .001) and diastolic WSS on the ventricularis (0.18 ± 0.07 Pa [0.04‐0.28 Pa], <jats:italic>P</jats:italic> < .001). Oscillatory shear index on the fibrosa was higher than on the ventricularis (0.29 ± 0.04 [0.24‐0.36] vs 0.05 ± 0.03 [0.01‐0.12], <jats:italic>P</jats:italic> < .001). A pilot study involving two patients with severe aortic regurgitation showed significantly different values in fluid dynamics.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Vector flow mapping method using intraoperative epi‐aortic echocardiogram is an effective way of measuring WSS and OSI on normal aortic leaflet in vivo, allowing for better understanding of the pathophysiology of aortic valve diseases.</jats:p></jats:sec>
収録刊行物
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- Echocardiography
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Echocardiography 37 (2), 323-330, 2020-01-31
Wiley
