title: Cardiac MRI based numerical modeling of left ventricular fluid dynamics with mitral valve incorporated.
abstract: Recent numerical studies were focused on the modeling of flow in patient-specific left ventricle (LV); however, the mitral valve (MV) was usually excluded. In this study, both patient-specific LV and MV were modeled to achieve a more realistic intraventricular flow. Cardiac MRI images were acquired from a pulmonary arterial hypertension (PAH) patient and a healthy volunteer, and manual segmentation was conducted to reconstruct three-dimensional (3D) LV and MV geometries at each frame. Based on these 3D geometries, vortex formation time (VFT) was derived, and the values were 4.0 and 6.5 for the normal subject and the PAH patient, respectively. Based on studies in the literature, VTF in the healthy subject fell within the normal range, while that in the PAH patient exceeded the threshold for normality. The vortex structures in the LV clearly showed that the vortex ring was initiated from the tips of the MV instead of the mitral annulus. The excessive VFT during the rapid filling phase in the PAH patient resulted in a trailing flow structure behind the primary vortex ring, which was not observed in the normal subject. It can be deduced from this study that incorporating the MV into a patient-specific model is necessary to produce more reasonable VFT and intraventricular flow.
authors.affiliation: National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore.
authors.forename: Boyang
authors.initials: B
authors.lastname: Su
authors.affiliation: National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore; Duke-NUS Graduate Medical School Singapore, Singapore.
authors.forename: Ru San
authors.initials: RS
authors.lastname: Tan
authors.affiliation: National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore.
authors.forename: Ju Le
authors.initials: JL
authors.lastname: Tan
authors.affiliation: National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore.
authors.forename: Kenneth Wei Qiang
authors.initials: KWQ
authors.lastname: Guo
authors.affiliation: National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore; Duke-NUS Graduate Medical School Singapore, Singapore.
authors.forename: Jun Mei
authors.initials: JM
authors.lastname: Zhang
authors.affiliation: National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore.
authors.forename: Shuang
authors.initials: S
authors.lastname: Leng
authors.affiliation: National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore.
authors.forename: Xiaodan
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Duke-NUS Graduate Medical School Singapore, Singapore.
authors.forename: John Carson
authors.initials: JC
authors.lastname: Allen
authors.affiliation: National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore; Duke-NUS Graduate Medical School Singapore, Singapore. Electronic address: zhong.liang@nhcs.com.sg.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhong
mesh_terms: D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D057446:Hydrodynamics; D006976:Hypertension, Pulmonary / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008943:Mitral Valve / Q000502:physiology*; D008955:Models, Cardiovascular; D016277:Ventricular Function, Left
keywords: Bileaflet mitral valve; Computational fluid dynamics; Patient-specific; Vortex formation