Key result
Coupled mitral valve-LV computational model accurately simulates cardiac function and matches in vivo data.
Why the study?
Understanding the interaction between heart valves and walls is important for assessing and treating heart dysfunction.
A novel coupled mitral valve-left ventricle computational model accurately simulates cardiac function and demonstrates increased diastolic filling pressure with impaired relaxation.
May support mechanistic insights into diastolic dysfunction; leaves open clinical translation pending prospective validation.
Understanding the interaction between the valves and walls of the heart is important in assessing and subsequently treating heart dysfunction. This study presents an integrated model of the mitral valve (MV) coupled to the left ventricle (LV), with the geometry derived from in vivo clinical magnetic resonance images. Numerical simulations using this coupled MV-LV model are developed using an immersed boundary/finite element method. The model incorporates detailed valvular features, left ventricular contraction, nonlinear soft tissue mechanics, and fluid-mediated interactions between the MV and LV wall. We use the model to simulate cardiac function from diastole to systole. Numerically predicted LV pump function agrees well with in vivo data of the imaged healthy volunteer, including the peak aortic flow rate, the systolic ejection duration, and the LV ejection fraction. In vivo MV dynamics are qualitatively captured. We further demonstrate that the diastolic filling pressure increases significantly with impaired myocardial active relaxation to maintain a normal cardiac output. This is consistent with clinical observations. The coupled model has the potential to advance our fundamental knowledge of mechanisms underlying MV-LV interaction, and help in risk stratification and optimisation of therapies for heart diseases.
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Luo et al. (2020) studied Healthy volunteer (n=1). Coupled mitral valve-left ventricle model with fluid-structure interaction vs. In vivo data was evaluated on LV pump function (peak aortic flow rate, systolic ejection duration, LV ejection fraction). A coupled mitral valve-left ventricle model successfully simulated cardiac function, with numerically predicted LV pump function agreeing well with in vivo data.
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