Effect of Blood Pressure Levels on Sinus Hemodynamics in Relation to Calcification After Bioprosthetic Aortic Valve Replacement

© 2023. The Author(s) under exclusive licence to Biomedical Engineering Society..

Coexisting hypertension and aortic stenosis are common. Some studies showed that elevated blood pressures may be associated with progression of calcific aortic valve disease (CAVD) while others showed no correlation. Flow dynamics in the sinuses of Valsalva are considered key factors in the progression of CAVD. While the relationship between hemodynamics and CAVD is not yet fully understood, it has been demonstrated that they are tightly correlated. This study aims to investigate the effect of changing systolic and diastolic blood pressures (SBP and DBP, respectively) on sinus hemodynamics in relation to potential initiation or progression of CAVD after aortic valve replacement (AVR). Evolut R, SAPIEN 3 and Magna valves were deployed in an aortic root under pulsatile conditions. Using particle image velocimetry, the hemodynamics in the sinus were assessed. The velocity, vorticity, circulation ( Γ ) and shear stress were calculated. This study shows that under elevated SBP and DBP, velocity, vorticity, and shear stress nearby the leaflets increased. Additionally, larger fluctuations of Γ and area under the curve throughout the cardiac cycle were observed. Elevated blood pressures are associated with higher velocity, vorticity, and shear stress near the leaflets which may initiate or accelerate pro-calcific changes in the prosthetic leaflets leading to bioprosthetic valve degeneration.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:52

Enthalten in:

Annals of biomedical engineering - 52(2024), 4 vom: 13. März, Seite 888-897

Sprache:

Englisch

Beteiligte Personen:

Vogl, Brennan [VerfasserIn]
Sularz, Agata [VerfasserIn]
Lilly, Scott [VerfasserIn]
Thourani, Vinod H [VerfasserIn]
Lindman, Brian R [VerfasserIn]
Alkhouli, Mohamad [VerfasserIn]
Hatoum, Hoda [VerfasserIn]

Links:

Volltext

Themen:

Hypertension
Journal Article
Particle image velocimetry
Sinus flow
Surgical aortic valve replacement
Transcatheter aortic valve replacement

Anmerkungen:

Date Completed 15.03.2024

Date Revised 15.03.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s10439-023-03426-4

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM366477579