Dynamics of systolic pulmonary, venous flow in mitral regurgitation: Mathematical modeling of the pulmonary venous system and atrium

摘要: The noninvasive assessment, of mitral regurgitation has been an elusive clinical goal. Recent studies have high-lighted the value pulmonary venous (PV) flow reversal in indicating presence severe regurgitation. purpose this study was to explore basic determinants PV inflow and absence In particular, hypothesis that systolic depends on interaction regurgitant volume with atrial properties (compliance, initial volume, total area veins at junction, inertia inflow) tested further, combination these variables, rather than alone, determines inflow. A mathematical model atrium developed. Atrial pressure were modeled as product chamber elastance where varied time simulate relaxation descent anulus. simplification modified unsteady Bernoulli equation used compute velocities resulted from developed gradient. modeling performed over a range elastances (0.77 0.2 mm Hg/cc), volumes (20 75 cc), areas (3.12 5.12 cm 2 ), inertances (8 18 gm/cm without addition two jets (regurgitant 20 60 cc). realistically simulated waveform magnitude morphology. As increased, peak velocity decreased, eventually late occurred. However, velocity, flow, influenced by compliance, inlet area, inertia. This found blunting increased decreased increased. inertia), acting combination, mediate physiologic impact lesion terms resulting rise reflected pattern influx. For example, is more likely acute compared chronic because less compliant smaller volume. There-fore, assessment using changes must be viewed context properties.