An Image-based Computational Hemodynamics Study of the Systolic Anterior Motion of the Mitral Valve

15/2020

An Image-based Computational Hemodynamics Study of the Systolic Anterior Motion of the Mitral Valve

Saturday 22nd February 2020

Fumagalli, I.; Fedele, M.; Vergara, C.; Dede', L.; Ippolito, S.; Nicolò, F.; Antona, C.; Scrofani, R.; Quarteroni, A.

Systolic Anterior Motion (SAM) of the mitral valve -- often associated to Hypertrophic Obstructive Cardiomyopathy (HOCM) -- is a cardiac pathology in which, during systole, a functional subaortic stenosis is induced by the mitral leaflets partially obstructing the outflow tract of the left ventricle. Its assessment by diagnostic tests is often difficult, possibly underestimating its severity and thus increasing the risk of sudden cardiac death. In the present work, the effects of SAM on the ventricular blood flow are investigated by means of Computational Fluid Dynamics (CFD) simulations. A novel image processing pipeline is set up to integrate cine-MRI data in the numerical model. Patient-specific geometry and motion of the left ventricle are accounted for by an Arbitrary Lagrangian-Eulerian approach, and the reconstructed mitral valve is immersed in the computational domain by means of a resistive method. Clinically relevant flow and pressure indicators are assessed for different degrees of SAM severity, in order to separate the effects of SAM from those of HOCM. Our numerical results and study provide preliminary indications that help better evaluating pathological condition and the design of its surgical treatment.

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Computers in Biology and Medicine, 123 (2020), 103922.