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Towards improving the accuracy of aortic transvalvular pressure gradients: rethinking Bernoulli

The transvalvular pressure gradient (TPG) is commonly estimated using the Bernoulli equation. However, the method is known to be inaccurate. Therefore, an adjusted Bernoulli model for accurate TPG assessment was developed and evaluated. Numerical simulations were used to calculate TPG(CFD) in patien...

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Autores principales: Franke, Benedikt, Weese, J., Waechter-Stehle, I., Brüning, J., Kuehne, T., Goubergrits, L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340661/
https://www.ncbi.nlm.nih.gov/pubmed/32451697
http://dx.doi.org/10.1007/s11517-020-02186-w
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author Franke, Benedikt
Weese, J.
Waechter-Stehle, I.
Brüning, J.
Kuehne, T.
Goubergrits, L.
author_facet Franke, Benedikt
Weese, J.
Waechter-Stehle, I.
Brüning, J.
Kuehne, T.
Goubergrits, L.
author_sort Franke, Benedikt
collection PubMed
description The transvalvular pressure gradient (TPG) is commonly estimated using the Bernoulli equation. However, the method is known to be inaccurate. Therefore, an adjusted Bernoulli model for accurate TPG assessment was developed and evaluated. Numerical simulations were used to calculate TPG(CFD) in patient-specific geometries of aortic stenosis as ground truth. Geometries, aortic valve areas (AVA), and flow rates were derived from computed tomography scans. Simulations were divided in a training data set (135 cases) and a test data set (36 cases). The training data was used to fit an adjusted Bernoulli model as a function of AVA and flow rate. The model-predicted TPG(Model) was evaluated using the test data set and also compared against the common Bernoulli equation (TPG(B)). TPG(B) and TPG(Model) both correlated well with TPG(CFD) (r > 0.94), but significantly overestimated it. The average difference between TPG(Model) and TPG(CFD) was much lower: 3.3 mmHg vs. 17.3 mmHg between TPG(B) and TPG(CFD). Also, the standard error of estimate was lower for the adjusted model: SEE(Model) = 5.3 mmHg vs. SEE(B) = 22.3 mmHg. The adjusted model’s performance was more accurate than that of the conventional Bernoulli equation. The model might help to improve non-invasive assessment of TPG. [Figure: see text]
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spelling pubmed-73406612020-07-09 Towards improving the accuracy of aortic transvalvular pressure gradients: rethinking Bernoulli Franke, Benedikt Weese, J. Waechter-Stehle, I. Brüning, J. Kuehne, T. Goubergrits, L. Med Biol Eng Comput Original Article The transvalvular pressure gradient (TPG) is commonly estimated using the Bernoulli equation. However, the method is known to be inaccurate. Therefore, an adjusted Bernoulli model for accurate TPG assessment was developed and evaluated. Numerical simulations were used to calculate TPG(CFD) in patient-specific geometries of aortic stenosis as ground truth. Geometries, aortic valve areas (AVA), and flow rates were derived from computed tomography scans. Simulations were divided in a training data set (135 cases) and a test data set (36 cases). The training data was used to fit an adjusted Bernoulli model as a function of AVA and flow rate. The model-predicted TPG(Model) was evaluated using the test data set and also compared against the common Bernoulli equation (TPG(B)). TPG(B) and TPG(Model) both correlated well with TPG(CFD) (r > 0.94), but significantly overestimated it. The average difference between TPG(Model) and TPG(CFD) was much lower: 3.3 mmHg vs. 17.3 mmHg between TPG(B) and TPG(CFD). Also, the standard error of estimate was lower for the adjusted model: SEE(Model) = 5.3 mmHg vs. SEE(B) = 22.3 mmHg. The adjusted model’s performance was more accurate than that of the conventional Bernoulli equation. The model might help to improve non-invasive assessment of TPG. [Figure: see text] Springer Berlin Heidelberg 2020-05-26 2020 /pmc/articles/PMC7340661/ /pubmed/32451697 http://dx.doi.org/10.1007/s11517-020-02186-w Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Article
Franke, Benedikt
Weese, J.
Waechter-Stehle, I.
Brüning, J.
Kuehne, T.
Goubergrits, L.
Towards improving the accuracy of aortic transvalvular pressure gradients: rethinking Bernoulli
title Towards improving the accuracy of aortic transvalvular pressure gradients: rethinking Bernoulli
title_full Towards improving the accuracy of aortic transvalvular pressure gradients: rethinking Bernoulli
title_fullStr Towards improving the accuracy of aortic transvalvular pressure gradients: rethinking Bernoulli
title_full_unstemmed Towards improving the accuracy of aortic transvalvular pressure gradients: rethinking Bernoulli
title_short Towards improving the accuracy of aortic transvalvular pressure gradients: rethinking Bernoulli
title_sort towards improving the accuracy of aortic transvalvular pressure gradients: rethinking bernoulli
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340661/
https://www.ncbi.nlm.nih.gov/pubmed/32451697
http://dx.doi.org/10.1007/s11517-020-02186-w
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