Model-based aortic power transfer: A potential measure for quantifying aortic stenosis severity based on measured data

• Published in: Medical engineering & physics Vol. 90; pp. 66 - 81
• Main Authors: Meiburg, R., Zelis, Jo M., van ’t Veer, J. Marcel, van Velthoven, Sjors J.A., van de Vosse, Frans N., Tonino, Pim. A.L., Rutten, Marcel C.M.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2021
• ISSN: 1350-4533; 1873-4030
• DOI: 10.1016/j.medengphy.2021.02.009

•Power transfer efficiency from ventricle to aorta was estimated using a 0D model.•Aortic valve area variability explains non-trivial pressure-flow behaviour of the valve.•A data assimilation approach was used for estimating missing data and synchronization.•Power transfer efficiency is heterogeneous and load-dependent.•Power transfer is a promising alternative measure in aortic stenosis grading. Current aortic stenosis severity grading is based mainly on the local properties of the stenotic valve, such as pressure gradient or jet velocity. Success rates of valve replacement therapy are still suboptimal, so alternative grading of AS should be investigated. We suggest the efficiency of power transfer from the left ventricle to the aorta, as it takes into account heart, valve and circulatory system. Left ventricular and circulatory power were estimated using a 0D model, which was optimised to patient data: left ventricular and aortic pressure, aortic flow and diastolic left ventricular volume. Optimisation was performed using a data assimilation method. These data were available in rest as well as chemically induced exercise for twelve patients. Using this limited data set, we showed that aortic valve efficiency is highly heterogeneous between patients, but also often dependent on the haemodynamic load. This indicates that power transfer efficiency is a highly interesting metric for further research in aortic stenosis.