Understanding the aortic isthmus Doppler profile and its changes with gestational age using a lumped model of the fetal circulation

Objective: The aortic isthmus (AoI) blood flow has a characteristic shape with a small end-systolic notch observed during the third trimester of pregnancy. However, what causes the appearance of this notch is not fully understood. We used a lumped model of the fetal circulation to study the possible...

ver descrição completa

Detalhes bibliográficos
Autores: Garcia Canadilla, Patricia, Crispi Brillas, Fàtima, Cruz-Lemini, Mónica, Valenzuela Alcaraz, Brenda, Rudenick, Paula A., Gratacós Solsona, Eduard, Bijnens, Bart
Formato: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2017
País:España
Recursos:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/36986
Acesso em linha:http://hdl.handle.net/10230/36986
http://dx.doi.org/10.1159/000444142
Access Level:acceso abierto
Palavra-chave:Computational model
Aortic isthmus
Fetal circulation
Doppler
id ES_d346748b7a63c73d2ea0ecf4076e6af3
oai_identifier_str oai:recercat.cat:10230/36986
network_acronym_str ES
network_name_str España
repository_id_str
spelling Understanding the aortic isthmus Doppler profile and its changes with gestational age using a lumped model of the fetal circulationGarcia Canadilla, PatriciaCrispi Brillas, FàtimaCruz-Lemini, MónicaValenzuela Alcaraz, BrendaRudenick, Paula A.Gratacós Solsona, EduardBijnens, BartComputational modelAortic isthmusFetal circulationDopplerObjective: The aortic isthmus (AoI) blood flow has a characteristic shape with a small end-systolic notch observed during the third trimester of pregnancy. However, what causes the appearance of this notch is not fully understood. We used a lumped model of the fetal circulation to study the possible factors causing the end-systolic notch and the changes of AoI flow through gestation. Methods: A validation of the model was performed by fitting patient-specific data from two normal fetuses. Then, different parametric analyses were performed to evaluate the major determinants of the appearance of the end-systolic notch. The changes in the AoI flow profile through gestation were assessed. Results: Our model allows to simulate the AoI waveform. The delay in the onset of ejection together with the longer ejection duration of the right ventricle are the most relevant factors in the origin of the notch. It appears around 25 weeks of gestation and becomes more pronounced with advancing gestation. Discussion: We demonstrated that the end-systolic notch on the AoI flow occurs mainly as a result of a delayed and longer ejection of the right ventricle. Our findings improve the understanding of hemodynamic changes in the fetal circulation and the interpretation of clinical imaging.This study was partly supported by grants from Ministerio de Economia y Competitividad (ref. SAF2012-37196, TIN2014-52923-R); the Instituto de Salud Carlos III (ref. (PI11/01709, PI12/00801, PI14/00226) integrado en el Plan Nacional de I+D+I y cofinanciado por el ISCIII-Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER) “Otra manera de hacer Europa”; the 1 EU FP7 for research, technological development and demonstration under grant agreement VP2HF (no 611823); The Cerebra Foundation for the Brain Injured Child (Carmarthen, Wales, UK); Obra Social "la Caixa” (Barcelona, Spain); Fundació Mutua Madrileña and Fundació Agrupació Mutua (Spain) and AGAUR 2014 SGR grant nº 928 (Barcelona, Spain). P.G.C. was supported by the Programa de Ayudas Predoctorales de Formación en investigación en Salud (FI12/00362) from the Instituto Carlos III, Spain. M.C.L. and B.V.A. wish to express her gratitude to the Mexican National Council for Science and Technology (CONACyT, Mexico City, Mexico) for supporting her predoctoral stay at Hospital Clinic, Barcelona, Spain.Karger (S. Karger AG)201920192017info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/36986http://dx.doi.org/10.1159/000444142reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésFetal Diagnosis and Therapy. 2017 February;41(1):41-50info:eu-repo/grantAgreement/ES/3PN/SAF2012-37196info:eu-repo/grantAgreement/ES/1PE/TIN2014-52923-Rinfo:eu-repo/grantAgreement/EC/FP7/611823© 2017 S. Karger AG, Basel ‘This is the peer-reviewed but unedited manuscript version of the following article: Garcia-Canadilla P, Crispi F, Cruz-Lemini M, Valenzuela-Alcaraz B, Rudenick PA, Gratacos E, Bijnens BH. Understanding the aortic isthmus Doppler profile and its changes with gestational age using a lumped model of the fetal circulation. Fetal Diagn Ther. 2017 February;41(1):41-50. The final, published version is available at http://dx.doi.org/10.1159/000444142info:eu-repo/semantics/openAccessoai:recercat.cat:10230/369862026-05-29T05:05:01Z
dc.title.none.fl_str_mv Understanding the aortic isthmus Doppler profile and its changes with gestational age using a lumped model of the fetal circulation
title Understanding the aortic isthmus Doppler profile and its changes with gestational age using a lumped model of the fetal circulation
spellingShingle Understanding the aortic isthmus Doppler profile and its changes with gestational age using a lumped model of the fetal circulation
Garcia Canadilla, Patricia
Computational model
Aortic isthmus
Fetal circulation
Doppler
title_short Understanding the aortic isthmus Doppler profile and its changes with gestational age using a lumped model of the fetal circulation
title_full Understanding the aortic isthmus Doppler profile and its changes with gestational age using a lumped model of the fetal circulation
title_fullStr Understanding the aortic isthmus Doppler profile and its changes with gestational age using a lumped model of the fetal circulation
title_full_unstemmed Understanding the aortic isthmus Doppler profile and its changes with gestational age using a lumped model of the fetal circulation
title_sort Understanding the aortic isthmus Doppler profile and its changes with gestational age using a lumped model of the fetal circulation
dc.creator.none.fl_str_mv Garcia Canadilla, Patricia
Crispi Brillas, Fàtima
Cruz-Lemini, Mónica
Valenzuela Alcaraz, Brenda
Rudenick, Paula A.
Gratacós Solsona, Eduard
Bijnens, Bart
author Garcia Canadilla, Patricia
author_facet Garcia Canadilla, Patricia
Crispi Brillas, Fàtima
Cruz-Lemini, Mónica
Valenzuela Alcaraz, Brenda
Rudenick, Paula A.
Gratacós Solsona, Eduard
Bijnens, Bart
author_role author
author2 Crispi Brillas, Fàtima
Cruz-Lemini, Mónica
Valenzuela Alcaraz, Brenda
Rudenick, Paula A.
Gratacós Solsona, Eduard
Bijnens, Bart
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Computational model
Aortic isthmus
Fetal circulation
Doppler
topic Computational model
Aortic isthmus
Fetal circulation
Doppler
description Objective: The aortic isthmus (AoI) blood flow has a characteristic shape with a small end-systolic notch observed during the third trimester of pregnancy. However, what causes the appearance of this notch is not fully understood. We used a lumped model of the fetal circulation to study the possible factors causing the end-systolic notch and the changes of AoI flow through gestation. Methods: A validation of the model was performed by fitting patient-specific data from two normal fetuses. Then, different parametric analyses were performed to evaluate the major determinants of the appearance of the end-systolic notch. The changes in the AoI flow profile through gestation were assessed. Results: Our model allows to simulate the AoI waveform. The delay in the onset of ejection together with the longer ejection duration of the right ventricle are the most relevant factors in the origin of the notch. It appears around 25 weeks of gestation and becomes more pronounced with advancing gestation. Discussion: We demonstrated that the end-systolic notch on the AoI flow occurs mainly as a result of a delayed and longer ejection of the right ventricle. Our findings improve the understanding of hemodynamic changes in the fetal circulation and the interpretation of clinical imaging.
publishDate 2017
dc.date.none.fl_str_mv 2017
2019
2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/36986
http://dx.doi.org/10.1159/000444142
url http://hdl.handle.net/10230/36986
http://dx.doi.org/10.1159/000444142
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Fetal Diagnosis and Therapy. 2017 February;41(1):41-50
info:eu-repo/grantAgreement/ES/3PN/SAF2012-37196
info:eu-repo/grantAgreement/ES/1PE/TIN2014-52923-R
info:eu-repo/grantAgreement/EC/FP7/611823
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Karger (S. Karger AG)
publisher.none.fl_str_mv Karger (S. Karger AG)
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869420445767303168
score 15,812429

Registos relacionados