Background: Many diseases that affect the mitral valve are accompanied by the proliferation or degradation of tissue microstructure. The early acoustic detection of these changes may lead to the better management of mitral valve disease. In this study, we examine the nonstationary acoustic effects of perturbing material parameters that characterize mitral valve tissue in terms of its microstructural components. Specifically, we examine the influence of the volume fraction, stiffness and splay of collagen fibers as well as the stiffness of the nonlinear matrix in which they are embedded. Methods and Results: To model the transient vibrations of the mitral valve apparatus bathed in a blood medium, we have constructed a dynamic nonlinear fluid-coupled finite element model of the valve leaflets and chordae tendinae. The material behavior for the leaflets is based on an experimentally derived structural constitutive equation. The gross movement and small-scale acoustic vibrations of the valvular structures result from the application of physiologic pressure loads. Material changes that preserved the anisotropy of the valve leaflets were found to preserve valvular function. By contrast, material changes that altered the anisotropy of the valve were found to profoundly alter valvular function. These changes were manifest in the acoustic signatures of the valve closure sounds. Abnormally, stiffened valves closed more slowly and were accompanied by lower peak frequencies. Conclusion: The relationship between stiffness and frequency, though never documented in a native mitral valve, has been an axiom of heart sounds research. We find that the relationship is more subtle and that increases in stiffness may lead to either increases or decreases in peak frequency depending on their relationship to valvular function.
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February 2005
Technical Papers
The Relationship of Normal and Abnormal Microstructural Proliferation to the Mitral Valve Closure Sound
Daniel R. Einstein,
Daniel R. Einstein
Department of Bioengineering, University of Washington, Seattle, Washington 98195
11
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Karyn S. Kunzelman,
Karyn S. Kunzelman
Central Maine Medical Center, Central Maine Heart and Vascular Institute, Lewiston, Maine 04240
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Per G. Reinhall,
Per G. Reinhall
Department of Mechanical Engineering, University of Washington, Seattle, Washington 98195
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Mark A. Nicosia,
Mark A. Nicosia
University of Minnesota, Department of Biomedical Engineering, Minneapolis, Minnesota 55455
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Richard P. Cochran
Richard P. Cochran
Central Maine Medical Center, Central Maine Heart and Vascular Institute, Lewiston, Maine 04240
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Daniel R. Einstein
11
Department of Bioengineering, University of Washington, Seattle, Washington 98195
Karyn S. Kunzelman
Central Maine Medical Center, Central Maine Heart and Vascular Institute, Lewiston, Maine 04240
Per G. Reinhall
Department of Mechanical Engineering, University of Washington, Seattle, Washington 98195
Mark A. Nicosia
University of Minnesota, Department of Biomedical Engineering, Minneapolis, Minnesota 55455
Richard P. Cochran
Central Maine Medical Center, Central Maine Heart and Vascular Institute, Lewiston, Maine 04240
Contributed by the Bioengineering Division for publication in the JOURNAL OF BIOMECHANICAL ENGINEERING. Manuscript received October 2003; revised manuscript received September 2004. Associate Editor: Michael Sacks.
J Biomech Eng. Feb 2005, 127(1): 134-147 (14 pages)
Published Online: March 8, 2005
Article history
Received:
October 1, 2003
Revised:
September 1, 2004
Online:
March 8, 2005
Citation
Einstein, D. R., Kunzelman, K. S., Reinhall, P. G., Nicosia, M. A., and Cochran, R. P. (March 8, 2005). "The Relationship of Normal and Abnormal Microstructural Proliferation to the Mitral Valve Closure Sound ." ASME. J Biomech Eng. February 2005; 127(1): 134–147. https://doi.org/10.1115/1.1835359
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