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Kotit S, Said K, ElFaramawy A, et al., 2017, Prevalence and prognostic value of echocardiographic screening for rheumatic heart disease, OPEN HEART, Vol: 4, ISSN: 2053-3624
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Yacoub MH, Bonow RO, 2017, Editors' page., Glob Cardiol Sci Pract, Vol: 2017, Pages: e201716-e201716, ISSN: 2305-7823
Kassem HS, Walsh R, Barton PJ, et al., 2017, A comparative study of mutation screening of sarcomeric genes ( MYBPC3 , MYH7 , TNNT2 ) using single gene approach versus targeted gene panel next generation sequencing in a cohort of HCM patients in Egypt, Egyptian Journal of Medical Human Genetics, Vol: 18, Pages: 381-387, ISSN: 1110-8630
BackgroundNGS enables simultaneous sequencing of large numbers of associated genes in genetic heterogeneous disorders, in a more rapid and cost-effective manner than traditional technologies. However there have been limited direct comparisons between NGS and more established technologies to assess the sensitivity and false negative rates of this new approach. The scope of the present manuscript is to compare variants detected in MYBPC3, MYH7 and TNNT2 genes using the stepwise dHPLC/Sanger versus targeted NGS.MethodsIn this study, we have analysed a group of 150 samples of patients from the Bibliotheca Alexandrina-Aswan Heart Centre National HCM program. The genetic testing was simultaneously undertaken by high throughput denaturing high-performance liquid chromatography (dHPLC) followed by Sanger based sequencing and targeted next generation deep sequencing using panel of inherited cardiac genes (ICC). The panel included over 100 genes including the 3 sarcomeric genes. Analysis of the sequencing data of the 3 genes was undertaken in a double blinded strategy.ResultsNGS analysis detected all pathogenic and likely pathogenic variants identified by dHPLC (50 in total, some samples had double hits). There was a 0% false negative rate for NGS based analysis. Nineteen variants were missed by dHPLC and detected by NGS, thus increasing the diagnostic yield in this co- analysed cohort from 22.0% (33/150) to 31.3% (47/150).Of interest to note that the mutation spectrum in this Egyptian HCM population revealed a high rate of homozygosity in MYBPC3 and MYH7 genes in comparison to other population studies (6/150, 4%). None of the homozygous samples were detected by dHPLC analysis.ConclusionNGS provides a useful and rapid tool to allow panoramic screening of several genes simultaneously with a high sensitivity rate amongst genes of known etiologic role allowing high throughput analysis of HCM patients and relevant control series in a less characterised population.
ElGuindy A, Afifi A, Simry W, et al., 2017, The Many Faces of EMF., JACC Cardiovasc Imaging, Vol: 10, Pages: 1072-1075
Badran H, Faheem N, Wassely K, et al., 2017, Relationship of left atrial mechanics to electrical activity on surface electrocardiography in idiopathic dilated cardiomyopathy, Publisher: OXFORD UNIV PRESS, Pages: 494-494, ISSN: 0195-668X
Krishnamoorthy N, Tseng Y-T, Gajendrarao P, et al., 2017, A Strategy to Enhance Secretion of Extracellular Matrix Components by Stem Cells: Relevance to Tissue Engineering., Tissue Engineering: Parts A, B, and C, Vol: 24, Pages: 145-156, ISSN: 1937-3341
The ability of cells to secrete extracellular matrix proteins is an important property in the repair, replacement, and regeneration of living tissue. Cells that populate tissue-engineered constructs need to be able to emulate these functions. The motifs, KTTKS or palmitoyl-KTTKS (peptide amphiphile), have been shown to stimulate production of collagen and fibronectin in differentiated cells. Molecular modeling was used to design different forms of active peptide motifs to enhance the efficacy of peptides to increase collagen and fibronectin production using terminals KTTKS/SKTTK/SKTTKS connected by various hydrophobic linkers, V4A3/V4A2/A4G3. Molecular dynamic simulations showed SKTTKS-V4A3-SKTTKS (P3), with palindromic (SKTTKS) motifs and SKTTK-V4A2-KTTKS (P5), maintained structural integrity and favorable surface electrostatic distributions that are required for functionality. In vitro studies showed that peptides, P3 and P5, showed low toxicity to human adipose-derived stem cells (hADSCs) and significantly increased the production of collagen and fibronectin in a concentration-dependent manner compared with the original active peptide motif. The 4-day treatment showed that stem cell markers of hADSCs remained stable with P3. The molecular design of novel peptides is a promising strategy for the development of intelligent biomaterials to guide stem cell function for tissue engineering applications.
Yacoub M, Mayosi B, ElGuindy A, et al., 2017, Eliminating acute rheumatic fever and rheumatic heart disease., Lancet, Vol: 390, Pages: 212-213
Salhiyyah K, Sarathchandra P, Latif N, et al., 2017, Hypoxia-mediated regulation of the secretory properties of mitral valve interstitial cells, American Journal of Physiology: Heart and Circulatory Physiology, Vol: 313, Pages: H14-H23, ISSN: 1522-1539
The sophisticated function of the mitral valve depends to a large extent on its extracellular matrix (ECM) and specific cellular components. These are tightly regulated by a repertoire of mechanical stimuli and biological pathways. One potentially important stimulus is hypoxia. The purpose of this investigation is to determine the effect of hypoxia on the regulation of mitral valve interstitial cells (MVICs) with respect to the synthesis and secretion of extracellular matrix proteins. Hypoxia resulted in reduced production of total collagen and sulfated glycosaminoglycans (sGAG) in cultured porcine MVICs. Increased gene expression of matrix metalloproteinases-1 and -9 and their tissue inhibitors 1 and 2 was also observed after incubation under hypoxic conditions for up to 24 h. Hypoxia had no effect on MVIC viability, morphology, or phenotype. MVICs expressed hypoxia-inducible factor (HIF)-1α under hypoxia. Stimulating HIF-1α chemically caused a reduction in the amount of sGAG produced, similar to the effect observed under hypoxia. Human rheumatic valves had greater expression of HIF-1α compared with normal or myxomatous degenerated valves. In conclusion, hypoxia affects the production of certain ECM proteins and expression of matrix remodeling enzymes by MVICs. The effects of hypoxia appear to correlate with the induction of HIF-1α. This study highlights a potential role of hypoxia and HIF-1α in regulating the mitral valve, which could be important in health and disease.NEW & NOTEWORTHY This study demonstrates that hypoxia regulates extracellular matrix secretion and the remodeling potential of heart valve interstitial cells. Expression of hypoxia-induced factor-1α plays a role in these effects. These data highlight the potential role of hypoxia as a physiological mediator of the complex function of heart valve cells.
Yacoub MH, Afifi A, Saad H, et al., 2017, Current state of the art and future of myectomy, ANNALS OF CARDIOTHORACIC SURGERY, Vol: 6, Pages: 307-317, ISSN: 2225-319X
Chester AH, Yacoub MH, Moncada S, 2017, Nitric oxide and pulmonary arterial hypertension, Global Cardiology Science & Practice, Vol: 2017, ISSN: 2305-7823
The pathogenesis of pulmonary arterial hypertension remains undefined. Changes in the expression and effects mediated by a number of vasoactive factors have been implicated to play a role in the onset and progression of the disease. The source of many of these mediators, such as nitric oxide (NO), prostacyclin and endothelin-1 (ET-1), is the pulmonary endothelium. This article focus in the role of nitric oxide in PAH, reviewing the evidence for its involvement in regulation of pulmonary a vascular tone under physiological conditions, the mechanisms by which it can contribute to the pathological changes seen in PAH and strategies for the use of NO as a therapy for treatment of the disease.
Mohamed NA, Davies RP, Lickiss PD, et al., 2017, Chemical and biological assessment of metal organic frameworks (MOFs) in pulmonary cells and in an acute in vivo model: relevance to pulmonary arterial hypertension therapy, Pulmonary Circulation, Vol: 7, Pages: 1-11, ISSN: 2045-8940
Pulmonary arterial hypertension (PAH) is a progressive and debilitating condition. Despite promoting vasodilation, current drugs have a therapeutic window within which they are limited by systemic side effects. Nanomedicine uses nanoparticles to improve drug delivery and/or reduce side effects. We hypothesize that this approach could be used to deliver PAH drugs avoiding the systemic circulation. Here we report the use of iron metal organic framework (MOF) MIL-89 and PEGylated MIL-89 (MIL-89 PEG) as suitable carriers for PAH drugs. We assessed their effects on viability and inflammatory responses in a wide range of lung cells including endothelial cells grown from blood of donors with/without PAH. Both MOFs conformed to the predicted structures with MIL-89 PEG being more stable at room temperature. At concentrations up to 10 or 30 µg/mL, toxicity was only seen in pulmonary artery smooth muscle cells where both MOFs reduced cell viability and CXCL8 release. In endothelial cells from both control donors and PAH patients, both preparations inhibited the release of CXCL8 and endothelin-1 and in macrophages inhibited inducible nitric oxide synthase activity. Finally, MIL-89 was well-tolerated and accumulated in the rat lungs when given in vivo. Thus, the prototypes MIL-89 and MIL-89 PEG with core capacity suitable to accommodate PAH drugs are relatively non-toxic and may have the added advantage of being anti-inflammatory and reducing the release of endothelin-1. These data are consistent with the idea that these materials may not only be useful as drug carriers in PAH but also offer some therapeutic benefit in their own right.
El-Sherbiny I, Khalil I, Ali I, et al., 2017, Updates on smart polymeric carrier systems for protein delivery, DRUG DEVELOPMENT AND INDUSTRIAL PHARMACY, Vol: 43, Pages: 1567-1583, ISSN: 0363-9045
Soliman AB, Haikal RR, Abugable AA, et al., 2017, Tailoring the Oxygen Reduction Activity of Hemoglobin through Immobilization within Microporous Organic Polymer-Graphene Composite, ACS APPLIED MATERIALS & INTERFACES, Vol: 9, Pages: 27918-27926, ISSN: 1944-8244
Yacoub MH, 2017, RESPONSE: Trainees in Regional Centers of Excellence in the Developing World A Win-Win for Global Cardiology, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 69, Pages: 2463-2464, ISSN: 0735-1097
Dokainish H, Teo K, Zhu J, et al., 2017, Global mortality variations in patients with heart failure: results from the International Congestive Heart Failure (INTER-CHF) prospective cohort study, LANCET GLOBAL HEALTH, Vol: 5, Pages: E665-E672, ISSN: 2214-109X
Background:Most data on mortality and prognostic factors in patients with heart failure come from North America and Europe, with little information from other regions. Here, in the International Congestive Heart Failure (INTER-CHF) study, we aimed to measure mortality at 1 year in patients with heart failure in Africa, China, India, the Middle East, southeast Asia and South America; we also explored demographic, clinical, and socioeconomic variables associated with mortality.Methods:We enrolled consecutive patients with heart failure (3695 [66%] clinic outpatients, 2105 [34%] hospital in patients) from 108 centres in six geographical regions. We recorded baseline demographic and clinical characteristics and followed up patients at 6 months and 1 year from enrolment to record symptoms, medications, and outcomes. Time to death was studied with Cox proportional hazards models adjusted for demographic and clinical variables, medications, socioeconomic variables, and region. We used the explained risk statistic to calculate the relative contribution of each level of adjustment to the risk of death.Findings:We enrolled 5823 patients within 1 year (with 98% follow-up). Overall mortality was 16·5%: highest in Africa (34%) and India (23%), intermediate in southeast Asia (15%), and lowest in China (7%), South America (9%), and the Middle East (9%). Regional differences persisted after multivariable adjustment. Independent predictors of mortality included cardiac variables (New York Heart Association Functional Class III or IV, previous admission for heart failure, and valve disease) and non-cardiac variables (body-mass index, chronic kidney disease, and chronic obstructive pulmonary disease). 46% of mortality risk was explained by multivariable modelling with these variables; however, the remainder was unexplained.Interpretation:Marked regional differences in mortality in patients with heart failure persisted after multivariable adjustment for cardiac and non-cardiac f
Jakovljevic DG, Yacoub MH, Schueler S, et al., 2017, Left ventricular assist device as a bridge to recovery for patients with advanced heart failure, Journal of the American College of Cardiology, Vol: 69, Pages: 1924-1933, ISSN: 0735-1097
BackgroundLeft ventricular assist devices (LVADs) have been used as an effective therapeutic option in patients with advanced heart failure, either as a bridge to transplantation, as destination therapy, or in some patients, as a bridge to recovery.ObjectivesThis study evaluated whether patients undergoing an LVAD bridge-to-recovery protocol can achieve cardiac and physical functional capacities equivalent to those of healthy controls.MethodsFifty-eight male patients—18 implanted with a continuous-flow LVAD, 16 patients with LVAD explanted (recovered patients), and 24 heart transplant candidates (HTx)—and 97 healthy controls performed a maximal graded cardiopulmonary exercise test with continuous measurements of respiratory gas exchange and noninvasive (rebreathing) hemodynamic data. Cardiac function was represented by peak exercise cardiac power output (mean arterial blood pressure × cardiac output) and functional capacity by peak exercise O2 consumption.ResultsAll patients demonstrated a significant exertional effort as demonstrated with the mean peak exercise respiratory exchange ratio >1.10. Peak exercise cardiac power output was significantly higher in healthy controls and explanted LVAD patients compared with other patients (healthy 5.35 ± 0.95 W; explanted 3.45 ± 0.72 W; LVAD implanted 2.37 ± 0.68 W; and HTx 1.31 ± 0.31 W; p < 0.05), as was peak O2 consumption (healthy 36.4 ± 10.3 ml/kg/min; explanted 29.8 ± 5.9 ml/kg/min; implanted 20.5 ± 4.3 ml/kg/min; and HTx 12.0 ± 2.2 ml/kg/min; p < 0.05). In the LVAD explanted group, 38% of the patients achieved peak cardiac power output and 69% achieved peak O2 consumption within the ranges of healthy controls.ConclusionsThe authors have shown that a substantial number of patients who recovered sufficiently to allow explantation of their LVAD can even achieve cardiac and physical functional capacities nearly equivalent to those of health
Gandhi GD, Krishnamoorthy N, Motal UMA, et al., 2017, Towards developing a vaccine for rheumatic heart disease, Global Cardiology Science & Practice, Vol: 2017, ISSN: 2305-7823
Rheumatic heart disease (RHD) is the most serious manifestations of rheumatic fever, which is caused by group A Streptococcus (GAS or Streptococcus pyogenes) infection. RHD is an auto immune sequelae of GAS pharyngitis, rather than the direct bacterial infection of the heart, which leads to chronic heart valve damage. Although antibiotics like penicillin are effective against GAS infection, improper medical care such as poor patient compliance, overcrowding, poverty, and repeated exposure to GAS, leads to acute rheumatic fever and RHD. Thus, efforts have been put forth towards developing a vaccine. However, a potential global vaccine is yet to be identified due to the widespread diversity of S. pyogenes strains and cross reactivity of streptococcal proteins with host tissues. In this review, we discuss the available vaccine targets of S. pyogenes and the significance of in silico approaches in designing a vaccine for RHD.
Porras AM, van Engeland NCA, Marchbanks E, et al., 2017, Robust Generation of Quiescent Porcine Valvular Interstitial Cell Cultures, Journal of the American Heart Association, Vol: 6, ISSN: 2047-9980
Background Valvular interstitial cells (VICs) in the healthy aortic valve leaflet exhibit a quiescent phenotype, with <5% of VICs exhibiting an activated phenotype. Yet, in vitro culture of VICs on tissue culture polystyrene surfaces in standard growth medium results in rapid transformation to an activated phenotype in >90% of cells. The inability to preserve a healthy VIC phenotype during in vitro studies has hampered the elucidation of mechanisms involved in calcific aortic valve disease. This study describes the generation of quiescent populations of porcine VICs in 2‐dimensional in vitro culture and their utility in studying valve pathobiology.Methods and Results Within 4 days of isolation from fresh porcine hearts, VICs cultured in standard growth conditions were predominantly myofibroblastic (activated VICs). This myofibroblastic phenotype was partially reversed within 4 days, and fully reversed within 9 days, following application of a combination of a fibroblast media formulation with culture on collagen coatings. Specifically, culture in this combination significantly reduced several markers of VIC activation, including proliferation, apoptosis, α‐smooth muscle actin expression, and matrix production, relative to standard growth conditions. Moreover, VICs raised in a fibroblast media formulation with culture on collagen coatings exhibited dramatically increased sensitivity to treatment with transforming growth factor β1, a known pathological stimulus, compared with VICs raised in either standard culture or medium with a fibroblast media formulation.Conclusions The approach using a fibroblast media formulation with culture on collagen coatings generates quiescent VICs that more accurately mimic a healthy VIC population and thus has the potential to transform the study of the mechanisms of VIC activation and dysfunction involved in the early stages of calcific aortic valve disease.
Hassan M, Wagdy K, Kharabish A, et al., 2017, Validation of Noninvasive Measurement of Cardiac Output Using Inert Gas Rebreathing in a Cohort of Patients With Heart Failure and Reduced Ejection Fraction, CIRCULATION-HEART FAILURE, Vol: 10, ISSN: 1941-3289
van Engeland NCA, Bertazzo S, Sarathchandra P, et al., 2017, Aortic calcified particles modulate valvular endothelial and interstitial cells., Cardiovascular Pathology, Vol: 28, Pages: 36-45, ISSN: 1054-8807
AbstractBackgroundNormal and calcified human valve cusps, coronary arteries, and aortae harbor spherical calcium phosphate microparticles of identical composition and crystallinity, and their role remains unknown.ObjectiveThe objective was to examine the direct effects of isolated calcified particles on human valvular cells.Method and resultsCalcified particles were isolated from healthy and diseased aortae, characterized, quantitated, and applied to valvular endothelial cells (VECs) and interstitial cells (VICs). Cell differentiation, viability, and proliferation were analyzed. Particles were heterogeneous, differing in size and shape, and were crystallized as calcium phosphate. Diseased donors had significantly more calcified particles compared to healthy donors (P<.05), but there were no differences between the composition of the particles from healthy and diseased donors. VECs treated with calcified particles showed a significant decrease in CD31 and VE-cadherin and an increase in von Willebrand factor expression, P<.05. There were significantly increased α-SMA and osteopontin in treated VICs (P<.05), significantly decreased VEC and VIC viability (P<.05), and significantly increased number of terminal deoxynucleotidyl transferase dUTP nick end labeling-positive VECs (P<.05) indicating apoptosis when treated with the calcified particles.ConclusionsIsolated calcified particles from human aortae are not innocent bystanders but induce a phenotypical and pathological change of VECs and VICs characteristic of activated and pathological cells. Therapy tailored to reduce these calcified particles should be investigated.
Karamichalis JM, Aguib H, Anastasopulos A, et al., 2017, Design, dynamism, and valve repair., J Thorac Cardiovasc Surg, Vol: 153, Pages: 396-398
El-Sherbiny IM, Elbaz NM, Sedki M, et al., 2017, Magnetic nanoparticles-based drug and gene delivery systems for the treatment of pulmonary diseases, NANOMEDICINE, Vol: 12, Pages: 387-402, ISSN: 1743-5889
Gemechu T, Mahmoud H, Parry EHO, et al., 2017, Community-based prevalence study of rheumatic heart disease in rural Ethiopia, EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, Vol: 24, Pages: 717-723, ISSN: 2047-4873
Yacoub M, Hosny H, Afifi A, 2017, Surgery for TGA in Developing Countries: The End of the Beginning., J Am Coll Cardiol, Vol: 69, Pages: 52-55
Yacoub M, Aguib H, 2017, Opposing forces and a river into a lake: Relevance to coronary hemodynamics in Kawasaki disease, Global Cardiology Science and Practice, Vol: 2017
El-Askary H, Lahaye N, Linstead E, et al., 2017, Remote sensing observation of annual dust cycles and possible causality of Kawasaki disease outbreaks in Japan, Global Cardiology Science and Practice, Vol: 2017
Kawasaki disease (KD) is a rare vascular disease that, if left untreated, can result in irreparable cardiac damage in children. While the symptoms of KD are well-known, as are best practices for treatment, the etiology of the disease and the factors contributing to KD outbreaks remain puzzling to both medical practitioners and scientists alike. Recently, a fungus known as Candida, originating in the farmlands of China, has been blamed for outbreaks in China and Japan, with the hypothesis that it can be transported over long ranges via different wind mechanisms. This paper provides evidence to understand the transport mechanisms of dust at different geographic locations and the cause of the annual spike of KD in Japan. Candida is carried along with many other dusts, particles or aerosols, of various sizes in major seasonal wind currents. The evidence is based upon particle categorization using the Moderate Resolution Imaging Spectrometer (MODIS) Aerosol Optical Depth (AOD), Fine Mode Fraction (FMF) and Ångström Exponent (AE), the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) attenuated backscatter and aerosol subtype, and the Aerosol Robotic Network's (AERONET) derived volume concentration. We found that seasonality associated with aerosol size distribution at different geographic locations plays a role in identifying dominant abundance at each location. Knowing the typical size of the Candida fungus, and analyzing aerosol characteristics using AERONET data reveals possible particle transport association with KD events at different locations. Thus, understanding transport mechanisms and accurate identification of aerosol sources is important in order to understand possible triggers to outbreaks of KD. This work provides future opportunities to leverage machine learning, including state-of-The-Art deep architectures, to build predictive models of KD outbreaks, with the ultimate goal of early forecasting and intervention within
Walley H, Yacoub M, Saad H, 2017, Pharmacological management of perioperative bleeding in cardiac surgery, Global Cardiology Science and Practice, Vol: 2017
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Nasr E, Ibrahim M, Yacoub M, 2017, Heart failure in a neonate with multiple cardiac masses., Heart, Vol: 103
CLINICAL INTRODUCTION: A 16-day-old male neonate weighing 3.4 kg presented with severe heart failure. His heart rate was 190/min, normal sinus rhythm, blood pressure was 55/30 mm Hg and respiratory rate was 65/min. Transthoracic echocardiography and cardiac MRI showed multiple intracardiac masses; the largest was filling most of the left ventricular cavity (figure 1A) (see online supplementary video 1 and figure S1), measuring around 2.8 cm×1.8 cm and arising from the apical septum. Left ventricular function was moderately impaired with an ejection fraction of 40%. Due to accelerated haemodynamic instability, the mass was excised surgically. Through left ventriculotomy, a large mass could be identified which was attached with a pedicle to the apical septum. This mass was excised with its pedicle.During early postoperative course, the patient developed subdural and intraventricular haemorrhage, necessitating insertion of a ventriculoperitoneal shunt. MRI of the brain showed dark-signalled subependymal nodules and multiple cortical patches of high T2 signals (see online supplementary figure S2). The patient had no neurological sequelae and was discharged home.The patient was discharged home with no neurological sequelae. During the 2-year follow-up period, serial echocardiograms showed regression of the rest of the cardiac tumours and improvement of cardiac functions (see online supplementary figure S3). However, fibrous plaques were observed on the child's forehead. QUESTION: What is the most likely diagnosis? HibernomaFibromaRhabdomyomaRhabdomyosarcoma.
Amindari A, Saltik L, Kirkkopru K, et al., 2017, Assessment of calcified aortic valve leaflet deformations and blood flow dynamics using fluid-structure interaction modeling, Informatics in Medicine Unlocked, Vol: 9, Pages: 191-199, ISSN: 2352-9148
Aortic valve diseases are among the most common cardiovascular defects. Since a non-functioning valve results in disturbed blood flow conditions, the diagnosis of such defects is based on identification of stenosis via echocardiography. Calculation of disease parameters such as valve orifice area or transvalvular pressure gradient using echocardiography is associated with substantial errors. Computational fluid dynamics (CFD) modeling has emerged as an alternative approach for accurate assessment of aortic valve hemodynamics. Fluid-structure interaction (FSI) modeling is adapted in these models to account for counter-interacting forces of flowing blood and deforming leaflets for most accurate results. However, implementation of this approach is difficult using custom built codes and algorithms. In this paper, we present an FSI modeling methodology for aortic valve hemodynamics using a commercial modeling software, ANSYS. We simulated the problem using fluid flow solver FLUENT and structural solver MECHANICAL APDL under ANSYS and coupled the solutions using System Coupling Module to enable FSI. This approach minimized adaptation problems that would raise if separate solvers were used. As an example case, we investigated influence of leaflet calcification on hemodynamic stresses and flow patterns. Model geometries were generated using b-mode echocardiography images of an aortic valve. A Doppler velocity measurement was used as velocity inlet boundary condition in the models. Simulation results were validated by comparing leaflet movements in the simulations with b-mode echo recordings. Wall shear stress levels, pressure levels and flow patterns agree well with previous studies demonstrating the accuracy of our results. Our modeling methodology can be easily adopted by researchers that are familiar with ANSYS and other similar CFD software to investigate similar biomedical problems.
El-Sherbiny IM, Sedki M, Soliman H, et al., 2017, Hydrogels for Pulmonary Drug Delivery, FUNCTIONAL HYDROGELS IN DRUG DELIVERY: KEY FEATURES AND FUTURE PERSPECTIVES, Editors: Spizzirri, Cirillo, Publisher: CRC PRESS-TAYLOR & FRANCIS GROUP, Pages: 327-351, ISBN: 978-1-4987-4901-5
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