Evidence map›Paper›PMID 34467514›Full record

ArticleCardiovascular engineering and technology2021

Alterations in Intracardiac Flow Patterns Affect Mitral Leaflets Dynamics in a Model of Ischemic Mitral Regurgitation.

G Pilla, M Levack, J Mcgarvey, E Hwuang, G Zsido, J Gorman, J Pilla, W R Witschey, R Gorman

Abstract read
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In one paragraph

Article in Cardiovascular engineering and technology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Intracardiac flow dynamics in mitral regurgitation: state of the art.European heart journal. Imaging methods and practice · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

G PillaDepartment of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. gabriellepilla95@gmail.com.ORCID http://orcid.org/0000-0003-4800-453X
M LevackDepartment of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
J McgarveyDepartment of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
E HwuangDepartment of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA.
G ZsidoDepartment of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
J GormanDepartment of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
J PillaDepartment of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
W R WitscheyDepartment of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA.
R GormanDepartment of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
University of Pennsylvania · US

Funding

Surgery to Prevent Post Infarction Ventricular RemodelingR01HL063954 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI GORMAN, ROBERT C · 2001 to 2018
$9.8M
Quantitative Methods for Optimizing IMR RepairR01HL073021 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI GORMAN, ROBERT C, SACKS, MICHAEL S · 2004 to 2022
$7.6M
Echocardiography to Predict Recurrent IMR After Surgical Mitral Valve ReplacementR01HL103723 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI GORMAN, ROBERT C, HUNG, JUDY W · 2011 to 2020
$5.3M
NHLBI NIH HHS HL103723NHLBI NIH HHS HL63954NHLBI NIH HHS HL73021
6 · The paper itself

Abstract

purposeThis study was to evaluate the effects of ischemic mitral regurgitation (IMR) on vortex formation and leaflet dynamics using an established porcine infarct model of IMR.

methodsUsing direct coronary ligation, five animals were subjected to a posterolateral myocardial infarction (MI) followed by an MRI at 12-weeks post MI. MR imaging consisted of 4D time-resolved left ventricular (LV) flow, full coverage 2D LV cine, and high resolution 2D cine of mitral valve dynamics. Five additional naïve animals underwent identical imaging protocols to serve as controls. Image analysis was performed to obtain mitral transvalvular flows as well as LV volumes throughout the cardiac cycle. In addition, anterior to posterior mid-leaflet tip distances were measured throughout the cardiac cycle for determination of temporal leaflet dynamics.

resultsIt was found IMR caused asymmetric vortex ring formation with the anterior vortex having a lower vorticity relative to its posterior counterpart. In contrast, normal ventricles create symmetric and tightly curled vortices in the basal chamber just underneath the mitral leaflets which conserve kinetic energy and aid in effective ejection. IMR animals were also evaluated for leaflet separation and were found to have a greater leaflet opening and achieved peak vorticity and peak leaflet opening later than control animals.

conclusionIn conclusion, this study shows the effects that altered vortex formation, due to IMR, can have on ventricular filling and leaflet dynamics. These findings have important implications for understanding blood flow through the dilated heart and how ring annuloplasty and volume reduction interventions may influence mitral valve dynamics.

Indexed as

Mitral Valve InsufficiencyMyocardial InfarctionMyocardial IschemiaAnimalsHemodynamicsMitral ValveSwine4D flowCardiovascular imagingHemodynamicsLeft ventricular flowMitral valve diseaseMitral valve vortex formationMRI imagingPhase contrast MRIValvular disease

Identifiers

PMID34467514
OpenAlexW3196868869

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.