Mitral valve geometrical echocardiographic analysis and 3D computational modeling of a normal mitral valve - supplementary material

<b>Aim: </b>This research aims to develop a consistent computational model of a normal mitral valve (MV) and describe mitral regurgitation (MR) geometry based on Carpentier’s classification. <b>Materials &amp;methods:</b>MV geometry was assessed by 2D transthoracic echocardiogram in 100 individuals. A 3D parametric geometric model of the MV was developed. A computational model of a normal MV was performed. <b>Results: </b>The simulation of the valve function was successfully accomplished and its kinematics was analyzed. Differences in geometry were revealed between normal and type III MR. <b>Conclusion: </b>3D computational models of the normal MV can be constructed relying on standard measurements performed by 2D echocardiography. Certain geometrical differences exist among the normal and the most severe type of MR.<b>Plain language summary: </b>Mitral insufficiency, represents the most common form of valvular heart disease and occurs when the mitral valve does not close tight causing blood to flow the wrong way in the heart. The simplest and most usual method to evaluate this dysfunction is the 2D transthoracic echocardiography, which uses ultrasound to create images of the heart. Mitral insufficiency can be classified into three types. This study tried to evaluate any differences in the clinical and<b>/</b>or echocardiographic geometrical characteristics between the normal MV and the three types of insufficient MV. Moreover, it tried to develop a 3D model to simulate the normal MV function. To achieve this, it enrolled 100 individuals (both normal and insufficientMV), evaluated theirMV with 2D echocardiography and compared all geometrical characteristics between them. Finally, computational simulation, using specific and appropriate methods, was used to create the 3D model. Regarding the results, the most differences were found between subjects with normal and subjects with type III mitral insufficiency. Moreover, a 3D model of the normal MV was successfully developed. To conclude, there are specific geometrical differences among the normal and the most severe type of the insufficient MV, while 3D models of the normal MV can be developed by 2D echocardiography measurements.