Topology of Blood Transport in the Human Left Ventricle by Novel Processing of Doppler Echocardiography

Novel processing of Doppler-echocardiography data was used to study blood transport in the left ventricle (LV) of six patients with dilated cardiomyopathy and six healthy volunteers. Bi-directional velocity field maps in the apical long axis of the LV were reconstructed from color-Doppler echocardiography. Resulting velocity field data were used to perform trajectory-based computation of Lagrangian coherent structures (LCS). LCS were shown to reveal the boundaries of blood injected and ejected from the heart over multiple beats. This enabled qualitative and quantitative assessments of blood transport patterns and residence times in the LV. Quantitative assessments of stasis in the LV are reported, as well as characterization of LV vortex formations from E-wave and A-wave filling.

[1]  Einar Heiberg,et al.  Vortex Ring Formation in the Left Ventricle of the Heart: Analysis by 4D Flow MRI and Lagrangian Coherent Structures , 2012, Annals of Biomedical Engineering.

[2]  Jianwen Luo,et al.  Imaging of wall motion coupled with blood flow velocity in the heart and vessels in vivo: a feasibility study. , 2011, Ultrasound in medicine & biology.

[3]  M. Keane,et al.  Quantitation of left ventricular volumes and ejection fraction in post-infarction patients from biplane and single plane two-dimensional echocardiograms. A prospective longitudinal study of 371 patients. , 1998, European heart journal.

[4]  Jerrold E. Marsden,et al.  Transport and stirring induced by vortex formation , 2007, Journal of Fluid Mechanics.

[5]  Dominique Pelletier,et al.  Lagrangian coherent structures in the human carotid artery bifurcation , 2009 .

[6]  Charles A. Taylor,et al.  Characterization of Coherent Structures in the Cardiovascular System , 2008, Annals of Biomedical Engineering.

[7]  上嶋 徳久,et al.  A new echocardiographic method for identifying vortex flow in the left ventricle : numerical validation , 2009 .

[8]  M. S. Chong,et al.  A general classification of three-dimensional flow fields , 1990 .

[9]  D. Paniagua,et al.  Numerical characterization of hemodynamics conditions near aortic valve after implantation of Left Ventricular Assist Device. , 2011, Mathematical biosciences and engineering : MBE.

[10]  Einar Heiberg,et al.  Transit of blood flow through the human left ventricle mapped by cardiovascular magnetic resonance. , 2007, Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance.

[11]  Damien Garcia,et al.  Two-Dimensional Intraventricular Flow Mapping by Digital Processing Conventional Color-Doppler Echocardiography Images , 2010, IEEE Transactions on Medical Imaging.

[12]  A. Weyman,et al.  Echocardiographic Doppler evaluation of left ventricular diastolic function. Physics and physiology. , 1991, Circulation.

[13]  Zoran B Popović,et al.  Assessment of left ventricular function by cardiac ultrasound. , 2006, Journal of the American College of Cardiology.

[14]  N. Fatouraee,et al.  Regularization of flow streamlines in multislice phase-contrast MR imaging , 2003, IEEE Transactions on Medical Imaging.

[15]  W. Gaasch,et al.  Left ventricular diastolic dysfunction and diastolic heart failure. , 2004, Annual review of medicine.

[16]  Jens-Uwe Voigt,et al.  Left ventricular flow patterns in healthy subjects and patients with prosthetic mitral valves: an in vivo study using echocardiographic particle image velocimetry. , 2010, The Journal of thoracic and cardiovascular surgery.

[17]  Gianni Pedrizzetti,et al.  Characterization and quantification of vortex flow in the human left ventricle by contrast echocardiography using vector particle image velocimetry. , 2008, JACC. Cardiovascular imaging.

[18]  A. Marsden,et al.  Lagrangian analysis of hemodynamics data from FSI simulation , 2013, International journal for numerical methods in biomedical engineering.

[19]  Petter Dyverfeldt,et al.  Semi-automatic quantification of 4D left ventricular blood flow , 2010, Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance.

[20]  Michael Markl,et al.  MRI-Based CFD Analysis of Flow in a Human Left Ventricle: Methodology and Application to a Healthy Heart , 2009, Annals of Biomedical Engineering.

[21]  V. Fuster,et al.  Thrombosis and embolism from cardiac chambers and infected valves. , 1986, Journal of the American College of Cardiology.

[22]  A. di Lenarda,et al.  Restrictive left ventricular filling pattern in dilated cardiomyopathy assessed by doppler echocardiography: Clinical, echocardiographic and hemodynamic correlations and prognostic implications , 1993 .

[23]  Per-Olof Persson,et al.  A Simple Mesh Generator in MATLAB , 2004, SIAM Rev..

[24]  W. Little,et al.  Mechanism of altered patterns of left ventricular filling during the development of congestive heart failure. , 1994, Circulation.

[25]  Matteo Astorino,et al.  Computational analysis of an aortic valve jet with Lagrangian coherent structures. , 2010, Chaos.

[26]  R. F. Rushmer,et al.  Left Ventricle as a Mixing Chamber , 1960, Circulation research.

[27]  Shawn C. Shadden.  Lagrangian Coherent Structures in Blood Flow , 2008 .

[28]  Arash Kheradvar,et al.  Echocardiographic particle image velocimetry: a novel technique for quantification of left ventricular blood vorticity pattern. , 2010, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[29]  Restrictive Left Ventricular Filling Pattern in Dilated Cardiomyopathy Assessed by Doppler Echocardiography: Clinical, Echocardiographic and Hemodynamic Correlations and Prognostic Implications , 1994 .

[30]  C. Kasai,et al.  Real-Time Two-Dimensional Blood Flow Imaging Using an Autocorrelation Technique , 1985, IEEE 1985 Ultrasonics Symposium.

[31]  K. Urasawa,et al.  A new approach for evaluation of left ventricular diastolic function: spatial and temporal analysis of left ventricular filling flow propagation by color M-mode Doppler echocardiography. , 1996, Journal of the American College of Cardiology.

[32]  Shawn C. Shadden,et al.  Lagrangian Coherent Structures , 2011 .

[33]  Pavlos P. Vlachos,et al.  Vortices Formed on the Mitral Valve Tips Aid Normal Left Ventricular Filling , 2013, Annals of Biomedical Engineering.

[34]  J. Marsden,et al.  Definition and properties of Lagrangian coherent structures from finite-time Lyapunov exponents in two-dimensional aperiodic flows , 2005 .

[35]  J. Marsden,et al.  Lagrangian analysis of fluid transport in empirical vortex ring flows , 2006 .

[36]  Shawn C. Shadden,et al.  Potential fluid mechanic pathways of platelet activation , 2012, Biomechanics and Modeling in Mechanobiology.

[37]  A J Tajik,et al.  Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician's Rosetta Stone. , 1997, Journal of the American College of Cardiology.

[38]  S. Shadden,et al.  Characterization of the transport topology in patient-specific abdominal aortic aneurysm models. , 2012, Physics of fluids.

[39]  Jerrold E. Marsden,et al.  Study of blood flow impact on growth of thrombi using a multiscale model , 2009 .