Simulation of left ventricle flow dynamics with dilated cardiomyopathy during the filling phase

Dilated cardiomyopathy (DCM) is a common cardiac disease which leads to the deterioration in cardiac performance. A computational fluid dynamics (CFD) approach can be used to enhance our understanding of the disease, by providing us with a detailed map of the intraventricular flow and pressure distributions. In the present work, effect of ventricular size on the intraventricular flow dynamics and intraventricular pressure gradients (IVPGs) was studied using two different implementation methods, i.e. the geometry-prescribed and the fluid structure interaction (FSI) methods. Results showed that vortex strength and IVPGs are significantly reduced in a dilated heart, leading to an increased risk of thrombus formation and impaired ventricular filling. We suggest FSI method as the ultimate method in studying ventricular dysfunction as it provides additional cardiac disease prognostic factors and more realistic model implementation.

[1]  C Kawai,et al.  Left ventricular regional wall stress in dilated cardiomyopathy. , 1990, Circulation.

[2]  Roberto Muñoz,et al.  A Noninvasive Method for Assessing Impaired Diastolic Suction in Patients With Dilated Cardiomyopathy , 2005, Circulation.

[3]  Mario J. Garcia,et al.  Relationship Between Early Diastolic Intraventricular Pressure Gradients, an Index of Elastic Recoil, and Improvements in Systolic and Diastolic Function , 2001, Circulation.

[4]  A D Augst,et al.  Accuracy and reproducibility of CFD predicted wall shear stress using 3D ultrasound images. , 2003, Journal of biomechanical engineering.

[5]  H. Oertel,et al.  Fluid-Structure Coupled CFD Simulation of the Left Ventricular Flow During Filling Phase , 2005, Annals of Biomedical Engineering.

[6]  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.

[7]  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.

[8]  Gianni Pedrizzetti,et al.  Fluid dynamics of the left ventricular filling in dilated cardiomyopathy. , 2002, Journal of biomechanics.

[9]  J. Towbin,et al.  Dilated cardiomyopathy , 2010, The Lancet.

[10]  Olga Pierrakos,et al.  The effect of vortex formation on left ventricular filling and mitral valve efficiency. , 2006, Journal of biomechanical engineering.

[11]  Y Nimura,et al.  Abnormal blood pathways in left ventricular cavity in acute myocardial infarction. Experimental observations with special reference to regional wall motion abnormality and hemostasis. , 1988, Circulation.

[12]  W Grossman,et al.  Wall Thickness and Diastolic Properties of the Left Ventricle , 1974, Circulation.

[13]  M N Kotler,et al.  Flow characteristics in the dilated left ventricle with thrombus: qualitative and quantitative Doppler analysis. , 1989, Journal of the American College of Cardiology.

[14]  E. Sonnenblick,et al.  The structural basis and importance of restoring forces and elastic recoil for the filling of the heart. , 1980, European Heart Journal.

[15]  Toshiaki Hisada,et al.  Computer Simulation of Blood Flow, Left Ventricular Wall Motion and Their Interrelationship by Fluid-Structure Interaction Finite Element Method , 2002 .

[16]  F. N. van de Vosse,et al.  Influence of dilated cardiomyopathy and a left ventricular assist device on vortex dynamics in the left ventricle , 2008, Computer methods in biomechanics and biomedical engineering.

[17]  P. Verdonck,et al.  Computer simulation of intraventricular flow and pressure gradients during diastole. , 2000, Journal of biomechanical engineering.