Computational study on the evolution of an intraventricular vortical flow during early diastole for the interpretation of color M-mode Doppler echocardiograms

A computational fluid dynamics study of intraventricular flow during early diastole was carried out using a 3D model of the human left ventricle (LV). It was found that a vortical flow formed under the aortic orifice and then grew in size and extended laterally along the ventricular wall towards the posterior side. With further expansion of the LV, it developed into an annular vortex asymmetrically enlarged on the side of the aortic orifice, narrowing the passage of blood inflow and thus causing a shift of the high-velocity portion of inflow towards the apex. This appeared as an elongation of the aliasing area when the velocity of the inflow was expressed as a spatiotemporal map in the same manner as a color M-mode Doppler (CMD) echocardiogram. Based on these findings, it was concluded that the shape of the aliasing area in a CMD echocardiogram shows the change in the velocity of blood inflow affected by the development of an annular vortex formed in the LV.

[1]  H N Sabbah,et al.  Pressure‐Diameter Relations during Early Diastole in Dogs: Incompatibility with the Concept of Passive Left Ventricular Filling , 1981, Circulation research.

[2]  W. Grossman,et al.  Diastolic pressure-volume relations in the diseased heart. , 1980, Federation proceedings.

[3]  P. Ludbrook,et al.  Transmitral pressure-flow velocity relation. Importance of regional pressure gradients in the left ventricle during diastole. , 1988, Circulation.

[4]  M. Yacoub,et al.  Asymmetric redirection of flow through the heart , 2000, Nature.

[5]  C. Peskin,et al.  A three-dimensional computational method for blood flow in the heart. 1. Immersed elastic fibers in a viscous incompressible fluid , 1989 .

[6]  P. Brun,et al.  Left ventricular flow propagation during early filling is related to wall relaxation: a color M-mode Doppler analysis. , 1992, Journal of the American College of Cardiology.

[7]  T W Taylor,et al.  Flow patterns in three-dimensional left ventricular systolic and diastolic flows determined from computational fluid dynamics. , 1995, Biorheology.

[8]  F. S. Henry,et al.  Formation and travel of vortices in model ventricles: application to the design of skeletal muscle ventricles. , 1996, Journal of biomechanics.

[9]  A P Yoganathan,et al.  Computational modeling of left heart diastolic function: examination of ventricular dysfunction. , 2000, Journal of biomechanical engineering.

[10]  T Ebbers,et al.  Noninvasive measurement of time-varying three-dimensional relative pressure fields within the human heart. , 2002, 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]  B J Bellhouse,et al.  Fluid mechanics of a model mitral valve and left ventricle. , 1972, Cardiovascular research.

[13]  T W Taylor,et al.  Realistic three-dimensional left ventricular ejection determined from computational fluid dynamics. , 1995, Medical engineering & physics.

[14]  A P Yoganathan,et al.  Left ventricular blood flow patterns in normal subjects: a quantitative analysis by three-dimensional magnetic resonance velocity mapping. , 1995, Journal of the American College of Cardiology.

[15]  J. De Sutter,et al.  Diastolic filling and pressure imaging: taking advantage of the information in a colour M-mode Doppler image. , 2001, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[16]  M. Kotler,et al.  Flow patterns in dilated cardiomyopathy: a pulsed-wave and color flow Doppler study. , 1990, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[17]  H Ihlen,et al.  Abnormalities of left ventricular filling in patients with coronary artery disease: assessment by colour M-mode Doppler technique. , 1994, European heart journal.

[18]  Shigeo Wada,et al.  Relationship between Intraventricular Flow Patterns and the Shapes of the Aliasing Area in Color M-mode Doppler Echocardiograms : A CFD Study with an Axisymmetric Model of the LV , 2001 .

[19]  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.

[20]  A. D. Gosman,et al.  Computational Flow Modeling of the Left Ventricle Based on In Vivo MRI Data: Initial Experience , 2001, Annals of Biomedical Engineering.

[21]  Automated eigenvector analysis for quantification of color M-mode Doppler filling patterns of the left ventricle in an ischemic canine model , 1997, Computers in Cardiology 1997.

[22]  P Boesiger,et al.  Quantification of the local heartwall motion by magnetic resonance myocardial tagging. , 1998, Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society.

[23]  C. Peskin,et al.  A three-dimensional computational method for blood flow in the heart. II. contractile fibers , 1989 .

[24]  J. Seward,et al.  Ratio of left ventricular peak E-wave velocity to flow propagation velocity assessed by color M-mode Doppler echocardiography in first myocardial infarction: prognostic and clinical implications. , 2000, Journal of the American College of Cardiology.

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

[26]  Shigeo Wada,et al.  A Computational Fluid Mechanical Study on the Effects of Opening and Closing of the Mitral Orifice on a Transmitral Flow Velocity Profile and an Early Diastolic Intraventricular Flow , 2002 .

[27]  A. Owen A numerical model of early diastolic filling: importance of intraventricular pressure wave propagation. , 1993, Cardiovascular research.

[28]  C. Hanet,et al.  Focus on diastolic dysfunction: a new approach to heart failure therapy. , 1989, British journal of clinical pharmacology.

[29]  C. Peskin,et al.  Heart Simulation by an Immersed Boundary Method with Formal Second-order Accuracy and Reduced Numerical Viscosity , 2001 .

[30]  H. Torp,et al.  Chrome congestive heart failure , 1994 .

[31]  E L Yellin,et al.  Left ventricular filling dynamics and diastolic function. , 1990, Progress in cardiovascular diseases.

[32]  C S Peskin,et al.  A general method for the computer simulation of biological systems interacting with fluids. , 1995, Symposia of the Society for Experimental Biology.

[33]  J. Tanouchi,et al.  Transmitral blood flow reflecting diastolic behavior of the left ventricle in health and disease--a study by pulsed Doppler technique. , 1982, Japanese circulation journal.

[34]  H. Torp,et al.  Cross‐sectional Early Mitral Flow‐Velocity Profiles From Color Doppler in Patients With Mitral Valve Disease , 1992, Circulation.

[35]  H. Ihlen,et al.  Intraventricular Early Diastolic Filling During Acute Myocardial Ischemia Assessment by Multigated Color M‐Mode Doppler Echocardiography , 1993, Circulation.

[36]  A P Yoganathan,et al.  Three-dimensional computational model of left heart diastolic function with fluid-structure interaction. , 2000, Journal of biomechanical engineering.