The Clinical Assessment of Intraventricular Flows

Abstract

Recent advances in imaging techniques have allowed physicians to obtain robust measurements of intracardiac flows in the clinical setting. Consequently, the physiological implications of intraventricular fluid dynamics are beginning to be understood. Initial data show that these flows involve complex fluid-structure interactions and mixing phenomena that are modified by disease. Here we critically review the most important aspects of intraventricular fluid mechanics relevant for clinical applications. We discuss current image and numerical methods for assessing intraventricular flows, as well as implemented approaches to analyze their impact on cardiac function. The physiological and clinical insights provided by such techniques are discussed both in health and in disease. The final goal is to encourage research in the application of fluid dynamic foundations to patient-based clinical data. A huge potential is anticipated not only in terms of the basic science of large-scale biological systems, but also in practical terms of improving patient care.

A clinical method for mapping and quantifying blood stasis in the left ventricle

“…Using a Lagrangian approach, T R evolution can be described by the advection equation with unit forcing, $${\partial }_t{T}_R+\nabla ·false({\overrightarrow{\upsilon }}_{\mathit{\text{inc}}}{T}_{R}false)=1,$$ where ${\overrightarrow{\upsilon }}_{\mathit{\text{inc}}}$ is the velocity field. Previous works have considered a similar equation with a non-zero mass diffusivity term (Esmaily-Moghadam et al 2013, Jozsa & Kramer 2000, Mangual et al 2012), but we note that the self-diffusivity of blood is negligible compared to its advective fluxes inside the LV (Bermejo et al 2015, Tarbell 2003). The full derivation of equation (1) can be found in Appendix I.…”

“…Flow in the heart involves complex fluid transport and mixing processes (Bermejo et al 2015). Intracardiac transport and mixing depends on convoluted trajectories of flow inside the chambers (Kilner et al 2000, Wigstrom et al 1999, Zhang et al 2012) as well as on the dynamical interactions between incoming flow and residual flow from preceding cycles (Bolger et al 2007).…”

Ultrasound Vector Flow Imaging: I: Sequential Systems

“…VFM is readily available in Hitachi scanners and has been tested in several clinical situations [114], [115], [116]. It has also been assessed in patients with echocardiographic data extracted from GE (General Electric Healthcare) Vivid scanners [117], [118], [119], [120]. It appears from these clinical studies that the analysis of the diastolic vortex dynamics could improve diastology.…”

Técnicas de imagen en la insuficiencia cardiaca aguda

“…Otra aproximació n a la caracterizació n de la funció n sistó lica de la cá mara se puede obtener mediante el estudio de la diná mica de fluidos de la sangre en el interior del VI 31 . Se conoce desde hace tiempo que la capacidad de aceleració n de la sangre durante la eyecció n se correlaciona con la elastancia má xima al final de la sístole, pará metro de referencia de la funció n sistó lica del VI 32 .…”