Bulletin of the American Physical Society
70th Annual Meeting of the APS Division of Fluid Dynamics
Volume 62, Number 14
Sunday–Tuesday, November 19–21, 2017; Denver, Colorado
Session F4: Cardiovascular IVBio Fluids: Internal
|
Hide Abstracts |
Chair: Arvind Santhanakrishnan, Oklahoma State University Room: 404 |
Monday, November 20, 2017 8:00AM - 8:13AM |
F4.00001: The intraventricular filling vortex under heightened aortic blood pressure Nicholas Nelsen, Manikantam Gaddam, Arvind Santhanakrishnan Hypertension, or high aortic blood pressure, can induce structural changes in the left ventricle (LV) such as concentric hypertrophy. Previous studies have identified that the intraventricular filling vortex serves as an effective means of blood transport during diastolic filling. However, a fundamental understanding of how hypertension affects this vortex is unavailable. This knowledge can be useful for improving diagnosis and treatment of related heart disease conditions, including hypertensive heart failure. In this experimental study, we hypothesized that the circulation of the filling vortex would diminish with increased aortic pressure. Using a LV physical model within a left heart simulator, we performed hemodynamic measurements to acquire pressure and volumetric inflow profiles and 2D particle image velocimetry to visualize the intraventricular flow fields. Peak aortic pressures of 120 mm Hg, 140 mm Hg, and 160 mm Hg were each tested at heart rates of 70, 100, and 110 beats per minute, under: 1) reduced ejection fraction (EF), and 2) constant EF. Our results indicate that peak vortex circulation is reduced under elevated aortic pressures. Hemodynamics and characteristics of the intraventricular filling vortex in all examined experimental cases will be presented. [Preview Abstract] |
Monday, November 20, 2017 8:13AM - 8:26AM |
F4.00002: Left ventricular filling under elevated left atrial pressure Manikantam Gaddam, Milad Samaee, Arvind Santhanakrishnan Left atrial pressure (LAP) is elevated in diastolic dysfunction, where left ventricular (LV) filling is impaired due to increase in ventricular stiffness. The impact of increasing LAP and LV stiffness on intraventricular filling hemodynamics remains unclear. We conducted particle image velocimetry and hemodynamics measurements in a left heart simulator (LHS) under increasing LAP and LV stiffness at a heart rate of 70 bpm. The LHS consisted of a flexible-walled LV physical model fitted within a fluid-filled chamber. LV wall motion was generated by a piston pump that imparted pressure fluctuations in the chamber. Resistance and compliance elements in the flow loop were adjusted to obtain bulk physiological hemodynamics in the least stiff LV model. Two LV models of increasing stiffness were subsequently tested under unchanged loop settings. LAP was varied between 5-20 mm Hg for each LV model, by adjusting fluid level in a reservoir upstream of the LV. For constant LV stiffness, increasing LAP lowered cardiac output (CO), while ejection fraction (EF) and E/A ratio were increased. For constant LAP, increasing LV stiffness lowered CO and EF, and increased E/A ratio. The implications of these altered hemodynamics on intraventricular filling vortex characteristics will be presented. [Preview Abstract] |
Monday, November 20, 2017 8:26AM - 8:39AM |
F4.00003: Towards reducing thrombogenicity of LVAD therapy: optimizing surgical and patient management strategies Venkat Keshav Chivukula, Ali Lafzi, Nahush Mokadam, Jennifer Beckman, Claudius Mahr, Alberto Aliseda Unfavourable hemodynamics in heart failure patients implanted with left ventricular assist devices (LVAD), due to non-optimal surgical configurations and patient management, strongly influence thrombogenicity. This is consistent with the increase in devastating thromboembolic complications (specifically thrombosis and stroke) in patients, even as the risk of thrombosis inside the device decreases with modern designs. Inflow cannula and outflow graft surgical configurations have been optimized via patient-specific modeling that computes the thrombogenic potential with a combination of Eulerian (endothelial) wall shear stress and Lagrangian (platelet shear history) tracking. Using this view of hemodynamics, the benefits of intermittent aortic valve opening (promoting washout and reducing stagnant flow in the aortic valve region) have been assessed in managing the patient's residual native cardiac output. The use of this methodology to understand the contribution of the hemodynamics in the flow surrounding the LVAD itself to thrombogenesis show promise in developing holistic patient-specific management strategies to minimize stroke risk and enhance efficacy of LVAD therapy. [Preview Abstract] |
Monday, November 20, 2017 8:39AM - 8:52AM |
F4.00004: Patient-Specific Modeling of Intraventricular Hemodynamics Vijay Vedula, Alison Marsden Heart disease is the one of the leading causes of death in the world. Apart from malfunctions in electrophysiology and myocardial mechanics, abnormal hemodynamics is a major factor attributed to heart disease across all ages. Computer simulations offer an efficient means to accurately reproduce in vivo flow conditions and also make predictions of post-operative outcomes and disease progression. We present an experimentally validated computational framework for performing patient-specific modeling of intraventricular hemodynamics. Our modeling framework employs the SimVascular open source software to build an anatomic model and employs robust image registration methods to extract ventricular motion from the image data. We then employ a stabilized finite element solver to simulate blood flow in the ventricles, solving the Navier-Stokes equations in arbitrary Lagrangian-Eulerian (ALE) coordinates by prescribing the wall motion extracted during registration. We model the fluid-structure interaction effects of the cardiac valves using an immersed boundary method and discuss the potential application of this methodology in single ventricle physiology and trans-catheter aortic valve replacement (TAVR). [Preview Abstract] |
Monday, November 20, 2017 8:52AM - 9:05AM |
F4.00005: Non-Invasive Mapping of Intraventricular Flow Patterns in Patients Treated with Left Ventricular Assist Devices Marissa Miramontes, Lorenzo Rossini, Oscar Braun, Michela Brambatti, Shone Almeida, Adam Mizeracki, Pablo Martinez-Legazpi, Yolanda Benito, Javier Bermejo, Andrew Kahn, Eric Adler, Juan C. del Álamo In heart failure patients, left ventricular (LV) assist devices (LVADs) decrease mortality and improve quality of life. We hypothesize echo color Doppler velocimetry (echo-CDV), an echocardiographic flow mapping modality, can non-invasively characterize the effect of LVAD support, optimize the device, thereby decreasing the stoke rate present in these patients. We used echo-CDV to image LV flow at baseline LVAD speed and during a ramp test in LVAD patients (Heartmate II, N$=$10). We tracked diastolic vortices and mapped blood stasis and cumulative shear. Compared to dilated cardiomyopathy (DCM) patients without LVADs, the flow had a less prominent diastolic vortex ring, and transited directly from mitral valve to cannula. Residence time and shear were significantly lower compared to healthy controls and DCMs. Aortic regurgitation and a large LV vortex presence or a direct mitral jet towards the cannula affected blood stasis region location and size. Flow patterns, residence time and shear depended on LV geometry, valve function and LVAD speed in a patient specific manner. This new methodology could be used with standard echo, hemodynamics and clinical information to find the flow optimizing LAVD setting minimizing stasis for each patient. [Preview Abstract] |
Monday, November 20, 2017 9:05AM - 9:18AM |
F4.00006: Experimental Assessment of the Hydraulics of a Miniature Axial-Flow Left Ventricular Assist Device P. Alex Smith, William Cohn, Ralph Metcalfe A minimally invasive partial-support left ventricular assist device (LVAD) has been proposed with a flow path from the left atrium to the arterial system to reduce left ventricular stroke work. In LVAD design, peak and average efficiency must be balanced over the operating range to reduce blood trauma. Axial flow pumps have many geometric parameters. Until recently, testing all these parameters was impractical, but modern 3D printing technology enables multi-parameter studies. Following theoretical design, experimental hydraulic evaluation in steady state conditions examines pressure, flow, pressure-flow gradient, efficiency, torque, and axial force as output parameters. Preliminary results suggest that impeller blades and stator vanes with higher inlet angles than recommended by mean line theory (MLT) produce flatter gradients and broader efficiency curves, increasing compatibility with heart physiology. These blades also produce less axial force, which reduces bearing load. However, they require slightly higher torque, which is more demanding of the motor. MLT is a low order, empirical model developed on large pumps. It does not account for the significant viscous losses in small pumps like LVADs. This emphasizes the importance of experimental testing for hydraulic design. [Preview Abstract] |
Monday, November 20, 2017 9:18AM - 9:31AM |
F4.00007: Comparison of different models for non-invasive FFR estimation Mehran Mirramezani, Shawn Shadden Coronary artery disease is a leading cause of death worldwide. Fractional flow reserve (FFR), derived from invasively measuring the pressure drop across a stenosis, is considered the gold standard to diagnose disease severity and need for treatment. Non-invasive estimation of FFR has gained recent attention for its potential to reduce patient risk and procedural cost versus invasive FFR measurement. Non-invasive FFR can be obtained by using image-based computational fluid dynamics to simulate blood flow and pressure in a patient-specific coronary model. However, 3D simulations require extensive effort for model construction and numerical computation, which limits their routine use. In this study we compare (ordered by increasing computational cost/complexity): reduced-order algebraic models of pressure drop across a stenosis; 1D, 2D (multiring) and 3D CFD models; as well as 3D FSI for the computation of FFR in idealized and patient-specific stenosis geometries. We demonstrate the ability of an appropriate reduced order algebraic model to closely predict FFR when compared to FFR from a full 3D simulation. [Preview Abstract] |
Monday, November 20, 2017 9:31AM - 9:44AM |
F4.00008: FFR analysis of blood flow through a stenosed Left Anterior Descending Artery. Jawahar Pasupathi, Arul Prakash K The numerical analyisis of blood flow through a stenosed tapering Left Anterior Descending (LAD) artery was done using Streamwise Upwind Petrov Galerkin (SUPG) method to obtain the clinical parameters such as Fractional Flow reserve (FFR) and Wall Shear Stress (WSS). The geometry was considered to be a straight tapering cylindrical duct with the severity of stenosis modeled using a curve equation based on the reduction in diameter at the stenosed region. Poiseuille velocity profile was given at the inlet such that at each time step the product of mean velocity and the inlet area gives the realistic flow rate through the LAD. The simulation was done for 30,50 and 70 percent reduction in cross-section of LAD. The average pressure values across the stenosis was used to quantify FFR. The FFR increased with higher pressure ratio across the stenosis, which is a result of increased severity of stenosis. The velocity gradients that are responsible for the shear stress at the walls were found to be dependent on the shape of the stenosis, i.e., the diameter and its length. [Preview Abstract] |
Monday, November 20, 2017 9:44AM - 9:57AM |
F4.00009: Abstract Withdrawn
|
Monday, November 20, 2017 9:57AM - 10:10AM |
F4.00010: Characterization of cardiac flow in heart disease patients by computational fluid dynamics and 4D flow MRI Jonas Lantz, Vikas Gupta, Lilian Henriksson, Matts Karlsson, Ander Persson, Carljohan Carhall, Tino Ebbers In this study, cardiac blood flow was simulated using Computational Fluid Dynamics and compared to in vivo flow measurements by 4D Flow MRI. In total, nine patients with various heart diseases were studied. Geometry and heart wall motion for the simulations were obtained from clinical CT measurements, with 0.3x0.3x0.3 mm spatial resolution and 20 time frames covering one heartbeat. The CFD simulations included pulmonary veins, left atrium and ventricle, mitral and aortic valve, and ascending aorta. Mesh sizes were on the order of 6-16 million cells, depending on the size of the heart, in order to resolve both papillary muscles and trabeculae. The computed flow field agreed visually very well with 4D Flow MRI, with characteristic vortices and flow structures seen in both techniques. Regression analysis showed that peak flow rate as well as stroke volume had an excellent agreement for the two techniques. We demonstrated the feasibility, and more importantly, fidelity of cardiac flow simulations by comparing CFD results to in vivo measurements. Both qualitative and quantitative results agreed well with the 4D Flow MRI measurements. Also, the developed simulation methodology enables “what if” scenarios, such as optimization of valve replacement and other surgical procedures. [Preview Abstract] |
Follow Us |
Engage
Become an APS Member |
My APS
Renew Membership |
Information for |
About APSThe American Physical Society (APS) is a non-profit membership organization working to advance the knowledge of physics. |
© 2024 American Physical Society
| All rights reserved | Terms of Use
| Contact Us
Headquarters
1 Physics Ellipse, College Park, MD 20740-3844
(301) 209-3200
Editorial Office
100 Motor Pkwy, Suite 110, Hauppauge, NY 11788
(631) 591-4000
Office of Public Affairs
529 14th St NW, Suite 1050, Washington, D.C. 20045-2001
(202) 662-8700