Stability of Carotid Artery Under Steady-State and Pulsatile Blood Flow: A Fluid–Structure Interaction Study

PubMed Central

Saeid Khalafvand, Seyed; Han, Hai-Chao

2015-01-01

It has been shown that arteries may buckle into tortuous shapes under lumen pressure, which in turn could alter blood flow. However, the mechanisms of artery instability under pulsatile flow have not been fully understood. The objective of this study was to simulate the buckling and post-buckling behaviors of the carotid artery under pulsatile flow using a fully coupled fluid–structure interaction (FSI) method. The artery wall was modeled as a nonlinear material with a two-fiber strain-energy function. FSI simulations were performed under steady-state flow and pulsatile flow conditions with a prescribed flow velocity profile at the inlet and different pressures at the outlet to determine the critical buckling pressure. Simulations were performed for normal (160 ml/min) and high (350 ml/min) flow rates and normal (1.5) and reduced (1.3) axial stretch ratios to determine the effects of flow rate and axial tension on stability. The results showed that an artery buckled when the lumen pressure exceeded a critical value. The critical mean buckling pressure at pulsatile flow was 17–23% smaller than at steady-state flow. For both steady-state and pulsatile flow, the high flow rate had very little effect (<5%) on the critical buckling pressure. The fluid and wall stresses were drastically altered at the location with maximum deflection. The maximum lumen shear stress occurred at the inner side of the bend and maximum tensile wall stresses occurred at the outer side. These findings improve our understanding of artery instability in vivo. PMID:25761257

Cardiovascular microbubble transport in vessel bifurcations with pulsatile flow: experimental model and theory

NASA Astrophysics Data System (ADS)

Valassis, Doug; Dodde, Robert; Eshpuniyani, Brijesh; Fowlkes, J. Brian; Bull, Joseph

2008-11-01

The behavior of long gas bubbles suspended in liquid flowing through successive bifurcations was investigated experimentally and theoretically as a model of cardiovascular bubble transport in gas embolotherapy. In this developmental cancer therapy, perflurocarbon droplets are vaporized in the vasculature and travel through a bifurcating network of vessels before lodging. The homogeneity of tumor necrosis is directly correlated with the transport and lodging of the emboli. An experimental model was used to explore the effects of flow pulsatility, frequency, gravity, and bifurcation roll angle on bubble splitting and lodging. At a bifurcation roll angle of 45-degrees, the most distinct difference in splitting ratios between three physiologic frequencies (1, 1.5, 2 Hz) was observed. As roll angle increased, lodged bubble volume in the first generation channel increased while bubble volume beyond the second bifurcation proportionately decreased. A corresponding time-dependent one-dimensional theoretical model was also developed. The results elucidate the effects of pulsatile flow and suggest the potential of gas embolotherapy to occlude blood flow to tumors.

21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pulsatile flow generator... Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow... device is placed in a cardiopulmonary bypass circuit downstream from the oxygenator. (b) Classification...

21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass pulsatile flow generator... Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow... device is placed in a cardiopulmonary bypass circuit downstream from the oxygenator. (b) Classification...

Pulsatile flow in ventricular catheters for hydrocephalus

NASA Astrophysics Data System (ADS)

Giménez, Á.; Galarza, M.; Thomale, U.; Schuhmann, M. U.; Valero, J.; Amigó, J. M.

2017-05-01

The obstruction of ventricular catheters (VCs) is a major problem in the standard treatment of hydrocephalus, the flow pattern of the cerebrospinal fluid (CSF) being one important factor thereof. As a first approach to this problem, some of the authors studied previously the CSF flow through VCs under time-independent boundary conditions by means of computational fluid dynamics in three-dimensional models. This allowed us to derive a few basic principles which led to designs with improved flow patterns regarding the obstruction problem. However, the flow of the CSF has actually a pulsatile nature because of the heart beating and blood flow. To address this fact, here we extend our previous computational study to models with oscillatory boundary conditions. The new results will be compared with the results for constant flows and discussed. It turns out that the corrections due to the pulsatility of the CSF are quantitatively small, which reinforces our previous findings and conclusions. This article is part of the themed issue `Mathematical methods in medicine: neuroscience, cardiology and pathology'.

Flow characteristics around a deformable stenosis under pulsatile flow condition

NASA Astrophysics Data System (ADS)

Choi, Woorak; Park, Jun Hong; Byeon, Hyeokjun; Lee, Sang Joon

2018-01-01

A specific portion of a vulnerable stenosis is deformed periodically under a pulsatile blood flow condition. Detailed analysis of such deformable stenosis is important because stenotic deformation can increase the likelihood of rupture, which may lead to sudden cardiac death or stroke. Various diagnostic indices have been developed for a nondeformable stenosis by using flow characteristics and resultant pressure drop across the stenosis. However, the effects of the stenotic deformation on the flow characteristics remain poorly understood. In this study, the flows around a deformable stenosis model and two different rigid stenosis models were investigated under a pulsatile flow condition. Particle image velocimetry was employed to measure flow structures around the three stenosis models. The deformable stenosis model was deformed to achieve high geometrical slope and height when the flow rate was increased. The deformation of the stenotic shape enhanced jet deflection toward the opposite vessel wall of the stenosis. The jet deflection in the deformable model increased the rate of jet velocity and turbulent kinetic energy (TKE) production as compared with those in the rigid models. The effect of stenotic deformation on the pulsating waveform related with the pressure drop was analyzed using the TKE production rate. The deformable stenosis model exhibited a phase delay of the peak point in the waveform. These results revealed the potential use of pressure drop waveform as a diagnostic index for deformable stenosis.

Dynamical systems characterization of inertial effects of fluid flow in a curved artery model under pulsatile flow forcing

NASA Astrophysics Data System (ADS)

Leggiero, Michael; Bulusu, Kartik V.; Plesniak, Michael W.

2013-11-01

The main objective of this study was to examine inertial effects in a 180-degree model of curved arteries under pulsatile inflow conditions. Two-component, two-dimensional particle image velocimetery (2C-2D PIV) data were acquired upstream of and at several cross-sectional locations in the curved artery model. A blood-analog fluid comprised of 71% saturated sodium iodide solution, 28% glycerol and 1% distilled water (by volume) was subjected to multi-harmonic pulsatile inflow functions. First, signal time-lag was quantified by cross-correlating the input (voltage-time) supplied to a programmable pump and the output PIV (flow rate-time) measurements. The experiment was then treated as a linear, time-invariant system, and frequency response was estimated for phase shifts across a certain spectrum. Input-output signal dissimilarities were attributable to intrinsic inertial effects of flow. By coupling pressure-time and upstream flow rate-time measurements, the experiment was modeled using system identification methods. Results elucidate the role of inertial effects in fluid flow velocity measurements and the effect of these delays on secondary flow structure detection in a curved artery model. Supported by the NSF Grant No. CBET- 0828903 and GW Center for Biomimetics and Bioinspired Engineering.

Pulsatile turbulent flow through pipe bends at high Dean and Womersley numbers

NASA Astrophysics Data System (ADS)

Kalpakli, Athanasia; Örlü, Ramis; Tillmark, Nils; Alfredsson, P. Henrik

2011-12-01

Turbulent pulsatile flows through pipe bends are prevalent in internal combustion engine components which consist of bent pipe sections and branching conduits. Nonetheless, most of the studies related to pulsatile flows in pipe bends focus on incompressible, low Womersley and low Dean number flows, primarily because they aim in modeling blood flow, while internal combustion engine related flows have mainly been addressed in terms of integral quantities and consist of single point measurements. The present study aims at bridging the gap between these two fields by means of time-resolved stereoscopic particle image velocimetry measurements in a pipe bend with conditions that are close to those encountered in exhaust manifolds. The time/phase-resolved three-dimensional cross-sectional flow-field 3 pipe diameters downstream the pipe bend is captured and the interplay between different secondary motions throughout a pulse cycle is discussed.

Oxygen and carbon dioxide transport in time-dependent blood flow past fiber rectangular arrays

NASA Astrophysics Data System (ADS)

Zierenberg, Jennifer R.; Fujioka, Hideki; Hirschl, Ronald B.; Bartlett, Robert H.; Grotberg, James B.

2009-03-01

The influence of time-dependent flows on oxygen and carbon dioxide transport for blood flow past fiber arrays arranged in in-line and staggered configurations was computationally investigated as a model for an artificial lung. Both a pulsatile flow, which mimics the flow leaving the right heart and passing through a compliance chamber before entering the artificial lung, and a right ventricular flow, which mimics flow leaving the right heart and directly entering the artificial lung, were considered in addition to a steady flow. The pulsatile flow was modeled as a sinusoidal perturbation superimposed on a steady flow while the right ventricular flow was modeled to accurately depict the period of flow acceleration (increasing flow) and deceleration (decreasing flow) during systole followed by zero flow during diastole. It was observed that the pulsatile flow yielded similar gas transport as compared to the steady flow, while the right ventricular flow resulted in smaller gas transport, with the decrease increasing with Re. The pressure drop across the fiber array (a measure of the resistance), work (an indicator of the work required of the right heart), and shear stress (a measure of potential blood cell activation and damage) are lowest for steady flow, followed by pulsatile flow, and then right ventricular flow. The pressure drop, work, shear stress, and Sherwood numbers (a measure of the gas transport efficiency) decrease with increasing porosity and are smaller for AR <1 as compared to AR >1 (AR is the distance between fibers in the flow direction/distance between fibers in direction perpendicular to flow), although for small porosities the Sherwood numbers are of similar magnitude. In general, for any fiber array geometry, high pressure drop, work, and shear stresses correlate with high Sherwood numbers, and low pressure drop, work, and shear stresses correlate with low Sherwood numbers creating a need for a compromise between pressure drop/work/shear stresses and gas transport.

Influence of pulsatile flow on LDL transport in the arterial wall.

PubMed

Sun, Nanfeng; Wood, Nigel B; Hughes, Alun D; Thom, Simon A M; Xu, X Yun

2007-10-01

The accumulation of low-density lipoprotein (LDL) is one of the important factors in atherogenesis. Two different time scales may influence LDL transport in vivo: (1) LDL transport is coupled to blood flow with a pulse cycle of around 1 s in humans; (2) LDL transport within the arterial wall is mediated by transmural flow in the order of 10(-8) m/s. Most existing models have assumed steady flow conditions and overlooked the interactions between physical phenomena with different time scales. The objective of this study was to investigate the influence of pulsatile flow on LDL transport and examine the validity of steady flow assumption. The effect of pulsatile flow on transmural transport was incorporated by using a lumen-free cyclic (LFC) and a lumen-free time-averaged (LFTA) procedures. It is found that the steady flow simulation predicted a focal distribution in the post-stenotic region, differing from the diffuse distribution pattern produced by the pulsatile flow simulation. The LFTA procedure, in which time-averaged shear-dependent transport properties calculated from instantaneous wall shear stress (WSS) were used, predicted a similar distribution pattern to the LFC simulations. We conclude that the steady flow assumption is inadequate and instantaneous hemodynamic conditions have important influence on LDL transmural transport in arterial geometries with disturbed and complicated flow patterns.

An in vitro test bench reproducing coronary blood flow signals.

PubMed

Chodzyński, Kamil Jerzy; Boudjeltia, Karim Zouaoui; Lalmand, Jacques; Aminian, Adel; Vanhamme, Luc; de Sousa, Daniel Ribeiro; Gremmo, Simone; Bricteux, Laurent; Renotte, Christine; Courbebaisse, Guy; Coussement, Grégory

2015-08-07

It is a known fact that blood flow pattern and more specifically the pulsatile time variation of shear stress on the vascular wall play a key role in atherogenesis. The paper presents the conception, the building and the control of a new in vitro test bench that mimics the pulsatile flows behavior based on in vivo measurements. An in vitro cardiovascular simulator is alimented with in vivo constraints upstream and provided with further post-processing analysis downstream in order to mimic the pulsatile in vivo blood flow quantities. This real-time controlled system is designed to perform real pulsatile in vivo blood flow signals to study endothelial cells' behavior under near physiological environment. The system is based on an internal model controller and a proportional-integral controller that controls a linear motor with customized piston pump, two proportional-integral controllers that control the mean flow rate and temperature of the medium. This configuration enables to mimic any resulting blood flow rate patterns between 40 and 700 ml/min. In order to feed the system with reliable periodic flow quantities in vivo measurements were performed. Data from five patients (1 female, 4 males; ages 44-63) were filtered and post-processed using the Newtonian Womersley's solution. These resulting flow signals were compared with 2D axisymmetric, numerical simulation using a Carreau non-Newtonian model to validate the approximation of a Newtonian behavior. This in vitro test bench reproduces the measured flow rate time evolution and the complexity of in vivo hemodynamic signals within the accuracy of the relative error below 5%. This post-processing method is compatible with any real complex in vivo signal and demonstrates the heterogeneity of pulsatile patterns in coronary arteries among of different patients. The comparison between analytical and numerical solution demonstrate the fair quality of the Newtonian Womersley's approximation. Therefore, Womersley's solution was used to calculate input flow rate for the in vitro test bench.

An experimental investigation of velocity fields in divergent glottal models of the human vocal tract

NASA Astrophysics Data System (ADS)

Erath, Byron D.; Plesniak, Michael W.

2005-09-01

In speech, sound production arises from fluid-structure interactions within the larynx as well as viscous flow phenomena that is most likely to occur during the divergent orientation of the vocal folds. Of particular interest are the flow mechanisms that influence the location of flow separation points on the vocal folds walls. Physiologically scaled pulsatile flow fields in 7.5 times real size static divergent glottal models were investigated. Three divergence angles were investigated using phase-averaged particle image velocimetry (PIV). The pulsatile glottal jet exhibited a bi-modal stability toward both glottal walls, although there was a significant amount of variance in the angle the jet deflected from the midline. The attachment of the Coanda effect to the glottal model walls occurred when the pulsatile velocity was a maximum, and the acceleration of the waveform was zero. The location of the separation and reattachment points of the flow from the glottal models was a function of the velocity waveform and divergence angle. Acoustic analogies show that a dipole sound source contribution arising from the fluid interaction (Coanda jet) with the vocal fold walls is expected. [Work funded by NIH Grant RO1 DC03577.

Pulsatile flow and mass transport over an array of cylinders: gas transfer in a cardiac-driven artificial lung.

PubMed

Chan, Kit Yan; Fujioka, Hideki; Bartlett, Robert H; Hirschl, Ronald B; Grotberg, James B

2006-02-01

The pulsatile flow and gas transport of a Newtonian passive fluid across an array of cylindrical microfibers are numerically investigated. It is related to an implantable, artificial lung where the blood flow is driven by the right heart. The fibers are modeled as either squared or staggered arrays. The pulsatile flow inputs considered in this study are a steady flow with a sinusoidal perturbation and a cardiac flow. The aims of this study are twofold: identifying favorable array geometry/spacing and system conditions that enhance gas transport; and providing pressure drop data that indicate the degree of flow resistance or the demand on the right heart in driving the flow through the fiber bundle. The results show that pulsatile flow improves the gas transfer to the fluid compared to steady flow. The degree of enhancement is found to be significant when the oscillation frequency is large, when the void fraction of the fiber bundle is decreased, and when the Reynolds number is increased; the use of a cardiac flow input can also improve gas transfer. In terms of array geometry, the staggered array gives both a better gas transfer per fiber (for relatively large void fraction) and a smaller pressure drop (for all cases). For most cases shown, an increase in gas transfer is accompanied by a higher pressure drop required to power the flow through the device.

Secondary flow in a curved artery model with Newtonian and non-Newtonian blood-analog fluids

NASA Astrophysics Data System (ADS)

Najjari, Mohammad Reza; Plesniak, Michael W.

2016-11-01

Steady and pulsatile flows of Newtonian and non-Newtonian fluids through a 180°-curved pipe were investigated using particle image velocimetry (PIV). The experiment was inspired by physiological pulsatile flow through large curved arteries, with a carotid artery flow rate imposed. Sodium iodide (NaI) and sodium thiocyanate (NaSCN) were added to the working fluids to match the refractive index (RI) of the test section to eliminate optical distortion. Rheological measurements revealed that adding NaI or NaSCN changes the viscoelastic properties of non-Newtonian solutions and reduces their shear-thinning property. Measured centerline velocity profiles in the upstream straight pipe agreed well with an analytical solution. In the pulsatile case, secondary flow structures, i.e. deformed-Dean, Dean, Wall and Lyne vortices, were observed in various cross sections along the curved pipe. Vortical structures at each cross section were detected using the d2 vortex identification method. Circulation analysis was performed on each vortex separately during the systolic deceleration phase, and showed that vortices split and rejoin. Secondary flow structures in steady flows were found to be morphologically similar to those in pulsatile flows for sufficiently high Dean number. supported by the George Washington University Center for Biomimetics and Bioinspired Engineering.

Effect of mild atherosclerosis on flow resistance in a coronary artery casting of man

NASA Technical Reports Server (NTRS)

Back, L. H.; Cho, Y. I.; Crawford, D. W.; Cuffel, R. F.

1984-01-01

An in-vitro flow study was conducted in a mildly atherosclerotic main coronary artery casting of man using sugar-water solutions simulating blood viscosity. Steady flow results indicated substantial increases in pressure drop, and thus flow resistance at the same Reynolds number, above those for Poiseuille flow by 30 to 100 percent in the physiological Reynolds number range from about 100 to 400. Time-averaged pulsatile flow data showed additional 5 percent increases in flow resistance above the steady flow results. Both pulsatile and steady flow data from the casting were found to be nearly equal to those from a straight, axisymmetric model of the casting up to a Reynolds number of about 200, above which the flow resistance of the casting became gradually larger than the corresponding values from the axisymmetric model.

Surface obstacles in pulsatile flow

NASA Astrophysics Data System (ADS)

Carr, Ian A.; Plesniak, Michael W.

2017-11-01

Flows past obstacles mounted on flat surfaces have been widely studied due to their ubiquity in nature and engineering. For nearly all of these studies, the freestream flow over the obstacle was steady, i.e., constant velocity, unidirectional flow. Unsteady, pulsatile flows occur frequently in biology, geophysics, biomedical engineering, etc. Our study is aimed at extending the comprehensive knowledge base that exists for steady flows to considerably more complex pulsatile flows. Characterizing the vortex and wake dynamics of flows around surface obstacles embedded in pulsatile flows can provide insights into the underlying physics in all wake and junction flows. In this study, we experimentally investigate the wake of two canonical obstacles: a cube and a circular cylinder with an aspect ratio of unity. Our previous studies of a surface-mounted hemisphere in pulsatile flow are used as a baseline for these two new, more complex geometries. Phase-averaged PIV and hot-wire anemometry are used to characterize the dynamics of coherent structures in the wake and at the windward junction of the obstacles. Complex physics occur during the deceleration phase of the pulsatile inflow. We propose a framework for understanding these physics based on self-induced vortex propagation, similar to the phenomena exhibited by vortex rings.

Correlation between vortices and wall shear stress in a curved artery model under pulsatile flow conditions

NASA Astrophysics Data System (ADS)

Cox, Christopher; Plesniak, Michael W.

2017-11-01

One of the most physiologically relevant factors within the cardiovascular system is the wall shear stress. The wall shear stress affects endothelial cells via mechanotransduction and atherosclerotic regions are strongly correlated with curvature and branching in the human vasculature, where the shear stress is both oscillatory and multidirectional. Also, the combined effect of curvature and pulsatility in cardiovascular flows produces unsteady vortices. In this work, our goal is to assess the correlation between multiple vortex pairs and wall shear stress. To accomplish this, we use an in-house high-order flux reconstruction Navier-Stokes solver to simulate pulsatile flow of a Newtonian blood-analog fluid through a rigid 180° curved artery model. We use a physiologically relevant flow rate and generate results using both fully developed and uniform entrance conditions, the latter motivated by the fact that flow upstream to a curved artery may not be fully developed. Under these two inflow conditions, we characterize the evolution of various vortex pairs and their subsequent effect on several wall shear stress metrics. Supported by GW Center for Biomimetics and Bioinspired Engineering.

High-order numerical simulations of pulsatile flow in a curved artery model

NASA Astrophysics Data System (ADS)

Cox, Christopher; Liang, Chunlei; Plesniak, Michael W.

2016-11-01

Cardiovascular flows are pulsatile, incompressible and occur in complex geometries with compliant walls. Together, these factors can produce an environment that can affect the progression of cardiovascular disease by altering wall shear stresses. Unstructured high-order CFD methods are well suited for capturing unsteady vortex-dominated viscous flows, and these methods provide high accuracy for similar cost as low-order methods. We use an in-house three-dimensional flux reconstruction Navier-Stokes solver to simulate secondary flows and vortical structures within a rigid 180-degree curved artery model under pulsatile flow of a Newtonian blood-analog fluid. Our simulations use a physiological flowrate waveform taken from the carotid artery. We are particularly interested in the dynamics during the deceleration phase of the waveform, where we observe the deformed-Dean, Dean, Lyne and Wall vortices. Our numerical results reveal the complex nature of these vortices both in space and time and their effect on overall wall shear stress. Numerical results agree with and complement experimental results obtained in our laboratory using particle image velocimetry. Supported by the GW Center for Biomimetics and Bioinspired Engineering.

Effect of centrifugal forces on formation of secondary flow structures in a 180-degree curved artery model under pulsatile inflow conditions

NASA Astrophysics Data System (ADS)

Callahan, Shannon; Sajjad, Roshan; Bulusu, Kartik V.; Plesniak, Michael W.

2013-11-01

An experimental investigation of secondary flow structures within a 180-degree bent tube model of a curved artery was performed using phase-averaged, two-component, two-dimensional, particle image velocimetry (2C-2D PIV) under pulsatile inflow conditions. Pulsatile waveforms ranging from simple sinusoidal to physiological inflows were supplied. We developed a novel continuous wavelet transform algorithm (PIVlet 1.2) and applied it to vorticity fields for coherent secondary flow structure detection. Regime maps of secondary flow structures revealed new, deceleration-phase-dependent flow morphologies. The temporal instances where streamwise centrifugal forces dominated were associated with large-scale coherent structures, such as deformed Dean-, Lyne- and Wall-type (D-L-W) vortical structures. Magnitudes of streamwise and cross-stream centrifugal forces tend to balance during deceleration phases. Deceleration events were also associated with spatial reorganization and asymmetry in large-scale D-L-W secondary flow structures. Hence, the interaction between streamwise and cross-stream centrifugal forces that affects secondary flow morphologies is explained using a ``residual force'' parameter i.e., the difference in magnitudes of these forces. Supported by the NSF Grant No. CBET- 0828903 and GW Center for Biomimetics and Bioinspired Engineering.

Aortic Wave Dynamics and Its Influence on Left Ventricular Workload

PubMed Central

Pahlevan, Niema M.; Gharib, Morteza

2011-01-01

The pumping mechanism of the heart is pulsatile, so the heart generates pulsatile flow that enters into the compliant aorta in the form of pressure and flow waves. We hypothesized that there exists a specific heart rate at which the external left ventricular (LV) power is minimized. To test this hypothesis, we used a computational model to explore the effects of heart rate (HR) and aortic rigidity on left ventricular (LV) power requirement. While both mean and pulsatile parts of the pressure play an important role in LV power requirement elevation, at higher rigidities the effect of pulsatility becomes more dominant. For any given aortic rigidity, there exists an optimum HR that minimizes the LV power requirement at a given cardiac output. The optimum HR shifts to higher values as the aorta becomes more rigid. To conclude, there is an optimum condition for aortic waves that minimizes the LV pulsatile load and consequently the total LV workload. PMID:21853075

Lung protection in cardio-pulmonary bypass.

PubMed

Salameh, A; Greimann, W; Vollroth, M; Dhein, S; Bahramsoltani, M; Dahnert, I

2017-02-01

Since the invention of the heart-lung machine paediatric cardiac surgery developed rapidly. For correction of complex cardiac malformations the application of a cardio-pulmonary bypass (CPB) has become indispensable but possible negative effects of this technique should not be neglected. Especially, both bypassed organs i.e. heart and lung are not perfused during the procedure and therefore are threatened by ischemia and reperfusion injury. Additionally, CPB was developed with a non-pulsatile flow but there are clinical observations that pulsatile flow might be superior with improved patient outcomes. Thus, the aim of our study was to evaluate the effect of CPB on lung structure and to assess whether different flow modalities (pulsatile vs. non-pulsatile flow) or application of the antibiotic minocycline might be advantageous. Thirty five piglets of four weeks age were examined and divided into five experimental groups: control (no CPB) without or with minocycline, CPB (non-pulsatile flow) without or with minocycline and CPB with pulsatile flow. CPB was performed for 90 min followed by a 120 min reperfusion and recovery phase. Thereafter, adenosine triphosphate-content of lung biopsies and histology was carried out. We found that CPB was associated with a significant thickening of alveolar wall accompanied by an infiltration of neutrophil leucocytes. Moreover, markers for hypoxia, apoptosis, nitrosative stress, inflammation and DNA damage were significantly elevated after CPB. These cellular damages could be partially inhibited by minocycline or pulsatile flow. Both, minocycline and pulsatile flow attenuate lung damage after CPB.

Pulsatile spiral blood flow through arterial stenosis.

PubMed

Linge, Fabian; Hye, Md Abdul; Paul, Manosh C

2014-11-01

Pulsatile spiral blood flow in a modelled three-dimensional arterial stenosis, with a 75% cross-sectional area reduction, is investigated by using numerical fluid dynamics. Two-equation k-ω model is used for the simulation of the transitional flow with Reynolds numbers 500 and 1000. It is found that the spiral component increases the static pressure in the vessel during the deceleration phase of the flow pulse. In addition, the spiral component reduces the turbulence intensity and wall shear stress found in the post-stenosis region of the vessel in the early stages of the flow pulse. Hence, the findings agree with the results of Stonebridge et al. (2004). In addition, the results of the effects of a spiral component on time-varying flow are presented and discussed along with the relevant pathological issues.

Vortex propagation around a wall-mounted obstacle in pulsatile flow

NASA Astrophysics Data System (ADS)

Carr, Ian A.; Plesniak, Michael W.

2015-11-01

Wall-mounted obstacles are prevalent in nature and engineering applications. Physiological flows observed in human vocal fold pathologies, such as polyps, can be modeled by flow over a wall-mounted protuberance. Despite their prevalence, studies of wall-mounted obstacles have been restricted to steady (constant velocity) freestream flow. In biological and geophysical applications, pulsatile flow is much more common, yet effects of pulsatility on the wake of a wall-mounted obstacle remain to be extensively studied. This study aims to characterize the complex physics produced in this unsteady, separated flow. Experiments were performed in a low-speed wind tunnel with a set of rotating vanes, which produce the pulsatile inflow waveform. Instantaneous and phase-averaged particle image velocimetry (PIV) results acquired around a hemispherical obstacle are presented and compared. A mechanism based on self-induced vortex propagation, analogous to that in vortex rings, is proposed to explain the observed dynamics of coherent structures. Predictions of the propagation velocity based on analytical expressions for vortex rings in a viscous fluid are compared to the experimentally measured propagation velocity. Effects of the unsteady boundary layer on the observed physics are explored. This material is based in part upon work supported by the National Science Foundation under Grant Number CBET-1236351, and GW Center for Biomimetics and Bioinspired Engineering (COBRE).

Methicillin Resistant Staphylococcus Aureus Biofilm Formation Over A Separated Flow Region Under Steady And Pulsatile Flow Conditions

NASA Astrophysics Data System (ADS)

Salek, M. Mehdi; Martinuzzi, Robert

2012-02-01

Several researchers have observed that the formation, morphology and susceptibility of bacterial biofilms are affected by the local hydrodynamic condition and, in particular, shear stresses acting on the fluid-biofilm interface. A backwards facing step (BFS) experimental model has been widely utilized as an in vitro model to examine and characterize the effect of flow separation and recirculation zones comparable to those present within various medical devices as well as those observed in vivo. The specific geometry of BFS covers a vide range of flow features observed in physiological or environmental conditions. The hypothesis of this study is that the flow behavior and structures can effectively contribute to the transport and attachment of cells and affecting the morphology of adhered colonies as well as suspended structures (i.e. biofilm streamers). Hence, the formation of the recirculation region occurring within a backward facing step (BFS) under steady and pulsatile conditions as well as three-dimensional flow structures arising close to the side walls are investigated to correlate to biofilms behavior. This hypothesis is investigated using a backward facing step incorporated into a flow cell under steady and pulsatile flow regimes to study the growth of methicillin resistant Staphylococcus aureus (MRSA) UC18 as the study microorganism.

Post-stenotic plug-like jet with a vortex ring demonstrated by 4D flow MRI.

PubMed

Kim, Guk Bae; Ha, Hojin; Kweon, Jihoon; Lee, Sang Joon; Kim, Young-Hak; Yang, Dong Hyun; Kim, Namkug

2016-05-01

To investigate the details of the flow structure of a plug-like jet that had a vortex ring in pulsatile stenotic phantoms using 4D flow MRI. Pulsatile Newtonian flows in two stenotic phantoms with 50% and 75% reductions in area were scanned by 4D flow MRI. Blood analog working fluid was circulated via the stenotic phantom using a pulsatile pump at a constant pulsating frequency of 1Hz. The velocity and vorticity fields of the plug-like jet with a vortex ring were quantitatively analyzed in the spatial and temporal domains. Pulsatile stenotic flow showed a plug-like jet at the specific stenotic degree of 50% in our pulsatile waveform design. This plug-like jet was found at the decelerating period in the post-stenotic region of 26.4mm (1.2 D). It revealed a vortex ring structure with vorticity strength in the range of ±100s(-1). We observed a plug-like jet with a vortex ring in pulsatile stenotic flow by in vitro visualization using 4D flow MRI. In this plug-like jet, the local fastest flow region occurred at the post-systole phase in the post-stenotic region, which was distinguishable from a typical stenotic jet flow at systole phase. Copyright © 2015 Elsevier Inc. All rights reserved.

The Effect of Pulsatile Versus Nonpulsatile Blood Flow on Viscoelasticity and Red Blood Cell Aggregation in Extracorporeal Circulation

PubMed Central

Ahn, Chi Bum; Kang, Yang Jun; Kim, Myoung Gon; Yang, Sung; Lim, Choon Hak; Son, Ho Sung; Kim, Ji Sung; Lee, So Young; Son, Kuk Hui; Sun, Kyung

2016-01-01

Background Extracorporeal circulation (ECC) can induce alterations in blood viscoelasticity and cause red blood cell (RBC) aggregation. In this study, the authors evaluated the effects of pump flow pulsatility on blood viscoelasticity and RBC aggregation. Methods Mongrel dogs were randomly assigned to two groups: a nonpulsatile pump group (n=6) or a pulsatile pump group (n=6). After ECC was started at a pump flow rate of 80 mL/kg/min, cardiac fibrillation was induced. Blood sampling was performed before and at 1, 2, and 3 hours after ECC commencement. To eliminate bias induced by hematocrit and plasma, all blood samples were adjusted to a hematocrit of 45% using baseline plasma. Blood viscoelasticity, plasma viscosity, hematocrit, arterial blood gas analysis, central venous O2 saturation, and lactate were measured. Results The blood viscosity and aggregation index decreased abruptly 1 hour after ECC and then remained low during ECC in both groups, but blood elasticity did not change during ECC. Blood viscosity, blood elasticity, plasma viscosity, and the aggregation index were not significantly different in the groups at any time. Hematocrit decreased abruptly 1 hour after ECC in both groups due to dilution by the priming solution used. Conclusion After ECC, blood viscoelasticity and RBC aggregation were not different in the pulsatile and nonpulsatile groups in the adult dog model. Furthermore, pulsatile flow did not have a more harmful effect on blood viscoelasticity or RBC aggregation than nonpulsatile flow. PMID:27298790

The Effect of Pulsatile Versus Nonpulsatile Blood Flow on Viscoelasticity and Red Blood Cell Aggregation in Extracorporeal Circulation.

PubMed

Ahn, Chi Bum; Kang, Yang Jun; Kim, Myoung Gon; Yang, Sung; Lim, Choon Hak; Son, Ho Sung; Kim, Ji Sung; Lee, So Young; Son, Kuk Hui; Sun, Kyung

2016-06-01

Extracorporeal circulation (ECC) can induce alterations in blood viscoelasticity and cause red blood cell (RBC) aggregation. In this study, the authors evaluated the effects of pump flow pulsatility on blood viscoelasticity and RBC aggregation. Mongrel dogs were randomly assigned to two groups: a nonpulsatile pump group (n=6) or a pulsatile pump group (n=6). After ECC was started at a pump flow rate of 80 mL/kg/min, cardiac fibrillation was induced. Blood sampling was performed before and at 1, 2, and 3 hours after ECC commencement. To eliminate bias induced by hematocrit and plasma, all blood samples were adjusted to a hematocrit of 45% using baseline plasma. Blood viscoelasticity, plasma viscosity, hematocrit, arterial blood gas analysis, central venous O2 saturation, and lactate were measured. The blood viscosity and aggregation index decreased abruptly 1 hour after ECC and then remained low during ECC in both groups, but blood elasticity did not change during ECC. Blood viscosity, blood elasticity, plasma viscosity, and the aggregation index were not significantly different in the groups at any time. Hematocrit decreased abruptly 1 hour after ECC in both groups due to dilution by the priming solution used. After ECC, blood viscoelasticity and RBC aggregation were not different in the pulsatile and nonpulsatile groups in the adult dog model. Furthermore, pulsatile flow did not have a more harmful effect on blood viscoelasticity or RBC aggregation than nonpulsatile flow.

Transition in Pulsatile Pipe Flow

NASA Astrophysics Data System (ADS)

Vlachos, Pavlos; Brindise, Melissa

2016-11-01

Transition has been observed to occur in the aorta, and stenotic vessels, where pulsatile flow exists. However, few studies have investigated the characteristics and effects of transition in oscillating or pulsatile flow and none have utilized a physiological waveform. In this work, we explore transition in pipe flow using three pulsatile waveforms which all maintain the same mean and maximum flow rates and range to zero flow, as is physiologically typical. Velocity fields were obtained using planar particle image velocimetry for each pulsatile waveform at six mean Reynolds numbers ranging between 500 and 4000. Turbulent statistics including turbulent kinetic energy (TKE) and Reynolds stresses were computed. Quadrant analysis was used to identify characteristics of the production and dissipation of turbulence. Coherent structures were identified using the λci method. We developed a wavelet-Hilbert time-frequency analysis method to identify high frequency structures and compared these to the coherent structures. The results of this study demonstrate that the different pulsatile waveforms induce different levels of TKE and high frequency structures, suggesting that the rates of acceleration and deceleration influence the onset and development of transition.

Hemodynamics of physiological blood flow in the aorta with nonlinear anisotropic heart valve

NASA Astrophysics Data System (ADS)

Sotiropoulos, Fotis; Gilmanov, Anvar; Stolarski, Henryk

2016-11-01

The hemodynamic blood flow in cardiovascular system is one of the most important factor, which causing several vascular diseases. We developed a new Curvilinear Immersed Boundary - Finite Element - Fluid Structure Interaction (CURVIB-FE-FSI) method to analyze hemodynamic of pulsatile blood flow in a real aorta with nonlinear anisotropic aortic valve at physiological conditions. Hyperelastic material model, which is more realistic for describing heart valve have been incorporated in the CURVIB-FE-FSI code to simulate interaction of aortic heart valve with pulsatile blood flow. Comparative studies of hemodynamics for linear and nonlinear models of heart valve show drastic differences in blood flow patterns and hence differences of stresses causing impact at leaflets and aortic wall. This work is supported by the Lillehei Heart Institute at the University of Minnesota.

A multiple disk centrifugal pump as a blood flow device.

PubMed

Miller, G E; Etter, B D; Dorsi, J M

1990-02-01

A multiple disk, shear force, valveless centrifugal pump was studied to determine its suitability as a blood flow device. A pulsatile version of the Tesla viscous flow turbine was designed by modifying the original steady flow pump concept to produce physiological pressures and flows with the aid of controlling circuitry. Pressures and flows from this pump were compared to a Harvard Apparatus pulsatile piston pump. Both pumps were connected to an artificial circulatory system. Frequency and systolic duration were varied over a range of physiological conditions for both pumps. The results indicated that the Tesla pump, operating in a pulsatile mode, is capable of producing physiologic pressures and flows similar to the Harvard pump and other pulsatile blood pumps.

Numerical simulation of particle transport and deposition in the pulmonary vasculature.

PubMed

Sohrabi, Salman; Zheng, Junda; Finol, Ender A; Liu, Yaling

2014-12-01

To quantify the transport and adhesion of drug particles in a complex vascular environment, computational fluid particle dynamics (CFPD) simulations of blood flow and drug particulate were conducted in three different geometries representing the human lung vasculature for steady and pulsatile flow conditions. A fully developed flow profile was assumed as the inlet velocity, and a lumped mathematical model was used for the calculation of the outlet pressure boundary condition. A receptor-ligand model was used to simulate the particle binding probability. The results indicate that bigger particles have lower deposition fraction due to less chance of successful binding. Realistic unsteady flow significantly accelerates the binding activity over a wide range of particle sizes and also improves the particle deposition fraction in bifurcation regions when comparing with steady flow condition. Furthermore, surface imperfections and geometrical complexity coupled with the pulsatility effect can enhance fluid mixing and accordingly particle binding efficiency. The particle binding density at bifurcation regions increases with generation order and drug carriers are washed away faster in steady flow. Thus, when studying drug delivery mechanism in vitro and in vivo, it is important to take into account blood flow pulsatility in realistic geometry. Moreover, tissues close to bifurcations are more susceptible to deterioration due to higher uptake.

A High Performance Pulsatile Pump for Aortic Flow Experiments in 3-Dimensional Models.

PubMed

Chaudhury, Rafeed A; Atlasman, Victor; Pathangey, Girish; Pracht, Nicholas; Adrian, Ronald J; Frakes, David H

2016-06-01

Aortic pathologies such as coarctation, dissection, and aneurysm represent a particularly emergent class of cardiovascular diseases. Computational simulations of aortic flows are growing increasingly important as tools for gaining understanding of these pathologies, as well as for planning their surgical repair. In vitro experiments are required to validate the simulations against real world data, and the experiments require a pulsatile flow pump system that can provide physiologic flow conditions characteristic of the aorta. We designed a newly capable piston-based pulsatile flow pump system that can generate high volume flow rates (850 mL/s), replicate physiologic waveforms, and pump high viscosity fluids against large impedances. The system is also compatible with a broad range of fluid types, and is operable in magnetic resonance imaging environments. Performance of the system was validated using image processing-based analysis of piston motion as well as particle image velocimetry. The new system represents a more capable pumping solution for aortic flow experiments than other available designs, and can be manufactured at a relatively low cost.

Generating pulsatility by pump speed modulation with continuous-flow total artificial heart in awake calves.

PubMed

Fukamachi, Kiyotaka; Karimov, Jamshid H; Sunagawa, Gengo; Horvath, David J; Byram, Nicole; Kuban, Barry D; Dessoffy, Raymond; Sale, Shiva; Golding, Leonard A R; Moazami, Nader

2017-12-01

The purpose of this study was to evaluate the effects of sinusoidal pump speed modulation of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) on hemodynamics and pump flow in an awake chronic calf model. The sinusoidal pump speed modulations, performed on the day of elective sacrifice, were set at ±15 and ± 25% of mean pump speed at 80 bpm in four awake calves with a CFTAH. The systemic and pulmonary arterial pulse pressures increased to 12.0 and 12.3 mmHg (±15% modulation) and to 15.9 and 15.7 mmHg (±25% modulation), respectively. The pulsatility index and surplus hemodynamic energy significantly increased, respectively, to 1.05 and 1346 ergs/cm at ±15% speed modulation and to 1.51 and 3381 ergs/cm at ±25% speed modulation. This study showed that it is feasible to generate pressure pulsatility with pump speed modulation; the platform is suitable for evaluating the physiologic impact of pulsatility and allows determination of the best speed modulations in terms of magnitude, frequency, and profiles.

Pulsatile extracorporeal circulation during on-pump cardiac surgery enhances aortic wall shear stress.

PubMed

Assmann, Alexander; Benim, Ali Cemal; Gül, Fethi; Lux, Philipp; Akhyari, Payam; Boeken, Udo; Joos, Franz; Feindt, Peter; Lichtenberg, Artur

2012-01-03

Controversy on superiority of pulsatile versus non-pulsatile extracorporeal circulation in cardiac surgery still continues. Stroke as one of the major adverse events during cardiopulmonary bypass is, in the majority of cases, caused by mobilization of aortic arteriosclerotic plaques that is inducible by pathologically elevated wall shear stress values. The present study employs computational fluid dynamics to evaluate the aortic blood flow and wall shear stress profiles under the influence of antegrade or retrograde perfusion with pulsatile versus non-pulsatile extracorporeal circulation. While, compared to physiological flow, a non-pulsatile perfusion resulted in generally decreased blood velocities and only moderately increased shear forces (48 Pa versus 20 Pa antegradely and 127 Pa versus 30 Pa retrogradely), a pulsatile perfusion extensively enhanced the occurrence of turbulences, maximum blood flow speed and maximum wall shear stress (1020 Pa versus 20 Pa antegradely and 1178 Pa versus 30 Pa retrogradely). Under these circumstances arteriosclerotic embolism has to be considered. Further simulations and experimental work are necessary to elucidate the impact of our findings on the scientific discourse of pulsatile versus non-pulsatile extracorporeal circulation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Extremely pulsatile flow around a surface-mounted hemisphere: synergistic experiments and simulations

NASA Astrophysics Data System (ADS)

Carr, Ian A.; Beratlis, Nikolaos; Balaras, Elias; Plesniak, Michael W.

2017-11-01

Extremely pulsatile flow (where the amplitude of oscillation pulsation is of the same order as the mean flow) over a three-dimensional, surface-mounted bluff body gives rise a wealth of fluid dynamics phenomena. In this study, we extend our previous experimental work on extremely pulsatile flow around a surface-mounted hemisphere by performing a complementary direct numerical simulation. Results from the experiment and simulation will be presented and compared. After establishing the agreement between experiment and simulation, we will examine the morphology and dynamics of the vortex structures in the wake of the hemisphere, and the effects of extreme pulsatility. The dynamics of the arch-type recirculation vortex is of primary interest, in particular its upstream propagation due to self-induced velocity in the direction opposite to the freestream during deceleration. In addition to the velocity field, the surface pressure field throughout the pulsatile cycle will be presented. These synergistic experiments and simulations provide a detailed view into the complex flow fields associated with pulsatile flow over a surface-mounted hemisphere. This material is based upon work supported by the National Science Foundation under Grant Number CBET-1236351 and the GW Center for Biomimetics and Bioinspired Engineering.

Turbulence significantly increases pressure and fluid shear stress in an aortic aneurysm model under resting and exercise flow conditions.

PubMed

Khanafer, Khalil M; Bull, Joseph L; Upchurch, Gilbert R; Berguer, Ramon

2007-01-01

The numerical models of abdominal aortic aneurysm (AAA) in use do not take into account the non-Newtonian behavior of blood and the development of local turbulence. This study examines the influence of pulsatile, turbulent, non-Newtonian flow on fluid shear stresses and pressure changes under rest and exercise conditions. We numerically analyzed pulsatile turbulent flow, using simulated physiological rest and exercise waveforms, in axisymmetric-rigid aortic aneurysm models (AAMs). Discretization of governing equations was achieved using a finite element scheme. Maximum turbulence-induced shear stress was found at the distal end of an AAM. In large AAMs (dilated to undilated diameter ratio = 3.33) at peak systolic flow velocity, fluid shear stress during exercise is 70.4% higher than at rest. Our study provides a numerical, noninvasive method for obtaining detailed data on the forces generated by pulsatile turbulent flow in AAAs that are difficult to study in humans and in physical models. Our data suggest that increased flow turbulence results in increased shear stress in aneurysms. While pressure readings are fairly uniform along the length of an aneurysm, the kinetic energy generated by turbulence impacting on the wall of the distal half of the aneurysm increases fluid and wall shear stress at this site. If the increased fluid shear stress results in further dilation and hence further turbulence, wall stress may be a mechanism for aneurysmal growth and eventual rupture.

[Clinical and experimental study of the production of renal hemodynamic effects of IABP-assisted pulsatile flow extracorporeal circulation].

PubMed

Moro, H

1992-01-01

Renal hemodynamics during IABP-assisted pulsatile flow extracorporeal circulation was assessed in terms of measurement values for intraoperative renal blood flow obtained by the local thermodilution method in human clinical patients. In addition, the effect of IABP on renal hemodynamics was investigated in an animal model of renal denervation in a study undertaken to elucidate the action mechanism of IABP. Eighteen patients with acquired heart disease were involved in the study and measured for the renal blood flow (RBF), cardiac output (CO), renal-systemic partition coefficient for blood flow (RBF/CO), renal vascular resistance (RVR) and perfusion pressure. In the pulsatile flow group, the RBF/CO increased as the number of pump runs increased, whole the RVR was conversely reduced with increasing pump runs. The experimental study without extracorporeal circulation was conducted on 19 mongrel dogs. During IABP runs RBF/CO increased, while the RVR decreased. After renal denervation, no noticeable influence of IABP upon renal hemodynamics was observed. Following a loading dose of noradrenaline (Norad), the RVR increased in a Norad concentration-dependent fashion, independently of IABP and renal denervation. These results indicate that IABP reduces the RVR and thereby exerts a favorable action on renal hemodynamics during pump times. The study thus warrants us to surmise that a mechanism involving the renal sympathetic nerves might play an important role in the production of favorable renal hemodynamic effects of IABP-assisted pulsatile flow extracorporeal circulation.

Blood flow dynamic improvement with aneurysm repair detected by a patient-specific model of multiple aortic aneurysms.

PubMed

Sughimoto, Koichi; Takahara, Yoshiharu; Mogi, Kenji; Yamazaki, Kenji; Tsubota, Ken'ichi; Liang, Fuyou; Liu, Hao

2014-05-01

Aortic aneurysms may cause the turbulence of blood flow and result in the energy loss of the blood flow, while grafting of the dilated aorta may ameliorate these hemodynamic disturbances, contributing to the alleviation of the energy efficiency of blood flow delivery. However, evaluating of the energy efficiency of blood flow in an aortic aneurysm has been technically difficult to estimate and not comprehensively understood yet. We devised a multiscale computational biomechanical model, introducing novel flow indices, to investigate a single male patient with multiple aortic aneurysms. Preoperative levels of wall shear stress and oscillatory shear index (OSI) were elevated but declined after staged grafting procedures: OSI decreased from 0.280 to 0.257 (first operation) and 0.221 (second operation). Graftings may strategically counter the loss of efficient blood delivery to improve hemodynamics of the aorta. The energy efficiency of blood flow also improved postoperatively. Novel indices of pulsatile pressure index (PPI) and pulsatile energy loss index (PELI) were evaluated to characterize and quantify energy loss of pulsatile blood flow. Mean PPI decreased from 0.445 to 0.423 (first operation) and 0.359 (second operation), respectively; while the preoperative PELI of 0.986 dropped to 0.820 and 0.831. Graftings contributed not only to ameliorate wall shear stress or oscillatory shear index but also to improve efficient blood flow. This patient-specific modeling will help in analyzing the mechanism of aortic aneurysm formation and may play an important role in quantifying the energy efficiency or loss in blood delivery.

Computational analysis of aortic hemodynamics during total and partial extracorporeal membrane oxygenation and intra-aortic balloon pump support.

PubMed

Caruso, Maria Vittoria; Gramigna, Vera; Renzulli, Attilio; Fragomeni, Gionata

2016-01-01

The extracorporeal membrane oxygenation (ECMO) is a temporary, but prolonged circulatory support for cardiopulmonary failure. Clinical evidence suggests that pulsed flow is healthier than non pulsatile perfusion. The aim of this study was to computationally evaluate the effects of total and partial ECMO assistance and pulsed flow on hemodynamics in a patient-specific aorta model. The pulsatility was obtained by means of the intra-aortic balloon pump (IABP), and two different cases were investigated, considering a cardiac output (CO) of 5 L/min: Case A - total assistance - the whole flow delivered through the ECMO arterial cannula; Case B - partial assistance - flow delivered half through the cannula and half through the aorta. Computational fluid dynamic (CFD) analysis was carried out using the multiscale approach to couple the 3D aorta model with the lumped parameter model (resistance boundary condition). In case A pulsatility followed the balloon radius change, while in case B it was mostly influenced by the cardiac one. Furthermore, during total assistance, a blood stagnation occurred in the ascending aorta; in the case of partial assistance, the flow was orderly when the IABP was on and was chaotic when the balloon was off. Moreover, the mean arterial pressure (MAP) was higher in case B. The wall shear stress was worse in ascending aorta in case A. Partial support is hemodynamically advisable.

Power consumption of rotary blood pumps: pulsatile versus constant-speed mode.

PubMed

Pirbodaghi, Tohid; Cotter, Chris; Bourque, Kevin

2014-12-01

We investigated the power consumption of a HeartMate III rotary blood pump based on in vitro experiments performed in a cardiovascular simulator. To create artificial-pulse mode, we modulated the pump speed by decreasing the mean speed by 2000 rpm for 200 ms and then increasing speed by 4000 rpm (mean speeds plus 2000 rpm) for another 200 ms, creating a square waveform shape. The HeartMate III was connected to a cardiovascular simulator consisting of a hydraulic pump system to simulate left ventricle pumping action, arterial and venous compliance chambers, and an adjustable valve for peripheral resistance to facilitate the desired aortic pressure. The simulator operated based on Suga's elastance model to mimic the Starling response of the heart, thereby reproducing physiological blood flow and pressure conditions. We measured the instantaneous total electrical current and voltage of the pump to evaluate its power consumption. The aim was to answer these fundamental questions: (i) How does pump speed modulation affect pump power consumption? (ii) How does the power consumption vary in relation to external pulsatile flow? The results indicate that speed modulation and external pulsatile flow both moderately increase the power consumption. Increasing the pump speed reduces the impact of external pulsatile flow. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Entrainment and thrust augmentation in pulsatile ejector flows

NASA Technical Reports Server (NTRS)

Sarohia, V.; Bernal, L.; Bui, T.

1981-01-01

This study comprised direct thrust measurements, flow visualization by use of a spark shadowgraph technique, and mean and fluctuating velocity measurements with a pitot tube and linearized constant temperature hot-wire anemometry respectively. A gain in thrust of as much as 10 to 15% was observed for the pulsatile ejector flow as compared to the steady flow configuration. From the velocity profile measurements, it is concluded that this enhanced augmentation for pulsatile flow as compared to a nonpulsatile one was accomplished by a corresponding increased entrainment by the primary jet flow. It is also concluded that the augmentation and total entrainment by a constant area ejector critically depends upon the inlet geometry of the ejector. Experiments were performed to evaluate the influence of primary jet to ejector area ratio, ejector length, and presence of a diffuser on pulsatile ejector performance.

Temporal gradients in shear stimulate osteoblastic proliferation via ERK1/2 and retinoblastoma protein

NASA Technical Reports Server (NTRS)

Jiang, Guang-Liang; White, Charles R.; Stevens, Hazel Y.; Frangos, John A.

2002-01-01

Bone cells are subject to interstitial fluid flow (IFF) driven by venous pressure and mechanical loading. Rapid dynamic changes in mechanical loading cause transient gradients in IFF. The effects of pulsatile flow (temporal gradients in fluid shear) on rat UMR106 cells and rat primary osteoblastic cells were studied. Pulsatile flow induced a 95% increase in S-phase UMR106 cells compared with static controls. In contrast, ramped steady flow stimulated only a 3% increase. Similar patterns of S-phase induction were also observed in rat primary osteoblastic cells. Pulsatile flow significantly increased relative UMR106 cell number by 37 and 62% at 1.5 and 24 h, respectively. Pulsatile flow also significantly increased extracellular signal-regulated kinase (ERK1/2) phosphorylation by 418%, whereas ramped steady flow reduced ERK1/2 activation to 17% of control. Correspondingly, retinoblastoma protein was significantly phosphorylated by pulsatile fluid flow. Inhibition of mitogen-activated protein (MAP)/ERK kinase (MEK)1/2 by U0126 (a specific MEK1/2 inhibitor) reduced shear-induced ERK1/2 phosphorylation and cell proliferation. These findings suggest that temporal gradients in fluid shear stress are potent stimuli of bone cell proliferation.

Simulation of blood flow using extended Boltzmann kinetic approach

NASA Astrophysics Data System (ADS)

Chen, Caixia; Chen, Hudong; Freed, David; Shock, Richard; Staroselsky, Ilya; Zhang, Raoyang; Ümit Coşkun, A.; Stone, Peter H.; Feldman, Charles L.

2006-03-01

Lattice Boltzmann (LB) simulations are conducted to obtain the detailed hydrodynamics in a variety of blood vessel setups, including a prototype stented channel and four human coronary artery geometries based on the images obtained from real patients. For a model of stented flow involving an S-shape stent, a pulsatile flow rate is applied as the inlet boundary condition, and the time- and space-dependent flow field is computed. The LB simulation is found to reproduce the analytical solutions for the velocity profiles and wall shear stress distributions for the pulsatile channel flow. For the coronary arteries, the distributions of wall shear stress, which is important for clinical diagnostic purposes, are in good agreement with the conventional CFD predictions.

Surface obstacles in pulsatile flow

NASA Astrophysics Data System (ADS)

Carr, Ian A.; Plesniak, Michael W.

2016-11-01

Flows past obstacles mounted on flat surfaces have been widely studied due to their ubiquity in nature and engineering. For nearly all of these studies, the freestream flow over the obstacle was steady, i.e. constant velocity unidirectional flow. Unsteady, pulsatile flows occur frequently in biology, geophysics, biomedical engineering, etc. Our study is aimed at extending the comprehensive knowledge base that exists for steady flows to considerably more complex pulsatile flows. Beyond the important practical applications, characterizing the vortex and wake dynamics of flows around surface obstacles embedded in pulsatile flows can provide insights into the underlying physics in all wake and junction flows. In this study, we experimentally investigated the wake of four canonical surface obstacles: hemisphere, cube, and circular cylinders with aspect ratio of 1:1 and 2:1. Phase-averaged PIV and hot-wire anemometry are used to characterize the dynamics of coherent structures in the wake and at the windward junction of the obstacles. Complex physics occur during the deceleration phase of the pulsatile inflow. We propose a framework for understanding these physics based on self-induced vortex propagation, similar to the phenomena exhibited by vortex rings. This material is based in part upon work supported by the National Science Foundation under Grant Number CBET-1236351, and GW Centeor Biomimetics and Bioinspired Engineering (COBRE).

Comparison of Irrigation Times Using Gravity and High-Pressure Lavage.

PubMed

Muscatelli, Stefano; Howe, Andrea; O'Hara, Nathan N; O'Toole, Robert V; Sprague, Sheila A; Slobogean, Gerard P

2017-05-01

The benefits of high-pressure pulsatile lavage for open fracture irrigation have been controversial based on conflicting experimental animal research. Recently published data definitively demonstrated that irrigation pressure does not affect the incidence of reoperation for the treatment of open fractures. However, proponents of pulsatile lavage argue a faster irrigation time is an important benefit of the high-pressure treatment. The purpose of this study was to determine the difference in irrigation time between gravity and high-pressure lavage. The experimental setup was designed to mimic clinical practice and compared mean irrigation flow times for high-pressure pulsatile lavage and gravity flow with 2 commonly used tube diameters. Each irrigation setup was tested 5 times at 3 different irrigation bag heights. Analysis of variance and Student's t tests were used to compare the mean flow times of 3 irrigation methods at each height and among the 3 heights for each irrigation method. The mean irrigation flow time in the various experimental models ranged from 161 to 243 seconds. Gravity irrigation with wide tubing was significantly faster than pulsatile lavage or gravity with narrow tubing (P<.001). Increasing irrigation bag height had only a marginal effect on the overall flow times (<9% difference). The difference in mean flow time among the testing techniques was slightly longer than 1 minute, which is unlikely to have a material impact on procedural costs, operating times, and subsequent gains in patient safety. [Orthopedics. 2017; 40(3):e413-e416.]. Copyright 2017, SLACK Incorporated.

Mathematical Modelling of CSF Pulsatile Flow in Aqueduct Cerebri.

PubMed

Czosnyka, Zofia; Kim, Dong-Joo; Balédent, Olivier; Schmidt, Eric A; Smielewski, Peter; Czosnyka, Marek

2018-01-01

The phase-contrast MRI technique permits the non-invasive assessment of CSF movements in cerebrospinal fluid cavities of the central nervous system. Of particular interest is pulsatile cerebrospinal fluid (CSF) flow through the aqueduct cerebri. It is allegedly increased in hydrocephalus, having potential diagnostic value, although not all scientific reports contain unequivocally positive conclusions. For the mathematical simulation of CSF flow, we used a computational model of cerebrospinal blood/fluid circulation designed by a former student as his PhD project. With this model, cerebral blood flow and CSF may be simulated in various vessels using a system of non-linear differential equations as time-varying signals. The amplitude of CSF flow seems to be positively related to the amplitude of pulse waveforms of intracranial pressure (ICP) in situations where mean ICP increases, such as during simulated infusion tests and following step increases of resistance to CSF outflow. An additional positive association between the pulse amplitude of ICP and CSF flow can be seen during simulated increases in the amplitude of arterial pulses (without changes in mean arterial pressure, MAP). The opposite effect can be observed during step increases in the resistance of the aqueduct cerebri and with decreasing elasticity of the system, where the CSF flow amplitude and the ICP pulse amplitude are related inversely. Vasodilatation caused by both gradual decreases in MAP and by increases in PaCO2 provokes an elevation in the observed amplitude of pulsatile CSF flow. Preliminary results indicate that the pulsations of CSF flow may carry information about both CSF-circulatory and cerebral vasogenic components. In most cases, the pulsations of CSF flow are positively related to the pulse amplitudes of both arterial pressure and ICP and to a degree of cerebrovascular dilatation.

Alkaline phosphatase in osteoblasts is down-regulated by pulsatile fluid flow

NASA Technical Reports Server (NTRS)

Hillsley, M. V.; Frangos, J. A.

1997-01-01

It is our hypothesis that interstitial fluid flow plays a role in the bone remodeling response to mechanical loading. The fluid flow-induced expression of three proteins (collagen, osteopontin, and alkaline phosphatase) involved in bone remodeling was investigated. Rat calvarial osteoblasts subjected to pulsatile fluid flow at an average shear stress of 5 dyne/cm2 showed decreased alkaline phosphatase (AP) mRNA expression after only 1 hour of flow. After 3 hours of flow, AP mRNA levels had decreased to 30% of stationary control levels and remained at this level for an additional 5 hours of flow. Steady flow (4 dyne/cm2 fluid shear stress), in contrast, resulted in a delayed and less dramatic decrease in AP mRNA expression to 63% of control levels after 8 hours of flow. The reduced AP mRNA expression under pulsatile flow conditions was followed by reduced AP enzyme activity after 24 hours. No changes in collagen or osteopontin mRNA expression were detected over 8 hours of pulsatile flow. This is the first time fluid flow has been shown to affect gene expression in osteoblasts.

Arterial stiffness, pressure and flow pulsatility and brain structure and function: the Age, Gene/Environment Susceptibility--Reykjavik study.

PubMed

Mitchell, Gary F; van Buchem, Mark A; Sigurdsson, Sigurdur; Gotal, John D; Jonsdottir, Maria K; Kjartansson, Ólafur; Garcia, Melissa; Aspelund, Thor; Harris, Tamara B; Gudnason, Vilmundur; Launer, Lenore J

2011-11-01

Aortic stiffness increases with age and vascular risk factor exposure and is associated with increased risk for structural and functional abnormalities in the brain. High ambient flow and low impedance are thought to sensitize the cerebral microcirculation to harmful effects of excessive pressure and flow pulsatility. However, haemodynamic mechanisms contributing to structural brain lesions and cognitive impairment in the presence of high aortic stiffness remain unclear. We hypothesized that disproportionate stiffening of the proximal aorta as compared with the carotid arteries reduces wave reflection at this important interface and thereby facilitates transmission of excessive pulsatile energy into the cerebral microcirculation, leading to microvascular damage and impaired function. To assess this hypothesis, we evaluated carotid pressure and flow, carotid-femoral pulse wave velocity, brain magnetic resonance images and cognitive scores in participants in the community-based Age, Gene/Environment Susceptibility--Reykjavik study who had no history of stroke, transient ischaemic attack or dementia (n = 668, 378 females, 69-93 years of age). Aortic characteristic impedance was assessed in a random subset (n = 422) and the reflection coefficient at the aorta-carotid interface was computed. Carotid flow pulsatility index was negatively related to the aorta-carotid reflection coefficient (R = -0.66, P<0.001). Carotid pulse pressure, pulsatility index and carotid-femoral pulse wave velocity were each associated with increased risk for silent subcortical infarcts (hazard ratios of 1.62-1.71 per standard deviation, P<0.002). Carotid-femoral pulse wave velocity was associated with higher white matter hyperintensity volume (0.108 ± 0.045 SD/SD, P = 0.018). Pulsatility index was associated with lower whole brain (-0.127 ± 0.037 SD/SD, P<0.001), grey matter (-0.079 ± 0.038 SD/SD, P = 0.038) and white matter (-0.128 ± 0.039 SD/SD, P<0.001) volumes. Carotid-femoral pulse wave velocity (-0.095 ± 0.043 SD/SD, P = 0.028) and carotid pulse pressure (-0.114 ± 0.045 SD/SD, P = 0.013) were associated with lower memory scores. Pulsatility index was associated with lower memory scores (-0.165 ± 0.039 SD/SD, P<0.001), slower processing speed (-0.118 ± 0.033 SD/SD, P<0.001) and worse performance on tests assessing executive function (-0.155 ± 0.041 SD/SD, P<0.001). When magnetic resonance imaging measures (grey and white matter volumes, white matter hyperintensity volumes and prevalent subcortical infarcts) were included in cognitive models, haemodynamic associations were attenuated or no longer significant, consistent with the hypothesis that increased aortic stiffness and excessive flow pulsatility damage the microcirculation, leading to quantifiable tissue damage and reduced cognitive performance. Marked stiffening of the aorta is associated with reduced wave reflection at the interface between carotid and aorta, transmission of excessive flow pulsatility into the brain, microvascular structural brain damage and lower scores in various cognitive domains.

Human Thiel-Embalmed Cadaveric Aortic Model with Perfusion for Endovascular Intervention Training and Medical Device Evaluation.

PubMed

McLeod, Helen; Cox, Ben F; Robertson, James; Duncan, Robyn; Matthew, Shona; Bhat, Raj; Barclay, Avril; Anwar, J; Wilkinson, Tracey; Melzer, Andreas; Houston, J Graeme

2017-09-01

The purpose of this investigation was to evaluate human Thiel-embalmed cadavers with the addition of extracorporeal driven ante-grade pulsatile flow in the aorta as a model for simulation training in interventional techniques and endovascular device testing. Three human cadavers embalmed according to the method of Thiel were selected. Extracorporeal pulsatile ante-grade flow of 2.5 L per min was delivered directly into the aorta of the cadavers via a surgically placed connection. During perfusion, aortic pressure and temperature were recorded and optimized for physiologically similar parameters. Pre- and post-procedure CT imaging was conducted to plan and follow up thoracic and abdominal endovascular aortic repair as it would be in a clinical scenario. Thoracic endovascular aortic repair (TEVAR) and endovascular abdominal repair (EVAR) procedures were conducted in simulation of a clinical case, under fluoroscopic guidance with a multidisciplinary team present. The Thiel cadaveric aortic perfusion model provided pulsatile ante-grade flow, with pressure and temperature, sufficient to conduct a realistic simulation of TEVAR and EVAR procedures. Fluoroscopic imaging provided guidance during the intervention. Pre- and post-procedure CT imaging facilitated planning and follow-up evaluation of the procedure. The human Thiel-embalmed cadavers with the addition of extracorporeal flow within the aorta offer an anatomically appropriate, physiologically similar robust model to simulate aortic endovascular procedures, with potential applications in interventional radiology training and medical device testing as a pre-clinical model.

A viscoelastic fluid-structure interaction model for carotid arteries under pulsatile flow.

PubMed

Wang, Zhongjie; Wood, Nigel B; Xu, Xiao Yun

2015-05-01

In this study, a fluid-structure interaction model (FSI) incorporating viscoelastic wall behaviour is developed and applied to an idealized model of the carotid artery under pulsatile flow. The shear and bulk moduli of the arterial wall are described by Prony series, where the parameters can be derived from in vivo measurements. The aim is to develop a fully coupled FSI model that can be applied to realistic arterial geometries with normal or pathological viscoelastic wall behaviour. Comparisons between the numerical and analytical solutions for wall displacements demonstrate that the coupled model is capable of predicting the viscoelastic behaviour of carotid arteries. Comparisons are also made between the solid only and FSI viscoelastic models, and the results suggest that the difference in radial displacement between the two models is negligible. Copyright © 2015 John Wiley & Sons, Ltd.

The Characteristics of Turbulence in Curved Pipes under Highly Pulsatile Flow Conditions

NASA Astrophysics Data System (ADS)

Kalpakli, A.; Örlü, R.; Tillmark, N.; Alfredsson, P. Henrik

High speed stereoscopic particle image velocimetry has been employed to provide unique data from a steady and highly pulsatile turbulent flow at the exit of a 90 degree pipe bend. Both the unsteady behaviour of the Dean cells under steady conditions, the so called "swirl switching" phenomenon, as well as the secondary flow under pulsations have been reconstructed through proper orthogonal decomposition. The present data set constitutes - to the authors' knowledge - the first detailed investigation of a turbulent, pulsatile flow through a pipe bend.

Application of full field optical studies for pulsatile flow in a carotid artery phantom

PubMed Central

Nemati, M.; Loozen, G. B.; van der Wekken, N.; van de Belt, G.; Urbach, H. P.; Bhattacharya, N.; Kenjeres, S.

2015-01-01

A preliminary comparative measurement between particle imaging velocimetry (PIV) and laser speckle contrast analysis (LASCA) to study pulsatile flow using ventricular assist device in a patient-specific carotid artery phantom is reported. These full-field optical techniques have both been used to study flow and extract complementary parameters. We use the high spatial resolution of PIV to generate a full velocity map of the flow field and the high temporal resolution of LASCA to extract the detailed frequency spectrum of the fluid pulses. Using this combination of techniques a complete study of complex pulsatile flow in an intricate flow network can be studied. PMID:26504652

Quantitative flow and velocity measurements of pulsatile blood flow with 4D-DSA

NASA Astrophysics Data System (ADS)

Shaughnessy, Gabe; Hoffman, Carson; Schafer, Sebastian; Mistretta, Charles A.; Strother, Charles M.

2017-03-01

Time resolved 3D angiographic data from 4D DSA provides a unique environment to explore physical properties of blood flow. Utilizing the pulsatility of the contrast waveform, the Fourier components can be used to track the waveform motion through vessels. Areas of strong pulsatility are determined through the FFT power spectrum. Using this method, we find an accuracy from 4D-DSA flow measurements within 7.6% and 6.8% RMSE of ICA PCVIPR and phantom flow probe validation measurements, respectively. The availability of velocity and flow information with fast acquisition could provide a more quantitative approach to treatment planning and evaluation in interventional radiology.

Tissue Doppler Imaging in the evaluation of abdominal aortic pulsatility: a useful tool for the neonatologist.

PubMed

Valerio, Enrico; Grison, Alessandra; Capretta, Anna; Golin, Rosanna; Ferrarese, Paola; Bellettato, Massimo

2017-03-01

Sonographic cardiac evaluation of newborns with suspected aortic coarctation (AoC) should tend to demonstrate a good phasic and pulsatile flow and the absence of pressure gradient along a normally conformed aortic arch from the modified left parasternal and suprasternal echocardiographic views; these findings, however, may not necessarily rule out a more distal coarctation in the descending aorta. For this reason, the sonographic exam of newborns with suspected AoC should always include a Doppler evaluation of abdominal aortic blood flow from the subcostal view. Occasionally, however, a clearly pulsatile Doppler flow trace in abdominal aorta may be difficult to obtain due to the bad insonation angle existing between the probe and the vessel. In such suboptimal ultrasonic alignment situation, the use of Tissue Doppler Imaging instead of classic Doppler flow imaging may reveal a preserved aortic pulsatility by sampling the aortic wall motion induced by normal flow. We propose to take advantage of the TDI pattern as a surrogate of a normal pulsatile Doppler flow trace in abdominal aorta when the latter is difficult to obtain due to malalignment with the insonated vessel.

Mathematical modeling of pulsatile flow of non-Newtonian fluid in stenosed arteries

NASA Astrophysics Data System (ADS)

Sankar, D. S.; Lee, Usik

2009-07-01

The pulsatile flow of blood through mild stenosed artery is studied. The effects of pulsatility, stenosis and non-Newtonian behavior of blood, treating the blood as Herschel-Bulkley fluid, are simultaneously considered. A perturbation method is used to analyze the flow. The expressions for the shear stress, velocity, flow rate, wall shear stress, longitudinal impedance and the plug core radius have been obtained. The variations of these flow quantities with different parameters of the fluid have been analyzed. It is found that, the plug core radius, pressure drop and wall shear stress increase with the increase of yield stress or the stenosis height. The velocity and the wall shear stress increase considerably with the increase in the amplitude of the pressure drop. It is clear that for a given value of stenosis height and for the increasing values of the stenosis shape parameter from 3 to 6, there is a sharp increase in the impedance of the flow and also the plots are skewed to the right-hand side. It is observed that the estimates of the increase in the longitudinal impedance increase with the increase of the axial distance or with the increase of the stenosis height. The present study also brings out the effects of asymmetric of the stenosis on the flow quantities.

Application of a pressure-relieving air compliance chamber in a single-pulsatile extracorporeal life support system: an experimental study.

PubMed

Kim, Tae Sik; Sun, Kyung; Lee, Kyu Baek; Lee, Hye Won; Baek, Kwang Je; Park, Sung Young; Son, Ho Sung; Kim, Kwang Taik; Kim, Hyoung Mook

2004-12-01

Nonpulsatile blood pumps are mainly used in extracorporeal life support systems. Although pulsating blood flow is known to be physiological, a pulsatile pump is not commonly applied in a circuit with a membrane oxygenator because of damage to the blood cells. The hypothesis that the placement of a pressure-relieving compliance chamber in a circuit might reduce blood cell trauma was tested. An extracorporeal life support circuit was constructed in an acute lung injury model of dogs by oleic acid infusion. The animals were divided into three groups. In group I (n = 6) a nonpulsatile centrifugal pump was used as a control. In group II (n = 4) a single-pulsatile pump was used, and in group III (n = 6) a single-pulsatile pump equipped with a compliance chamber was used. Pump flow was maintained at 1.8-2.0 L/min for 2 h. Hemodynamics and blood gas analyses indicated that the pulsatile groups II and III had better results than the nonpulsatile group I. The plasma-free hemoglobin level, which indicates blood cell trauma, was the lowest in group I and the highest in group II but was significantly decreased in group III. A pressure-relieving compliance chamber could significantly reduce high circuit pressures and blood cell trauma.

Cyclic variation of ultrasonic backscattering from porcine whole blood under pulsatile flow

NASA Astrophysics Data System (ADS)

Lin, Yu-Hong

1997-10-01

The cyclic variation of ultrasonic backscattering from blood under pulsatile flow is believed to be related to the change of aggregation state of red cells and is only observed in whole blood. This study was to investigate the phenomenon by an invasive approach which was performed by inserting a 10 MHz catheter mounted transducer into a vessel. For ultrasonic measurement from blood, the most fundamental scheme is the hematocrit dependence. The backscatter maximum location was changed as the blood was stirred or stationary, as well as under steady laminar or turbulent flows. The same trend was also observed under pulsatile flow with 10% to 50% hematocrits in this study, as the backscattering to hematocrit curves were plotted at different times during a flow cycle. When the cyclic variation at 20 beats per minute (BPM) was interpreted in time domain, the enhanced aggregation at the beginning of shearing was observed. At 20 BPM with 40% hematocrit, the amplitude of cyclic variation was reduced when the shear rate was increased and the threshold of 150 s-1 was estimated. The results showed that there was no cyclic variation at 60 BPM. The backscattering was also plotted against the mean flow velocity, which demonstrated the hysteresis loops. The ultrasonic measurements showed that the relationship between the forward and backward paths of the loops were altered as beat rate, hematocrit, and shear rate were varied. Since the pulsatile flow was very complicated, a computational fluid dynamics package, FIDAPTM, was used to compute the shear rate based on the Power Law Model for non-Newtonian fluid viscosity. The non- Newtonian index and consistency in the model were computed from the viscosity to shear rate curves at 10% to 50% hematocrits measured by a cone-plate viscometer. For in vivo measurements, small pigs were used as models. Ultrasonic backscattering measurements were performed in the arteries and veins. The effect of stenosis was also investigated at the site below the renal branch in the artery. The results show that the cyclic variation from whole blood was mediated by the shear rate, hematocrit, beat rate, and fibrinogen concentration.

Pulsatile support using a rotary left ventricular assist device with an electrocardiography-synchronized rotational speed control mode for tracking heart rate variability.

PubMed

Arakawa, Mamoru; Nishimura, Takashi; Takewa, Yoshiaki; Umeki, Akihide; Ando, Masahiko; Kishimoto, Yuichiro; Kishimoto, Satoru; Fujii, Yutaka; Date, Kazuma; Kyo, Shunei; Adachi, Hideo; Tatsumi, Eisuke

2016-06-01

We previously developed a novel control system for a continuous-flow left ventricular assist device (LVAD), the EVAHEART, and demonstrated that sufficient pulsatility can be created by increasing its rotational speed in the systolic phase (pulsatile mode) in a normal heart animal model. In the present study, we assessed this system in its reliability and ability to follow heart rate variability. We implanted an EVAHEART via left thoracotomy into five goats for the Study for Fixed Heart Rate with ventricular pacing at 80, 100, 120 and 140 beats/min and six goats for the Study for native heart rhythm. We tested three modes: the circuit clamp, the continuous mode and the pulsatile mode. In the pulsatile mode, rotational speed was increased during the initial 35 % of the RR interval by automatic control based on the electrocardiogram. Pulsatility was evaluated by pulse pressure and dP/dt max of aortic pressure. As a result, comparing the pulsatile mode with the continuous mode, the pulse pressure was 28.5 ± 5.7 vs. 20.3 ± 7.9 mmHg, mean dP/dt max was 775.0 ± 230.5 vs 442.4 ± 184.7 mmHg/s at 80 bpm in the study for fixed heart rate, respectively (P < 0.05). The system successfully determined the heart rate to be 94.6 % in native heart rhythm. Furthermore, pulse pressure was 41.5 ± 7.9 vs. 27.8 ± 5.6 mmHg, mean dP/dt max was 716.2 ± 133.9 vs 405.2 ± 86.0 mmHg/s, respectively (P < 0.01). In conclusion, our newly developed the pulsatile mode for continuous-flow LVADs reliably provided physiological pulsatility with following heart rate variability.

The Dynamics of Agglomerated Ferrofluid in Steady and Pulsatile Flows

NASA Astrophysics Data System (ADS)

Williams, Alicia; Stewart, Kelley; Vlachos, Pavlos

2007-11-01

Magnetic Drug Targeting (MDT) is a promising technique to deliver medication via functionalized magnetic particles to target sites in the treatment of diseases. In this work, the physics of steady and pulsatile flows laden with superparamagnetic nanoparticles in a square channel under the influence of a magnetic field induced by a 0.6 Tesla permanent magnet is studied. Herein, the dynamics of ferrofluid shedding from an initially accumulated mass in water are examined through shadowgraph imaging using two orthogonal cameras. Fundamental differences in the ferrofluid behavior occur between the steady and pulsatile flow cases, as expected. For steady flows, vortex ring shedding is visualized from the mass, and periodic shedding occurs only for moderate mass sizes where the shear forces in the flow interact with the magnetic forces. At Reynolds numbers below 500 with pulsatile flow, suction and roll up of the ferrofluid is seen during the low and moderate periods of flow, followed by the ejection of ferrofluid during high flow. These shadowgraphs illustrate the beauty and richness of ferrofluid dynamics, an understanding of which is instrumental to furthering MDT as an effective drug delivery device.

Augmentative effect of pulsatility on the wall shear stress in tube flow.

PubMed

Nakata, M; Tatsumi, E; Tsukiya, T; Taenaka, Y; Nishimura, T; Nishinaka, T; Takano, H; Masuzawa, T; Ohba, K

1999-08-01

Wall shear stress (WSS) has been considered to play an important role in the physiological and metabolic functions of the vascular endothelial cells. We investigated the effects of the pulse rate and the maximum flow rate on the WSS to clarify the influence of pulsatility. Water was perfused in a 1/2 inch transparent straight cylinder with a nonpulsatile centrifugal pump and a pulsatile pneumatic ventricular assist device (VAD). In nonpulsatile flow (NF), the flow rate was changed 1 to 6 L/min by 1 L/min increments to obtain standard values of WSS at each flow rate. In pulsatile flow (PF), the pulse rate was controlled at 40, 60, and 80 bpm, and the maximum flow rate was varied from 3.3 to 12.0 L/min while the mean flow rate was kept at 3 L/min. The WSS was estimated from the velocity profile at measuring points using the laser illuminated fluorescence method. In NF, the WSS was 12.0 dyne/cm2 at 3 L/min and 33.0 dyne/cm2 at 6 L/min. In PF, the pulse rate change with the same mean, and the maximum flow rate did not affect WSS. On the other hand, the increase in the maximum flow rate at the constant mean flow rate of 3 L/min augmented the mean WSS from 13.1 to 32.9 dyne/cm2. We concluded that the maximum flow rate exerted a substantial augmentative effect on WSS, and the maximum flow rate was a dominant factor of pulsatility in this effect.

Mathematical Modeling of Ischemia-Reperfusion Injury and Postconditioning Therapy.

PubMed

Fong, D; Cummings, L J

2017-11-01

Reperfusion (restoration of blood flow) after a period of ischemia (interruption of blood flow) can paradoxically place tissues at risk of further injury: so-called ischemia-reperfusion injury or IR injury. Recent studies have shown that postconditioning (intermittent periods of further ischemia applied during reperfusion) can reduce IR injury. We develop a mathematical model to describe the reperfusion and postconditioning process following an ischemic insult, treating the blood vessel as a two-dimensional channel, lined with a monolayer of endothelial cells that interact (respiration and mechanotransduction) with the blood flow. We investigate how postconditioning affects the total cell density within the endothelial layer, by varying the frequency of the pulsatile flow and the oxygen concentration at the inflow boundary. We find that, in the scenarios we consider, the pulsatile flow should be of high frequency to minimize cellular damage, while oxygen concentration at the inflow boundary should be held constant, or subject to only low-frequency variations, to maximize cell proliferation.

The effect of vessel material properties and pulsatile wall motion on the fixation of a proximal stent of an endovascular graft.

PubMed

Corbett, T J; Molony, D S; Callanan, A; McGloughlin, T M

2011-01-01

Migration is a serious failure mechanism associated with endovascular abdominal aortic aneurysm (AAA) repair (EVAR). The effect of vessel material properties and pulsatile wall motion on stent fixation has not been previously investigated. A proximal stent from a commercially available stent graft was implanted into the proximal neck of silicone rubber abdominal aortic aneurysm models of varying proximal neck stiffness (β=25.39 and 20.44). The stent was then dislodged by placing distal force on the stent struts. The peak force to completely dislodge the stent was measured using a loadcell. Dislodgment was performed at ambient pressure with no flow (NF) and during pulsatile flow (PF) at pressures of 120/80 mmHg and 140/100 mmHg to determine if pulsatile wall motions affected the dislodgement force. An imaging analysis was performed at ambient pressure and at pressures of 120 mmHg and 140 mmHg to investigate diameter changes on the model due to the radial force of the stent and internal pressurisation. Stent displacement forces were ~50% higher in the stiffer model (7.16-8.4 N) than in the more compliant model (3.67-4.21 N). The mean displacement force was significantly reduced by 10.95-12.83% from the case of NF to the case of PF at 120/80 mmHg. A further increase in pressure to 140/120 mmHg had no significant effect on the displacement force. The imaging analysis showed that the diameter in the region of the stent was 0.37 mm greater in the less stiff model at all the pressures which could reduce the fixation of the stent. The results suggest that the fixation of passively fixated aortic stents could be comprised in more compliant walls and that pulsatile motions of the wall can reduce the maximum stent fixation. Copyright © 2010 IPEM. Published by Elsevier Ltd. All rights reserved.

Numerical investigation of flow parameters for solid rigid spheroidal particle in a pulsatile pipe flow

NASA Astrophysics Data System (ADS)

Varghese, Joffin; Jayakumar, J. S.

2017-09-01

Quantifying, forecasting and analysing the displacement rates of suspended particles are essential while discussing about blood flow analysis. Because blood is one of the major organs in the body, which enables transport phenomena, comprising of numerous blood cells. In order to model the blood flow, a flow domain was created and numerically simulated. Flow field velocity in the stream is solved utilizing Finite Volume Method utilizing FVM unstructured solver. In pulsatile flow, the effect of parameters such as average Reynolds number, tube radius, particle size and Womersley number are taken into account. In this study spheroidal particle trajectory in axial direction is simulated at different values of pulsating frequency including 1.2 Hz, 3.33 Hz and 4.00 Hz and various densities including 1005 kg/m3 and 1025 kg/m3 for the flow domain. The analysis accomplishes the interaction study of blood constituents for different flow situations which have applications in diagnosis and treatment of cardio vascular related diseases.

The effects of the pulsatile period on the size of recirculation bubble in the vicinity of stent struts

NASA Astrophysics Data System (ADS)

Jiang, B.; Thondapu, V.; Barlis, P.; Poon, E. K. W.; Ooi, A. S. H.

2017-04-01

Incomplete stent apposition (ISA) is sometimes found in stent deployment at complex lesions, and it is considered to be one of the causes of post-stenting complications, such as late stent thrombosis and restenosis. The presence of ISA leads to large recirculation bubbles behind the stent struts, which can reduce shear stress at the arterial wall that retards neointimal formation process and thus lead to complications. Computational fluid dynamics (CFD) simulations are performed on simplified two-dimensional axisymmetric arterial models with stents struts of square and circular cross-sectional shapes at a malapposition distance of 120 μm from the arterial wall. To investigate the effects of pulsatile flow period on the dynamics of the recirculation bubbles, high fidelity simulations are carried out with pulsatile flows of period 0.4 s and 0.8 s. Under the condition of the same flow rate, both square and circular strut cases show that shorter period provides greater flow deceleration, leading to the formation of a larger recirculation bubble. With the same thickness, circular strut has a significant improvement over the square strut in terms of the size of the recirculation bubble, and therefore less likely to lead to complications.

Improving hemodynamics of cardiovascular system under a novel intraventricular assist device support via modeling and simulations.

PubMed

Zhu, Shidong; Luo, Lin; Yang, Bibo; Li, Xinghui; Wang, Xiaohao

2017-12-01

Ventricular assist devices (LVADs) are increasingly recognized for supporting blood circulation in heart failure patients who are non-transplant eligible. Because of its volume, the traditional pulsatile device is not easy to implant intracorporeally. Continuous flow LVADs (CF-LVADs) reduce arterial pulsatility and only offer continuous flow, which is different from physiological flow, and may cause long-term complications in the cardiovascular system. The aim of this study was to design a new pulsatile assist device that overcomes this disadvantage, and to test this device in the cardiovascular system. Firstly, the input and output characteristics of the new device were tested in a simple cardiovascular mock system. A detailed mathematical model was established by fitting the experimental data. Secondly, the model was tested in four pathological cases, and was simulated and coupled with a fifth-order cardiovascular system and a new device model using Matlab software. Using assistance of the new device, we demonstrated that the left ventricle pressure, aortic pressure, and aortic flow of heart failure patients improved to the levels of a healthy individual. Especially, in state IV level heart failure patients, the systolic blood pressure increased from 81.34 mmHg to 132.1 mmHg, whereas the diastolic blood pressure increased from 54.28 mmHg to 78.7 mmHg. Cardiac output increased from 3.21 L/min to 5.16 L/min. The newly-developed assist device not only provided a physiological flow that was similar to healthy individuals, but also effectively improved the ability of the pathological ventricular volume. Finally, the effects of the new device on other hemodynamic parameters are discussed.

Development of a flow feedback pulse duplicator system with rhesus monkey arterial input impedance characteristics

NASA Technical Reports Server (NTRS)

Schaub, J. D.; Koenig, S. C.; Schroeder, M. J.; Ewert, D. L.; Drew, G. A.; Swope, R. D.; Convertino, V. A. (Principal Investigator)

1999-01-01

An in vitro pulsatile pump flow system that is capable of producing physiologic pressures and flows in a mock circulatory system tuned to reproduce the first nine harmonics of the input impedance of a rhesus monkey was developed and tested. The system was created as a research tool for evaluating cardiovascular function and for the design, testing, and evaluation of electrical-mechanical cardiovascular models and chronically implanted sensors. The system possesses a computerized user interface for controlling a linear displacement pulsatile pump in a controlled flow loop format to emulate in vivo cardiovascular characteristics. Evaluation of the pump system consisted of comparing its aortic pressure and flow profiles with in vivo rhesus hemodynamic waveforms in the time and frequency domains. Comparison of aortic pressure and flow data between the pump system and in vivo data showed good agreement in the time and frequency domains, however, the pump system produced a larger pulse pressure. The pump system can be used for comparing cardiovascular parameters with predicted cardiovascular model values and for evaluating such items as vascular grafts, heart valves, biomaterials, and sensors. This article describes the development and evaluation of this feedback controlled cardiovascular dynamics simulation modeling system.

Differential response of endothelial cells to simvastatin when conditioned with steady, non-reversing pulsatile or oscillating shear stress.

PubMed

Rossi, Joanna; Jonak, Paul; Rouleau, Leonie; Danielczak, Lisa; Tardif, Jean-Claude; Leask, Richard L

2011-01-01

Few studies have investigated whether fluid mechanics can impair or enhance endothelial cell response to pharmacological agents such as statin drugs. We evaluated and compared Kruppel-like factor 2 (KLF2), endothelial nitric oxide synthase (eNOS), and thrombomodulin (TM) expression in human abdominal aortic endothelial cells (HAAEC) treated with increasing simvastatin concentrations (0.1, 1 or 10 μM) under static culture and shear stress (steady, non-reversing pulsatile, and oscillating). Simvastatin, steady flow, and non-reversing pulsatile flow each separately upregulated KLF2, eNOS, and TM mRNA. At lower simvastatin concentrations (0.1 and 1 μM), the combination of statin and unidirectional steady or pulsatile flow produced an overall additive increase in mRNA levels. At higher simvastatin concentration (10 μM), a synergistic increase in eNOS and TM mRNA expression was observed. In contrast, oscillating flow impaired KLF2 and TM, but not eNOS expression by simvastatin at 1 μM. A higher simvastatin concentration of 10 μM overcame the inhibitory effect of oscillating flow. Our findings suggest that oscillating shear stress renders the endothelial cells less responsive to simvastatin than cells exposed to unidirectional steady or pulsatile flow. Consequently, the pleiotropic effects of statins in vivo may be less effective in endothelial cells exposed to atheroprone hemodynamics.

The pulsating brain: A review of experimental and clinical studies of intracranial pulsatility

PubMed Central

2011-01-01

The maintenance of adequate blood flow to the brain is critical for normal brain function; cerebral blood flow, its regulation and the effect of alteration in this flow with disease have been studied extensively and are very well understood. This flow is not steady, however; the systolic increase in blood pressure over the cardiac cycle causes regular variations in blood flow into and throughout the brain that are synchronous with the heart beat. Because the brain is contained within the fixed skull, these pulsations in flow and pressure are in turn transferred into brain tissue and all of the fluids contained therein including cerebrospinal fluid. While intracranial pulsatility has not been a primary focus of the clinical community, considerable data have accrued over the last sixty years and new applications are emerging to this day. Investigators have found it a useful marker in certain diseases, particularly in hydrocephalus and traumatic brain injury where large changes in intracranial pressure and in the biomechanical properties of the brain can lead to significant changes in pressure and flow pulsatility. In this work, we review the history of intracranial pulsatility beginning with its discovery and early characterization, consider the specific technologies such as transcranial Doppler and phase contrast MRI used to assess various aspects of brain pulsations, and examine the experimental and clinical studies which have used pulsatility to better understand brain function in health and with disease. PMID:21349153

Non-dimensional physics of pulsatile cardiovascular networks and energy efficiency.

PubMed

Yigit, Berk; Pekkan, Kerem

2016-01-01

In Nature, there exist a variety of cardiovascular circulation networks in which the energetic ventricular load has both steady and pulsatile components. Steady load is related to the mean cardiac output (CO) and the haemodynamic resistance of the peripheral vascular system. On the other hand, the pulsatile load is determined by the simultaneous pressure and flow waveforms at the ventricular outlet, which in turn are governed through arterial wave dynamics (transmission) and pulse decay characteristics (windkessel effect). Both the steady and pulsatile contributions of the haemodynamic power load are critical for characterizing/comparing disease states and for predicting the performance of cardiovascular devices. However, haemodynamic performance parameters vary significantly from subject to subject because of body size, heart rate and subject-specific CO. Therefore, a 'normalized' energy dissipation index, as a function of the 'non-dimensional' physical parameters that govern the circulation networks, is needed for comparative/integrative biological studies and clinical decision-making. In this paper, a complete network-independent non-dimensional formulation that incorporates pulsatile flow regimes is developed. Mechanical design variables of cardiovascular flow systems are identified and the Buckingham Pi theorem is formally applied to obtain the corresponding non-dimensional scaling parameter sets. Two scaling approaches are considered to address both the lumped parameter networks and the distributed circulation components. The validity of these non-dimensional number sets is tested extensively through the existing empirical allometric scaling laws of circulation systems. Additional validation studies are performed using a parametric numerical arterial model that represents the transmission and windkessel characteristics, which are adjusted to represent different body sizes and non-dimensional haemodynamic states. Simulations demonstrate that the proposed non-dimensional indices are independent of body size for healthy conditions, but are sensitive to deviations caused by off-design disease states that alter the energetic load. Sensitivity simulations are used to identify the relationship between pulsatile power loss and non-dimensional characteristics, and optimal operational states are computed. © 2016 The Author(s).

Pulsatile Flow Across a Cylinder--An Investigation of Flow in a Total Artificial Lung

NASA Astrophysics Data System (ADS)

Lin, Yu-Chun

2005-11-01

The effect of pulsatility on flow across a single cylinder has been examined experimentally using particle image velocimetry. This work is motivated by the ongoing development of a total artificial lung (TAL), a device which would serve as a bridge to lung transplant. The prototype TAL consists of hollow microfibers through which oxygen-rich gas flows and blood flows around. Flow through the device is provided entirely by right heart and, therefore, is puslatile. The Peclet number of the flow is large and consequently the development of secondary flow affects the resulting gas exchange. The effects of frequency and average flow rate of pulsatile flow around a cylinder were investigated experimentally in a water tunnel and some of the results were compared with preliminary numerical results. Vortices developed behind the cylinder at lower Reynolds numbers in pulsatile flow than steady flow. The results indicate that there are critical values of the Reynolds number between 3 to 5 and Stokes numbers of 0.22, below which vortices were not observed. The findings suggest that higher Stokes and Reynolds numbers within the device could enhance vortex formation. However, this enhanced gas exchange could be at the expense of higher device resistance and increased likelihood of blood trauma. Intelligent TAL design will require consideration of these effects. This work is supported by NIH grant HL69420.

Low-pressure sequential compression of lower limbs enhances forearm skin blood flow.

PubMed

Amah, Guy; Voicu, Sebastian; Bonnin, Philippe; Kubis, Nathalie

2016-12-01

We investigated whether forearm skin blood flow could be improved when a multilayer pulsatile inflatable suit was applied at a low pressure to the lower limbs and abdomen. We hypothesized that a non-invasive purely mechanical stimulation of the lower limbs could induce remote forearm blood flow modifications. The pulsatile suit induced a sequential compartmentalized low compression (65 mmHg), which was synchronized with each diastole of the cardiac cycle with each phase evolving centripetally (lower limbs to abdomen). Modifications of the forearm skin blood flow were continuously recorded by laser Doppler flowmetry (LDF) at baseline and during the pulsatile suit application. Endothelium-dependent and endothelium-independent vasodilations of the forearm skin microcirculation were measured by LDF in response to a local transdermal iontophoretic application of acetylcholine (ACh-test) and to hyperthermia (hyperT- test). Twenty-four healthy volunteers, 12 men and 12 women (43±14 years) were included in the study. LDF responses increased 1) under pulsatile suit (97±106%, p.

In Vivo Validation of Volume Flow Measurements of Pulsatile Flow Using a Clinical Ultrasound System and Matrix Array Transducer.

PubMed

Hudson, John M; Williams, Ross; Milot, Laurent; Wei, Qifeng; Jago, James; Burns, Peter N

2017-03-01

The goal of this study was to evaluate the accuracy of a non-invasive C-plane Doppler estimation of pulsatile blood flow in the lower abdominal vessels of a porcine model. Doppler ultrasound measurements from a matrix array transducer system were compared with invasive volume flow measurements made on the same vessels with a surgically implanted ultrasonic transit-time flow probe. For volume flow rates ranging from 60 to 750 mL/min, agreement was very good, with a Pearson correlation coefficient of 0.97 (p < 0.0001) and a mean bias of -4.2%. The combination of 2-D matrix array technology and fast processing gives this Doppler method clinical potential, as many of the user- and system-dependent parameters of previous methods, including explicit vessel angle and diameter measurements, are eliminated. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Spiral blood flows in an idealized 180-degree curved artery model

NASA Astrophysics Data System (ADS)

Bulusu, Kartik V.; Kulkarni, Varun; Plesniak, Michael W.

2017-11-01

Understanding of cardiovascular flows has been greatly advanced by the Magnetic Resonance Velocimetry (MRV) technique and its potential for three-dimensional velocity encoding in regions of anatomic interest. The MRV experiments were performed on a 180-degree curved artery model using a Newtonian blood analog fluid at the Richard M. Lucas Center at Stanford University employing a 3 Tesla General Electric (Discovery 750 MRI system) whole body scanner with an eight-channel cardiac coil. Analysis in two regions of the model-artery was performed for flow with Womersley number=4.2. In the entrance region (or straight-inlet pipe) the unsteady pressure drop per unit length, in-plane vorticity and wall shear stress for the pulsatile, carotid artery-based flow rate waveform were calculated. Along the 180-degree curved pipe (curvature ratio =1/7) the near-wall vorticity and the stretching of the particle paths in the vorticity field are visualized. The resultant flow behavior in the idealized curved artery model is associated with parameters such as Dean number and Womersley number. Additionally, using length scales corresponding to the axial and secondary flow we attempt to understand the mechanisms leading to the formation of various structures observed during the pulsatile flow cycle. Supported by GW Center for Biomimetics and Bioinspired Engineering (COBRE), MRV measurements in collaboration with Prof. John K. Eaton and, Dr. Chris Elkins at Stanford University.

Numerical analysis of the hemodynamic effect of plaque ulceration in the stenotic carotid artery bifurcation

NASA Astrophysics Data System (ADS)

Wong, Emily Y.; Milner, Jaques S.; Steinman, David A.; Poepping, Tamie L.; Holdsworth, David W.

2009-02-01

The presence of ulceration in carotid artery plaque is an independent risk factor for thromboembolic stroke. However, the associated pathophysiological mechanisms - in particular the mechanisms related to the local hemodynamics in the carotid artery bifurcation - are not well understood. We investigated the effect of carotid plaque ulceration on the local time-varying three-dimensional flow field using computational fluid dynamics (CFD) models of a stenosed carotid bifurcation geometry, with and without the presence of ulceration. CFD analysis of each model was performed with a spatial finite element discretization of over 150,000 quadratic tetrahedral elements and a temporal discretization of 4800 timesteps per cardiac cycle, to adequately resolve the flow field and pulsatile flow, respectively. Pulsatile flow simulations were iterated for five cardiac cycles to allow for cycle-to-cycle analysis following the damping of initial transients in the solution. Comparison between models revealed differences in flow patterns induced by flow exiting from the region of the ulcer cavity, in particular, to the shape, orientation and helicity of the high velocity jet through the stenosis. The stenotic jet in both models exhibited oscillatory motion, but produced higher levels of phase-ensembled turbulence intensity in the ulcerated model. In addition, enhanced out-of-plane recirculation and helical flow was observed in the ulcerated model. These preliminary results suggest that local fluid behaviour may contribute to the thrombogenic risk associated with plaque ulcerations in the stenotic carotid artery bifurcation.

Assessment of turbulence models for pulsatile flow inside a heart pump.

PubMed

Al-Azawy, Mohammed G; Turan, A; Revell, A

2016-02-01

Computational fluid dynamics (CFD) is applied to study the unsteady flow inside a pulsatile pump left ventricular assist device, in order to assess the sensitivity to a range of commonly used turbulence models. Levels of strain and wall shear stress are directly relevant to the evaluation of risk from haemolysis and thrombosis, and thus understanding the sensitivity to these turbulence models is important in the assessment of uncertainty in CFD predictions. The study focuses on a positive displacement or pulsatile pump, and the CFD model includes valves and moving pusher plate. An unstructured dynamic layering method was employed to capture this cyclic motion, and valves were simulated in their fully open position to mimic the natural scenario, with in/outflow triggered at control planes away from the valves. Six turbulence models have been used, comprising three relevant to the low Reynolds number nature of this flow and three more intended to investigate different transport effects. In the first group, we consider the shear stress transport (SST) [Formula: see text] model in both its standard and transition-sensitive forms, and the 'laminar' model in which no turbulence model is used. In the second group, we compare the one equation Spalart-Almaras model, the standard two equation [Formula: see text] and the full Reynolds stress model (RSM). Following evaluation of spatial and temporal resolution requirements, results are compared with available experimental data. The model was operated at a systolic duration of 40% of the pumping cycle and a pumping rate of 86 BPM (beats per minute). Contrary to reasonable preconception, the 'transition' model, calibrated to incorporate additional physical modelling specifically for these flow conditions, was not noticeably superior to the standard form of the model. Indeed, observations of turbulent viscosity ratio reveal that the transition model initiates a premature increase of turbulence in this flow, when compared with both experimental and higher order numerical results previously reported in the literature. Furthermore, the RSM is indicated to provide the most accurate prediction over much of the flow, due to its ability to more correctly account for three-dimensional effects. Finally, the clinical relevance of the results is reported along with a discussion on the impact of such modelling uncertainties.

Analysis of flow disturbance in a stenosed carotid artery bifurcation using two-equation transitional and turbulence models.

PubMed

Tan, F P P; Soloperto, G; Bashford, S; Wood, N B; Thom, S; Hughes, A; Xu, X Y

2008-12-01

In this study, newly developed two-equation turbulence models and transitional variants are employed for the prediction of blood flow patterns in a diseased carotid artery where the growth, progression, and structure of the plaque at rupture are closely linked to low and oscillating wall shear stresses. Moreover, the laminar-turbulent transition in the poststenotic zone can alter the separation zone length, wall shear stress, and pressure distribution over the plaque, with potential implications for stresses within the plaque. Following the validation with well established experimental measurements and numerical studies, a magnetic-resonance (MR) image-based model of the carotid bifurcation with 70% stenosis was reconstructed and simulated using realistic patient-specific conditions. Laminar flow, a correlation-based transitional version of Menter's hybrid k-epsilon/k-omega shear stress transport (SST) model and its "scale adaptive simulation" (SAS) variant were implemented in pulsatile simulations from which analyses of velocity profiles, wall shear stress, and turbulence intensity were conducted. In general, the transitional version of SST and its SAS variant are shown to give a better overall agreement than their standard counterparts with experimental data for pulsatile flow in an axisymmetric stenosed tube. For the patient-specific case reported, the wall shear stress analysis showed discernable differences between the laminar flow and SST transitional models but virtually no difference between the SST transitional model and its SAS variant.

Preload-Based Starling-Like Control for Rotary Blood Pumps: Numerical Comparison with Pulsatility Control and Constant Speed Operation

PubMed Central

Mansouri, Mahdi; Salamonsen, Robert F.; Lim, Einly; Akmeliawati, Rini; Lovell, Nigel H.

2015-01-01

In this study, we evaluate a preload-based Starling-like controller for implantable rotary blood pumps (IRBPs) using left ventricular end-diastolic pressure (PLVED) as the feedback variable. Simulations are conducted using a validated mathematical model. The controller emulates the response of the natural left ventricle (LV) to changes in PLVED. We report the performance of the preload-based Starling-like controller in comparison with our recently designed pulsatility controller and constant speed operation. In handling the transition from a baseline state to test states, which include vigorous exercise, blood loss and a major reduction in the LV contractility (LVC), the preload controller outperformed pulsatility control and constant speed operation in all three test scenarios. In exercise, preload-control achieved an increase of 54% in mean pump flow (QP-) with minimum loading on the LV, while pulsatility control achieved only a 5% increase in flow and a decrease in mean pump speed. In a hemorrhage scenario, the preload control maintained the greatest safety margin against LV suction. PLVED for the preload controller was 4.9 mmHg, compared with 0.4 mmHg for the pulsatility controller and 0.2 mmHg for the constant speed mode. This was associated with an adequate mean arterial pressure (MAP) of 84 mmHg. In transition to low LVC, QP- for preload control remained constant at 5.22 L/min with a PLVED of 8.0 mmHg. With regards to pulsatility control, QP- fell to the nonviable level of 2.4 L/min with an associated PLVED of 16 mmHg and a MAP of 55 mmHg. Consequently, pulsatility control was deemed inferior to constant speed mode with a PLVED of 11 mmHg and a QP- of 5.13 L/min in low LVC scenario. We conclude that pulsatility control imposes a danger to the patient in the severely reduced LVC scenario, which can be overcome by using a preload-based Starling-like control approach. PMID:25849979

Effect of non-Newtonian and pulsatile blood flow on mass transport in the human aorta.

PubMed

Liu, Xiao; Fan, Yubo; Deng, Xiaoyan; Zhan, Fan

2011-04-07

To investigate the effects of both non-Newtonian behavior and the pulsation of blood flow on the distributions of luminal surface LDL concentration and oxygen flux along the wall of the human aorta, we numerically compared a non-Newtonian model with the Newtonian one under both steady flow and in vivo pulsatile flow conditions using a human aorta model constructed from MRI images. The results showed that under steady flow conditions, although the shear thinning non-Newtonian nature of blood could elevate wall shear stress (WSS) in most regions of the aorta, especially areas with low WSS, it had little effect on luminal surface LDL concentration (c(w)) in most regions of the aorta. Nevertheless, it could significantly enhance c(w) in areas with high luminal surface LDL concentration through the shear dependent diffusivity of LDLs. For oxygen transport, the shear thinning non-Newtonian nature of blood could slightly reduce oxygen flux in most regions of the aorta, but this effect became much more apparent in areas with already low oxygen flux. The pulsation of blood flow could significantly reduce c(w) and enhance oxygen flux in these disturbed places. In most other regions of the aorta, the oxygen flux was also significantly higher than that for the steady flow simulation. In conclusion, the shear shining non-Newtonian nature of blood has little effect on LDL and oxygen transport in most regions of the aorta, but in the atherogenic-prone areas where luminal surface LDL concentration is high and oxygen flux is low, its effect is apparent. Similar is for the effect of pulsatile flow on the transport of LDLs. But, the pulsation of blood flow can apparently affect oxygen flux in the aorta, especially in areas with low oxygen flux. Copyright © 2011 Elsevier Ltd. All rights reserved.

Numerical solutions of pulsating flow and heat transfer characteristics in a channel with a backward-facing step

NASA Astrophysics Data System (ADS)

Valencia, A.; Hinojosa, L.

The incompressible laminar flow of air and heat transfer in a channel with a backward-facing step is studied for steady cases and for pulsatile inlet conditions. For steady flows the influence of the inlet velocity profile, the height of the step and the Reynolds number on the reattachment length is investigated. A parabolic entrance profile was used for pulsatile flow. It was found with amplitude of oscillation of one by Re=100 that the primary vortex breakdown through one pulsatile cycle. The wall shear rate in the separation zone varied markedly with pulsatile flows and the wall heat transfer remained relatively constant. The time-average pulsatile heat transfer at the walls was greater as with steady flow with the same mean Reynolds number. Zusammenfassung Es wird eine zweidimensionale numerische Untersuchung des instationären Wärmeübergangs und Druckverlustes im laminar durchströmten Spaltkanal mit einer plötzlichen Kanalerweiterung dargelegt und zwar für stationäre und periodische Geschwindigkeitsprofile am Eintritt des Kanals. Für stationäre Strömungen wurden die Form des Eintrittsprofils, die Reynoldszahl und die Kanalerweiterung variiert. Als Lösung der Navier/Stokes-und der Energiegleichungen mit periodischen Randbedingungen resultiert eine oszillierende Strömung, die das Aufplatzen des Primärwirbels in einer Schwingungsperiode zur Folge hat. Der Einfluß dieser Oszillation auf den Wärmeübergang und den Strömungsverlust wurde für die maximale Amplitude und für Re=100 eingehend untersucht.

Pulsatile pipe flow transition: Flow waveform effects

NASA Astrophysics Data System (ADS)

Brindise, Melissa C.; Vlachos, Pavlos P.

2018-01-01

Although transition is known to exist in various hemodynamic environments, the mechanisms that govern this flow regime and their subsequent effects on biological parameters are not well understood. Previous studies have investigated transition in pulsatile pipe flow using non-physiological sinusoidal waveforms at various Womersley numbers but have produced conflicting results, and multiple input waveform shapes have yet to be explored. In this work, we investigate the effect of the input pulsatile waveform shape on the mechanisms that drive the onset and development of transition using particle image velocimetry, three pulsatile waveforms, and six mean Reynolds numbers. The turbulent kinetic energy budget including dissipation rate, production, and pressure diffusion was computed. The results show that the waveform with a longer deceleration phase duration induced the earliest onset of transition, while the waveform with a longer acceleration period delayed the onset of transition. In accord with the findings of prior studies, for all test cases, turbulence was observed to be produced at the wall and either dissipated or redistributed into the core flow by pressure waves, depending on the mean Reynolds number. Turbulent production increased with increasing temporal velocity gradients until an asymptotic limit was reached. The turbulence dissipation rate was shown to be independent of mean Reynolds number, but a relationship between the temporal gradients of the input velocity waveform and the rate of turbulence dissipation was found. In general, these results demonstrated that the shape of the input pulsatile waveform directly affected the onset and development of transition.

Coronary Blood Flow Is Increased in RV Hypertrophy, but the Shape of Normalized Waves Is Preserved Throughout the Arterial Tree.

PubMed

Huo, Yunlong; Kassab, Ghassan S

2018-01-01

A pulsatile hemodynamic analysis was carried out in the right coronary arterial (RCA) tree of control and RV hypertrophy (RVH) hearts. The shape of flow and wall shear stress (WSS) waves was hypothesized to be maintained throughout the RCA tree in RVH (i.e., similar patterns of normalized flow and WSS waves in vessels of various sizes). Consequently, we reconstructed the entire RCA tree down to the first capillary bifurcation of control and RVH hearts based on measured morphometric data. A Womersley-type model was used to compute the flow and WSS waves in the tree. The hemodynamic parameters obtained from experimental measurements were incorporated into the numerical model. Given an increased number of arterioles, the mean and amplitude of flow waves at the inlet of RCA tree in RVH was found to be two times larger than that in control, but no significant differences ( p > 0.05) were found in precapillary arterioles. The increase of stiffness in RCA of RVH preserved the shape of normalized flow and WSS waves, but increased the PWV in coronary arteries and reduced the phase angle difference for the waves between the most proximal RCA and the most distal precapillary arteriole. The study is important for understanding pulsatile coronary blood flow in ventricular hypertrophy.

A computer model of the pediatric circulatory system for testing pediatric assist devices.

PubMed

Giridharan, Guruprasad A; Koenig, Steven C; Mitchell, Michael; Gartner, Mark; Pantalos, George M

2007-01-01

Lumped parameter computer models of the pediatric circulatory systems for 1- and 4-year-olds were developed to predict hemodynamic responses to mechanical circulatory support devices. Model parameters, including resistance, compliance and volume, were adjusted to match hemodynamic pressure and flow waveforms, pressure-volume loops, percent systole, and heart rate of pediatric patients (n = 6) with normal ventricles. Left ventricular failure was modeled by adjusting the time-varying compliance curve of the left heart to produce aortic pressures and cardiac outputs consistent with those observed clinically. Models of pediatric continuous flow (CF) and pulsatile flow (PF) ventricular assist devices (VAD) and intraaortic balloon pump (IABP) were developed and integrated into the heart failure pediatric circulatory system models. Computer simulations were conducted to predict acute hemodynamic responses to PF and CF VAD operating at 50%, 75% and 100% support and 2.5 and 5 ml IABP operating at 1:1 and 1:2 support modes. The computer model of the pediatric circulation matched the human pediatric hemodynamic waveform morphology to within 90% and cardiac function parameters with 95% accuracy. The computer model predicted PF VAD and IABP restore aortic pressure pulsatility and variation in end-systolic and end-diastolic volume, but diminish with increasing CF VAD support.

Does Flexible Arterial Tubing Retain More Hemodynamic Energy During Pediatric Pulsatile Extracorporeal Life Support?

PubMed

Wang, Shigang; Kunselman, Allen R; Ündar, Akif

2017-01-01

The objective of this study was to evaluate the hemodynamic performance and energy transmission of flexible arterial tubing as the arterial line in a simulated pediatric pulsatile extracorporeal life support (ECLS) system. The ECLS circuit consisted of a Medos Deltastream DP3 diagonal pump head, Medos Hilite 2400 LT oxygenator, Biomedicus arterial/venous cannula (10 Fr/14 Fr), 3 feet of polyvinyl chloride (PVC) arterial tubing or latex rubber arterial tubing, primed with lactated Ringer's solution and packed red blood cells (hematocrit 40%). Trials were conducted at flow rates of 300 to 1200 mL/min (300 mL/min increments) under nonpulsatile and pulsatile modes at 36°C using either PVC arterial tubing (PVC group) or latex rubber tubing (Latex group). Real-time pressure and flow data were recorded using a custom-based data acquisition system. Mean pressures and energy equivalent pressures (EEP) were the same under nonpulsatile mode between the two groups. Under pulsatile mode, EEPs were significantly great than mean pressure, especially in the Latex group (P < 0.05). There was no difference between the two groups with regards to pressure drops across ECLS circuit, but pulsatile flow created more pressure drops than nonpulsatile flow (P < 0.05). Surplus hemodynamic energy (SHE) levels were always higher in the Latex group than in the PVC group at all sites. Although total hemodynamic energy (THE) losses were higher under pulsatile mode compared to nonpulsatile mode, more THE was delivered to the pseudopatient, particularly in the Latex group (P < 0.05). The results showed that the flexible arterial tubing retained more hemodynamic energy passing through it under pulsatile mode while mean pressures and pressure drops across the ECLS circuit were similar between PVC and latex rubber arterial tubing. Further studies are warranted to verify our findings. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Pulsatile blood flow in elastic artery with model aneurysm

NASA Astrophysics Data System (ADS)

Nikolov, N.; Radev, St.; Tabakova, S.

2017-11-01

The mathematical modeling and numerical simulations are expected to play an important role to predict the genesis of different cardiovascular diseases, such as the formation and rupture of aneurysms. In the present work, the numerical solutions of the oscillatory blood flow are constructed for an elastic artery with a model aneurysm by use of the software ANSYS. It is observed that the artery elastic strain behaves in a different way: stably or unstably depending on the different combinations between the flow parameter (outlet pressure) and the elastic modulus of the artery wall.

Temporally resolved electrocardiogram-triggered diffusion-weighted imaging of the human kidney: correlation between intravoxel incoherent motion parameters and renal blood flow at different time points of the cardiac cycle.

PubMed

Wittsack, Hans-Jörg; Lanzman, Rotem S; Quentin, Michael; Kuhlemann, Julia; Klasen, Janina; Pentang, Gael; Riegger, Caroline; Antoch, Gerald; Blondin, Dirk

2012-04-01

To evaluate the influence of pulsatile blood flow on apparent diffusion coefficients (ADC) and the fraction of pseudodiffusion (F(P)) in the human kidney. The kidneys of 6 healthy volunteers were examined by a 3-T magnetic resonance scanner. Electrocardiogram (ECG)-gated and respiratory-triggered diffusion-weighted imaging (DWI) and phase-contrast flow measurements were performed. Flow imaging of renal arteries was carried out to quantify the dependence of renal blood flow on the cardiac cycle. ECG-triggered DWI was acquired in the coronal plane with 16 b values in the range of 0 s/mm(2) and 750 s/mm(2) at the time of minimum (MIN) (20 milliseconds after R wave) and maximum renal blood flow (MAX) (197 ± 24 milliseconds after R wave). The diffusion coefficients were calculated using the monoexponential approach as well as the biexponential intravoxel incoherent motion model and correlated to phase-contrast flow measurements. Flow imaging showed pulsatile renal blood flow depending on the cardiac cycle. The mean flow velocity at MIN was 45 cm/s as compared with 61 cm/s at MAX. F(p) at MIN (0.29) was significantly lower than at MAX (0.40) (P = 0.001). Similarly, ADC(mono), derived from the monoexponential model, also showed a significant difference (P < 0.001) between MIN (ADC(mono) = 2.14 ± 0.08 × 10(-3) mm(2)/s) and MAX (ADC(mono) = 2.37 ± 0.04 × 10(-3) mm(2)/s). The correlation between renal blood flow and F(p) (r = 0.85) as well as ADC(mono) (r = 0.67) was statistically significant. Temporally resolved ECG-gated DWI enables for the determination of the diffusion coefficients at different time points of the cardiac cycle. ADC(mono) and FP vary significantly among acquisitions at minimum (diastole) and maximum (systole) renal blood flow. Temporally resolved ECG-gated DWI might therefore serve as a novel technique for the assessment of pulsatility in the human kidney.

The association between the pulse pressure gradient at the cranio-cervical junction derived from phase-contrast magnetic resonance imaging and invasively measured pulsatile intracranial pressure in symptomatic patients with Chiari malformation type 1.

PubMed

Frič, Radek; Lindstrøm, Erika Kristina; Ringstad, Geir Andre; Mardal, Kent-André; Eide, Per Kristian

2016-12-01

In symptomatic Chiari malformation type 1 (CMI), impaired intracranial compliance (ICC) is associated with an increased cranio-spinal pulsatile pressure gradient. Phase-contrast magnetic resonance imaging (MRI) represents a non-invasive modality for the assessment of the pulse pressure gradient at the cranio-cervical junction (CCJ). We wished to explore how the MRI-derived pulse pressure gradient (MRI-dP) compares with invasively measured pulsatile intracranial pressure (ICP) in CMI, and with healthy controls. From phase-contrast MRI of CMI patients and healthy controls, we computed cerebrospinal fluid (CSF) flow velocities and MRI-dP at the CCJ. We assessed bidirectional flow and compared the flow between the anterior and the posterior subarachnoid space at the CCJ. We computed total intracranial volume (ICV), ventricular CSF volume (VV), and posterior cranial fossa volume (PCFV). We analyzed the static and pulsatile ICP scores from overnight monitoring in CMI patients. Five CMI patients and four healthy subjects were included. The CMI group had a significantly larger extent of tonsillar ectopia, smaller PCFV, and a smaller area of CSF in the FM. The pulsatile ICP (mean ICP wave amplitude, MWA) was abnormally increased in 4/5 CMI patients and correlated positively with MRI-dP. However, the MRI-dP as well as the CSF flow velocities did not differ significantly between CMI and healthy subjects. Moreover, bidirectional flow was observed in both CMI as well as healthy subjects, with no significant difference. In symptomatic CMI patients, we found a significant association between the pulse pressure gradient at the CCJ derived from phase-contrast MRI and the pulsatile ICP (MWA) measured invasively. However, the MRI-dP was close to identical in CMI patients and healthy subjects. Moreover, the CSF flow velocities at the CCJ and the occurrence of bidirectional flow were not different in CMI patients and healthy individuals. Further studies are required to determine the diagnostic role of phase-contrast MRI in CMI patients.

Mechanical stress regulates transport in a compliant 3D model of the blood-brain barrier.

PubMed

Partyka, Paul P; Godsey, George A; Galie, John R; Kosciuk, Mary C; Acharya, Nimish K; Nagele, Robert G; Galie, Peter A

2017-01-01

Transport of fluid and solutes is tightly controlled within the brain, where vasculature exhibits a blood-brain barrier and there is no organized lymphatic network facilitating waste transport from the interstitial space. Here, using a compliant, three-dimensional co-culture model of the blood-brain barrier, we show that mechanical stimuli exerted by blood flow mediate both the permeability of the endothelial barrier and waste transport along the basement membrane. Application of both shear stress and cyclic strain facilitates tight junction formation in the endothelial monolayer, with and without the presence of astrocyte endfeet in the surrounding matrix. We use both dextran perfusion and TEER measurements to assess the initiation and maintenance of the endothelial barrier, and microparticle image velocimetry to characterize the fluid dynamics within the in vitro vessels. Application of pulsatile flow to the in vitro vessels induces pulsatile strain to the vascular wall, providing an opportunity to investigate stretch-induced transport along the basement membrane. We find that a pulsatile wave speed of approximately 1 mm/s with Womersley number of 0.004 facilitates retrograde transport of high molecular weight dextran along the basement membrane between the basal endothelium and surrounding astrocytes. Together, these findings indicate that the mechanical stress exerted by blood flow is an important regulator of transport both across and along the walls of cerebral microvasculature. Copyright © 2016 Elsevier Ltd. All rights reserved.

A turbulence model for pulsatile arterial flows.

PubMed

Younis, B A; Berger, S A

2004-10-01

Difficulties in predicting the behavior of some high Reynolds number flows in the circulatory system stem in part from the severe requirements placed on the turbulence model chosen to close the time-averaged equations of fluid motion. In particular, the successful turbulence model is required to (a) correctly capture the "nonequilibrium" effects wrought by the interactions of the organized mean-flow unsteadiness with the random turbulence, (b) correctly reproduce the effects of the laminar-turbulent transitional behavior that occurs at various phases of the cardiac cycle, and (c) yield good predictions of the near-wall flow behavior in conditions where the universal logarithmic law of the wall is known to be not valid. These requirements are not immediately met by standard models of turbulence that have been developed largely with reference to data from steady, fully turbulent flows in approximate local equilibrium. The purpose of this paper is to report on the development of a turbulence model suited for use in arterial flows. The model is of the two-equation eddy-viscosity variety with dependent variables that are zero-valued at a solid wall and vary linearly with distance from it. The effects of transition are introduced by coupling this model to the local value of the intermittency and obtaining the latter from the solution of a modeled transport equation. Comparisons with measurements obtained in oscillatory transitional flows in circular tubes show that the model produces substantial improvements over existing closures. Further pulsatile-flow predictions, driven by a mean-flow wave form obtained in a diseased human carotid artery, indicate that the intermittency-modified model yields much reduced levels of wall shear stress compared to the original, unmodified model. This result, which is attributed to the rapid growth in the thickness of the viscous sublayer arising from the severe acceleration of systole, argues in favor of the use of the model for the prediction of arterial flows.

A Hybrid Windkessel Model of Blood Flow in Arterial Tree Using Velocity Profile Method

NASA Astrophysics Data System (ADS)

Aboelkassem, Yasser; Virag, Zdravko

2016-11-01

For the study of pulsatile blood flow in the arterial system, we derived a coupled Windkessel-Womersley mathematical model. Initially, a 6-elements Windkessel model is proposed to describe the hemodynamics transport in terms of constant resistance, inductance and capacitance. This model can be seen as a two compartment model, in which the compartments are connected by a rigid pipe, modeled by one inductor and resistor. The first viscoelastic compartment models proximal part of the aorta, the second elastic compartment represents the rest of the arterial tree and aorta can be seen as the connection pipe. Although the proposed 6-elements lumped model was able to accurately reconstruct the aortic pressure, it can't be used to predict the axial velocity distribution in the aorta and the wall shear stress and consequently, proper time varying pressure drop. We then modified this lumped model by replacing the connection pipe circuit elements with a vessel having a radius R and a length L. The pulsatile flow motions in the vessel are resolved instantaneously along with the Windkessel like model enable not only accurate prediction of the aortic pressure but also wall shear stress and frictional pressure drop. The proposed hybrid model has been validated using several in-vivo aortic pressure and flow rate data acquired from different species such as, humans, dogs and pigs. The method accurately predicts the time variation of wall shear stress and frictional pressure drop. Institute for Computational Medicine, Dept. Biomedical Engineering.

Pulsatile perfusion bioreactor for cardiac tissue engineering.

PubMed

Brown, Melissa A; Iyer, Rohin K; Radisic, Milica

2008-01-01

Cardiovascular disease is the number one cause of mortality in North America. Cardiac tissue engineering aims to engineer a contractile patch of physiological thickness to use in surgical repair of diseased heart tissue. We previously reported that perfusion of engineered cardiac constructs resulted in improved tissue assembly. Because heart tissues respond to mechanical stimuli in vitro and experience rhythmic mechanical forces during contraction in vivo, we hypothesized that provision of pulsatile interstitial medium flow to an engineered cardiac patch would result in enhanced tissue assembly by way of mechanical conditioning and improved mass transport. Thus, we constructed a novel perfusion bioreactor capable of providing pulsatile fluid flow at physiologically relevant shear stresses and flow rates. Pulsatile perfusion (PP) was achieved by incorporation of a normally closed solenoid pinch valve into the perfusion loop and was carried out at a frequency of 1 Hz and a flow rate of 1.50 mL/min (PP) or 0.32 mL/min (PP-LF). Nonpulsatile flow at 1.50 mL/min (NP) or 0.32 mL/min (NP-LF) served as controls. Static controls were cultivated in well plates. The main experimental groups were seeded with cells enriched for cardiomyocytes by one preplating step (64% cardiac Troponin I+, 34% prolyl-4-hydroxylase+), whereas pure cardiac fibroblasts and cells enriched for cardiomyocytes by two preplating steps (81% cardiac Troponin I+, 16% prolyl-4-hydroxylase+) served as controls. Cultivation under pulsatile flow had beneficial effects on contractile properties. Specifically, the excitation threshold was significantly lower in the PP condition (pulsatile perfusion at 1.50 mL/min) than in the Static control, and the contraction amplitude was the highest; whereas high maximum capture rate was observed for the PP-LF conditions (pulsatile perfusion at 0.32 mL/min). The enhanced hypertrophy index observed for the PP-LF group was consistent with the highest cellular length and diameter in this group. Within the same cultivation groups (Static, NP-LF, PP-LF, PP, and NP) there were no significant differences in the diameter between fibroblasts and cardiomyocytes, although cardiomyocytes were significantly more elongated than fibroblasts under PP-LF conditions. Cultivation of control cell populations resulted in noncontractile constructs when cardiac fibroblasts were used (as expected) and no overall improvement in functional properties when two steps of preplating were used to enrich for cardiomyocytes in comparison with only one step of preplating.

A new imaging technique on strength and phase of pulsatile tissue-motion in brightness-mode ultrasonogram

NASA Astrophysics Data System (ADS)

Fukuzawa, Masayuki; Yamada, Masayoshi; Nakamori, Nobuyuki; Kitsunezuka, Yoshiki

2007-03-01

A new imaging technique has been developed for observing both strength and phase of pulsatile tissue-motion in a movie of brightness-mode ultrasonogram. The pulsatile tissue-motion is determined by evaluating the heartbeat-frequency component in Fourier transform of a series of pixel value as a function of time at each pixel in a movie of ultrasonogram (640x480pixels/frame, 8bit/pixel, 33ms/frame) taken by a conventional ultrasonograph apparatus (ATL HDI5000). In order to visualize both the strength and the phase of the pulsatile tissue-motion, we propose a pulsatile-phase image that is obtained by superimposition of color gradation proportional to the motion phase on the original ultrasonogram only at which the motion strength exceeds a proper threshold. The pulsatile-phase image obtained from a cranial ultrasonogram of normal neonate clearly reveals that the motion region gives good agreement with the anatomical shape and position of the middle cerebral artery and the corpus callosum. The motion phase is fluctuated with the shape of arteries revealing local obstruction of blood flow. The pulsatile-phase images in the neonates with asphyxia at birth reveal decreases of the motion region and increases of the phase fluctuation due to the weakness and local disturbance of blood flow, which is useful for pediatric diagnosis.

Microvascular Responsiveness to Pulsatile and Nonpulsatile Flow During Cardiopulmonary Bypass.

PubMed

O'Neil, Michael P; Alie, Rene; Guo, Linrui Ray; Myers, Mary-Lee; Murkin, John M; Ellis, Christopher G

2018-06-01

Pulsatile perfusion may offer microcirculatory advantages over conventional nonpulsatile perfusion during cardiopulmonary bypass (CPB). Here, we present direct visual evidence of microvascular perfusion and vasoreactivity between perfusion modalities. A prospective, randomized cohort study of 20 high-risk cardiac surgical patients undergoing pulsatile (n = 10) or nonpulsatile (n = 10) flow during CPB was conducted. Changes in sublingual mucosal microcirculation were assessed with orthogonal polarization spectral imaging along with near-infrared spectroscopic indices of thenar muscle tissue oxygen saturation (StO 2 ) and its recovery during a vascular occlusion test at the following time points: baseline (T 0 ), 30 minutes on CPB (T 1 ), 90 minutes on CPB (T 2 ), 1 hour after CPB (T 3 ), and 24 hours after CPB (T 4 ). On the basis of our scoring scale, a shift in microcirculatory blood flow occurred over time. The pulsatile group maintained normal perfusion characteristics, whereas the nonpulsatile group exhibited deterioration in perfusion during CPB (T 2 : 74.0% ± 5.6% versus 57.6% ± 5.0%) and after CPB (T 3 : 76.2% ± 2.7% versus 58.9% ± 5.2%, T 4 : 85.7% ± 2.6% versus 69.8% ± 5.9%). Concurrently, no important differences were found between groups in baseline StO 2 and consumption slope at all time points. Reperfusion slope was substantially different between groups 24 hours after CPB (T 4 : 6.1% ± 0.6% versus 3.7% ± 0.5%), indicating improved microvascular responsiveness in the pulsatile group versus the nonpulsatile group. Pulsatility generated by the roller pump during CPB improves microcirculatory blood flow and tissue oxygen saturation compared with nonpulsatile flow in high-risk cardiac surgical patients, which may reflect attenuation of the systemic inflammatory response and ischemia-reperfusion injury. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Choroidal microcirculation in patients with rotary cardiac assist device.

PubMed

Polska, Elzbieta; Schima, Heinrich; Wieselthaler, Georg; Schmetterer, Leopold

2007-06-01

In recent years, fully implanted rotary blood pumps have been used for long-term cardiac assist in patients with end-stage heart failure. With these pumps, the pulsatility of arterial blood flow and arterial pressure pulse is considerably reduced. Effects on end-organ perfusion, particularly microcirculation, have been assessed. The ocular choroid offers a unique opportunity to study the pulsatile component of blood flow by measurement of fundus pulsation amplitude (FPA) as well as the microcirculation by laser Doppler flowmetry. Both techniques were applied in three male patients with rotary pumps (MicroMed DeBakey VAD), in whom pump velocity was adjusted to four levels of flow between individual minimal need and maximal support. In addition, blood flow velocities in the ophthalmic artery (peak, end-diastolic and mean flow velocity--PSV, EDV and MFV, respectively) were measured using color Doppler imaging. Systolic blood pressure increased by 6 to 22 mm Hg with increasing support. At maximal support FPA was reduced by -60% to -52% as compared with minimal pump support. Blood flow in the choroidal microvasculature, however, did not show relevant changes. A reduction in PSV (-31%, range -47% to -21%) and a pronounced rise in EDV (+93%, range +28% to +147%) was observed, whereas MFV was independent of pump flow. Our data indicate that mean choroidal blood flow is maintained when pump support is varied within therapeutic values, whereas the ratio of pulsatile to non-pulsatile choroidal flow changes. This study shows that, in patients with ventricular assist devices, a normal perfusion rate in the ocular microcirculation is maintained over a wide range of support conditions.

SPH simulations of WBC adhesion to the endothelium: the role of haemodynamics and endothelial binding kinetics.

PubMed

Gholami, Babak; Comerford, Andrew; Ellero, Marco

2015-11-01

A multiscale Lagrangian particle solver introduced in our previous work is extended to model physiologically realistic near-wall cell dynamics. Three-dimensional simulation of particle trajectories is combined with realistic receptor-ligand adhesion behaviour to cover full cell interactions in the vicinity of the endothelium. The selected stochastic adhesion model, which is based on a Monte Carlo acceptance-rejection method, fits in our Lagrangian framework and does not compromise performance. Additionally, appropriate inflow/outflow boundary conditions are implemented for our SPH solver to enable realistic pulsatile flow simulation. The model is tested against in-vitro data from a 3D geometry with a stenosis and sudden expansion. In both steady and pulsatile flow conditions, results show close agreement with the experimental ones. Furthermore we demonstrate, in agreement with experimental observations, that haemodynamics alone does not account for adhesion of white blood cells, in this case U937 monocytic human cells. Our findings suggest that the current framework is fully capable of modelling cell dynamics in large arteries in a realistic and efficient manner.

Elimination of motion, pulsatile flow and cross-talk artifacts using blade sequences in lumbar spine MR imaging.

PubMed

Lavdas, Eleftherios; Mavroidis, Panayiotis; Kostopoulos, Spiros; Glotsos, Dimitrios; Roka, Violeta; Koutsiaris, Aristotle G; Batsikas, Georgios; Sakkas, Georgios K; Tsagkalis, Antonios; Notaras, Ioannis; Stathakis, Sotirios; Papanikolaou, Nikos; Vassiou, Katerina

2013-07-01

The purpose of this study is to evaluate the ability of T2 turbo spin echo (TSE) axial and sagittal BLADE sequences in reducing or even eliminating motion, pulsatile flow and cross-talk artifacts in lumbar spine MRI examinations. Forty four patients, who had routinely undergone a lumbar spine examination, participated in the study. The following pairs of sequences with and without BLADE were compared: a) T2 TSE Sagittal (SAG) in thirty two cases, and b) T2 TSE Axial (AX) also in thirty two cases. Both quantitative and qualitative analyses were performed based on measurements in different normal anatomical structures and examination of seven characteristics, respectively. The qualitative analysis was performed by experienced radiologists. Also, the presence of image motion, pulsatile flow and cross-talk artifacts was evaluated. Based on the results of the qualitative analysis for the different sequences and anatomical structures, the BLADE sequences were found to be significantly superior to the conventional ones in all the cases. The BLADE sequences eliminated the motion artifacts in all the cases. In our results, it was found that in the examined sequences (sagittal and axial) the differences between the BLADE and conventional sequences regarding the elimination of motion, pulsatile flow and cross-talk artifacts were statistically significant. In all the comparisons, the T2 TSE BLADE sequences were significantly superior to the corresponding conventional sequences regarding the classification of their image quality. In conclusion, this technique appears to be capable of potentially eliminating motion, pulsatile flow and cross-talk artifacts in lumbar spine MR images and producing high quality images in collaborative and non-collaborative patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Tissue engineering of heart valves: in vitro experiences.

PubMed

Sodian, R; Hoerstrup, S P; Sperling, J S; Daebritz, S H; Martin, D P; Schoen, F J; Vacanti, J P; Mayer, J E

2000-07-01

Tissue engineering is a new approach, whereby techniques are being developed to transplant autologous cells onto biodegradable scaffolds to ultimately form new functional tissue in vitro and in vivo. Our laboratory has focused on the tissue engineering of heart valves, and we have fabricated a trileaflet heart valve scaffold from a biodegradable polymer, a polyhydroxyalkanoate. In this experiment we evaluated the suitability of this scaffold material as well as in vitro conditioning to create viable tissue for tissue engineering of a trileaflet heart valve. We constructed a biodegradable and biocompatible trileaflet heart valve scaffold from a porous polyhydroxyalkanoate (Meatabolix Inc, Cambridge, MA). The scaffold consisted of a cylindrical stent (1 x 15 x 20 mm inner diameter) and leaflets (0.3 mm thick), which were attached to the stent by thermal processing techniques. The porous heart valve scaffold (pore size 100 to 240 microm) was seeded with vascular cells grown and expanded from an ovine carotid artery and placed into a pulsatile flow bioreactor for 1, 4, and 8 days. Analysis of the engineered tissue included biochemical examination, enviromental scanning electron microscopy, and histology. It was possible to create a trileaflet heart valve scaffold from polyhydroxyalkanoate, which opened and closed synchronously in a pulsatile flow bioreactor. The cells grew into the pores and formed a confluent layer after incubation and pulsatile flow exposure. The cells were mostly viable and formed connective tissue between the inside and the outside of the porous heart valve scaffold. Additionally, we demonstrated cell proliferation (DNA assay) and the capacity to generate collagen as measured by hydroxyproline assay and movat-stained glycosaminoglycans under in vitro pulsatile flow conditions. Polyhydroxyalkanoates can be used to fabricate a porous, biodegradable heart valve scaffold. The cells appear to be viable and extracellular matrix formation was induced after pulsatile flow exposure.

Cerebral Hemodynamics in the Elderly: A Transcranial Doppler Study in the Einstein Aging Study Cohort.

PubMed

Yang, Dixon; Cabral, Digna; Gaspard, Emmanuel N; Lipton, Richard B; Rundek, Tatjana; Derby, Carol A

2016-09-01

We sought to describe the relationship between age, sex, and race/ethnicity with transcranial Doppler hemodynamic characteristics from major intracerebral arterial segments in a large elderly population with varying demographics. We analyzed 369 stroke-free participants aged 70 years and older from the Einstein Aging Study. Single-gate, nonimaging transcranial Doppler sonography, a noninvasive sonographic technique that assesses real-time cerebrovascular hemodynamics, was used to interrogate 9 cerebral arterial segments. Individual Doppler spectra and cerebral blood flow velocities were acquired, and the pulsatility index and resistive index were calculated by the device's automated waveform-tracking function. Multiple linear regression models were used to examine the independent associations of age, sex, and race/ethnicity with transcranial Doppler measures, adjusting for hypertension, history of myocardial infarction or revascularization, and history of diabetes. Among enrolled participants, 303 individuals had at least 1 vessel insonated (mean age [SD], 80 [6] years; 63% women; 58% white; and 32% black). With age, transcranial Doppler measures of mean blood flow velocity were significantly decreased in the basilar artery (P = .001) and posterior cerebral artery (right, P = .003; left, P = .02). Pulsatility indices increased in the left middle cerebral artery (P = .01) and left anterior cerebral artery (P = .03), and the resistive index was increased in the left middle cerebral artery (P = .007) with age. Women had higher pulsatility and resistive indices compared to men in several vessels. We report a decreased mean blood flow velocity and weakly increased arterial pulsatility and resistance with aging in a large elderly stroke-free population. These referential trends in cerebrovascular hemodynamics may carry important implications in vascular diseases associated with advanced age, increased risk of cerebrovascular disease, cognitive decline, and dementia.

A fluid--structure interaction finite element analysis of pulsatile blood flow through a compliant stenotic artery

NASA Technical Reports Server (NTRS)

Bathe, M.; Kamm, R. D.

1999-01-01

A new model is used to analyze the fully coupled problem of pulsatile blood flow through a compliant, axisymmetric stenotic artery using the finite element method. The model uses large displacement and large strain theory for the solid, and the full Navier-Stokes equations for the fluid. The effect of increasing area reduction on fluid dynamic and structural stresses is presented. Results show that pressure drop, peak wall shear stress, and maximum principal stress in the lesion all increase dramatically as the area reduction in the stenosis is increased from 51 to 89 percent. Further reductions in stenosis cross-sectional area, however, produce relatively little additional change in these parameters due to a concomitant reduction in flow rate caused by the losses in the constriction. Inner wall hoop stretch amplitude just distal to the stenosis also increases with increasing stenosis severity, as downstream pressures are reduced to a physiological minimum. The contraction of the artery distal to the stenosis generates a significant compressive stress on the downstream shoulder of the lesion. Dynamic narrowing of the stenosis is also seen, further augmenting area constriction at times of peak flow. Pressure drop results are found to compare well to an experimentally based theoretical curve, despite the assumption of laminar flow.

Numerical analysis of the effect of turbulence transition on the hemodynamic parameters in human coronary arteries.

PubMed

Mahalingam, Arun; Gawandalkar, Udhav Ulhas; Kini, Girish; Buradi, Abdulrajak; Araki, Tadashi; Ikeda, Nobutaka; Nicolaides, Andrew; Laird, John R; Saba, Luca; Suri, Jasjit S

2016-06-01

Local hemodynamics plays an important role in atherogenesis and the progression of coronary atherosclerosis disease (CAD). The primary biological effect due to blood turbulence is the change in wall shear stress (WSS) on the endothelial cell membrane, while the local oscillatory nature of the blood flow affects the physiological changes in the coronary artery. In coronary arteries, the blood flow Reynolds number ranges from few tens to several hundreds and hence it is generally assumed to be laminar while calculating the WSS calculations. However, the pulsatile blood flow through coronary arteries under stenotic condition could result in transition from laminar to turbulent flow condition. In the present work, the onset of turbulent transition during pulsatile flow through coronary arteries for varying degree of stenosis (i.e., 0%, 30%, 50% and 70%) is quantitatively analyzed by calculating the turbulent parameters distal to the stenosis. Also, the effect of turbulence transition on hemodynamic parameters such as WSS and oscillatory shear index (OSI) for varying degree of stenosis is quantified. The validated transitional shear stress transport (SST) k-ω model used in the present investigation is the best suited Reynolds averaged Navier-Stokes turbulence model to capture the turbulent transition. The arterial wall is assumed to be rigid and the dynamic curvature effect due to myocardial contraction on the blood flow has been neglected. Our observations shows that for stenosis 50% and above, the WSSavg, WSSmax and OSI calculated using turbulence model deviates from laminar by more than 10% and the flow disturbances seems to significantly increase only after 70% stenosis. Our model shows reliability and completely validated. Blood flow through stenosed coronary arteries seems to be turbulent in nature for area stenosis above 70% and the transition to turbulent flow begins from 50% stenosis.

LONG-TERM MECHANICAL CIRCULATORY SUPPORT (DESTINATION THERAPY): ON TRACK TO COMPETE WITH HEART TRANSPLANTATIO?

PubMed Central

Kirklin, James K.; Naftel, David C.; Pagani, Francis D.; Kormos, Robert L.; Stevenson, Lynne; Miller, Marissa; Young, James B.

2012-01-01

Objective(s) Average two-year survival following cardiac transplantation is approximately 80%. The evolution and subsequent approval of larger pulsatile and, more recently, continuous flow mechanical circulatory support (MCS) technology for destination therapy (DT) offers the potential for triage of some patients awaiting cardiac transplantation to DT. Methods The National Heart, Lung and Blood Institute Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) is a national multi-institutional study of chronic mechanical circulatory support. Between June 2006 and December 2011, 127 pulsatile and 1160 continuous flow pumps (24% of total primary LVADs) carried an initial strategy of DT therapy. Results By multivariable analysis, risk factors (p<0.05) for mortality following DT included older age, larger body mass index, history of cancer, history of cardiac surgery, INTERMACS level I (cardiogenic shock), dialysis, increased BUN, use of a pulsatile flow device and use of a RVAD. Among continuous flow LVAD patients who were not in cardiogenic shock, a particularly favorable survival was associated with no cancer, patients not in cardiogenic shock, and BUN < 50, resulting in one and two year survival of 88 and 80%. Conclusions 1) Evolution from pulsatile to continuous flow technology has dramatically improved one and two year survival; 2) Destination Therapy is not appropriate for patients with rapid hemodynamic deterioration; or severe right ventricular failure 4) Important subsets of continuous flow DT patients now enjoy survival which is competitive with heart transplantation out to about two years. PMID:22795459

Mathematical Modeling of Rotary Blood Pumps in a Pulsatile In Vitro Flow Environment.

PubMed

Pirbodaghi, Tohid

2017-08-01

Nowadays, sacrificing animals to develop medical devices and receive regulatory approval has become more common, which increases ethical concerns. Although in vivo tests are necessary for development and evaluation of new devices, nonetheless, with appropriate in vitro setups and mathematical models, a part of the validation process can be performed using these models to reduce the number of sacrificed animals. The main aim of this study is to present a mathematical model simulating the hydrodynamic function of a rotary blood pump (RBP) in a pulsatile in vitro flow environment. This model relates the pressure head of the RBP to the flow rate, rotational speed, and time derivatives of flow rate and rotational speed. To identify the model parameters, an in vitro setup was constructed consisting of a piston pump, a compliance chamber, a throttle, a buffer reservoir, and the CentriMag RBP. A 40% glycerin-water mixture as a blood analog fluid and deionized water were used in the hydraulic circuit to investigate the effect of viscosity and density of the working fluid on the model parameters. First, model variables were physically measured and digitally acquired. Second, an identification algorithm based on regression analysis was used to derive the model parameters. Third, the completed model was validated with a totally different set of in vitro data. The model is usable for both mathematical simulations of the interaction between the pump and heart and indirect pressure measurement in a clinical context. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Flow-induced Flutter of Heart Valves: Experiments with Canonical Models

NASA Astrophysics Data System (ADS)

Dou, Zhongwang; Seo, Jung-Hee; Mittal, Rajat

2017-11-01

For the better understanding of hemodynamics associated with valvular function in health and disease, the flow-induced flutter of heart valve leaflets is studied using benchtop experiments with canonical valve models. A simple experimental model with flexible leaflets is constructed and a pulsatile pump drives the flow through the leaflets. We quantify the leaflet dynamics using digital image analysis and also characterize the dynamics of the flow around the leaflets using particle imaging velocimetry. Experiments are conducted over a wide range of flow and leaflet parameters and data curated for use as a benchmark for validation of computational fluid-structure interaction models. The authors would like to acknowledge Supported from NSF Grants IIS-1344772, CBET-1511200 and NSF XSEDE Grant TG-CTS100002.

On the Evolution of Pulsatile Flow Subject to a Transverse Impulse Body Force

NASA Astrophysics Data System (ADS)

di Labbio, Giuseppe; Keshavarz-Motamed, Zahra; Kadem, Lyes

2014-11-01

In the event of an unexpected abrupt traffic stop or car accident, automotive passengers will experience an abrupt body deceleration. This may lead to tearing or dissection of the aortic wall known as Blunt Traumatic Aortic Rupture (BTAR). BTAR is the second leading cause of death in automotive accidents and, although quite frequent, the mechanisms leading to BTAR are still not clearly identified, particularly the contribution of the flow field. As such, this work is intended to provide a fundamental framework for the investigation of the flow contribution to BTAR. In this fundamental study, pulsatile flow in a three-dimensional, straight pipe of circular cross-section is subjected to a unidirectional, transverse, impulse body force applied on a strictly bounded volume of fluid. These models were simulated using the Computational Fluid Dynamics (CFD) software FLUENT. The evolution of fluid field characteristics was investigated during and after the application of the force. The application of the force significantly modified the flow field. The force induces a transverse pressure gradient causing the development of secondary flow structures that dissipate the energy added by the acceleration. Once the force ceases to act, these structures are carried downstream and gradually dissipate their excess energy.

Hemodynamic energy generated by a combined centrifugal pump with an intra-aortic balloon pump.

PubMed

Lim, Choon Hak; Son, Ho Sung; Fang, Yung Hu; Lee, Jung Joo; Baik, Kwang Je; Kim, Kyung Hyun; Kim, Bum Soo; Lee, Hye Won; Sun, Kyung

2006-01-01

We examined the pulsatility generated by an intra-aortic balloon pump/centrifugal pump (IABP/CP) combination in terms of energy equivalent pressure (EEP) and surplus hemodynamic energy (SHE). In five cardiac-arrested pigs, the outflow cannula of the CP was inserted into the ascending aorta, the inflow cannula in the right atrium. A 30-ml IABP was subsequently placed in the descending aorta. Extracorporeal circulation was maintained for 30 minutes using a pump flow of 75 ml/kg per minute by CP alone or by IABP/CP with pressure and flow measured in the right internal carotid artery. The IABP/CP combination converted the flow to pulsatile and increased pulse pressure significantly from 9.1 +/- 1.3 mm Hg to 54.9 +/- 6.1 mm Hg (p = 0.012). It also significantly increased the percent change from mean arterial pressure to EEP from 0.2 +/- 0.3% to 23.3 +/- 6.1% (p = 0.012) and SHE from 133.2 +/- 234.5 erg/cm to 20,219.8 +/- 5842.7 erg/cm3 (p = 0.012). However, no statistical difference was observed between CP and IABP/CP in terms of mean carotid artery pressure (p = NS). In a cardiac-arrested animal model, pulsatility generated by a IABP/CP combination may be effective in terms of energy equivalent pressure and surplus hemodynamic energy.

First In Vivo Results of a Novel Pediatric Oxygenator with an Integrated Pulsatile Pump.

PubMed

Stang, Katharina; Borchardt, Ralf; Neumann, Bernd; Kurz, Julia; Stoppelkamp, Sandra; Greiner, Tim O; Fahrner, Christine; Schenk, Martin; Schlensak, Christian; Schubert, Maria; Lausberg, Henning; Herold, Sabine; Schlanstein, Peter C; Steinseifer, Ulrich; Arens, Jutta; Wendel, Hans-Peter

2015-01-01

Extracorporeal membrane oxygenation (ECMO) is a pivotal bridge to recovery for cardiopulmonary failure in children. Besides its life-saving quality, it is often associated with severe system-related complications, such as hemolysis, inflammation, and thromboembolism. Novel oxygenator and pump systems may reduce such ECMO-related complications. The ExMeTrA oxygenator is a newly designed pediatric oxygenator with an integrated pulsatile pump minimizing the priming volume and reducing the surface area of blood contact. The aim of our study was to investigate the feasibility and safety of this new ExMeTrA (expansion mediated transport and accumulation) oxygenator in an animal model. During 6 h of extracorporeal circulation (ECC) in pigs, parameters of the hemostatic system including coagulation, platelets and complement activation, and flow rates were investigated. A nonsignificant trend in C3 consumption, thrombin-antithrombin-III (TAT) complex formation and a slight trend in hemolysis were detected. During the ECC, the blood flow was constantly at 500 ml/min using only flexible silicone tubes inside the oxygenator as pulsatile pump. Our data clearly indicate that the hemostatic markers were only slightly influenced by the ExMeTrA oxygenator. Additionally, the oxygenator showed a constant quality of blood flow. Therefore, this novel pediatric oxygenator shows the potential to be used in pediatric and neonatal support with ECMO.

Development of a High-Order Navier-Stokes Solver Using Flux Reconstruction to Simulate Three-Dimensional Vortex Structures in a Curved Artery Model

NASA Astrophysics Data System (ADS)

Cox, Christopher

Low-order numerical methods are widespread in academic solvers and ubiquitous in industrial solvers due to their robustness and usability. High-order methods are less robust and more complicated to implement; however, they exhibit low numerical dissipation and have the potential to improve the accuracy of flow simulations at a lower computational cost when compared to low-order methods. This motivates our development of a high-order compact method using Huynh's flux reconstruction scheme for solving unsteady incompressible flow on unstructured grids. We use Chorin's classic artificial compressibility formulation with dual time stepping to solve unsteady flow problems. In 2D, an implicit non-linear lower-upper symmetric Gauss-Seidel scheme with backward Euler discretization is used to efficiently march the solution in pseudo time, while a second-order backward Euler discretization is used to march in physical time. We verify and validate implementation of the high-order method coupled with our implicit time stepping scheme using both steady and unsteady incompressible flow problems. The current implicit time stepping scheme is proven effective in satisfying the divergence-free constraint on the velocity field in the artificial compressibility formulation. The high-order solver is extended to 3D and parallelized using MPI. Due to its simplicity, time marching for 3D problems is done explicitly. The feasibility of using the current implicit time stepping scheme for large scale three-dimensional problems with high-order polynomial basis still remains to be seen. We directly use the aforementioned numerical solver to simulate pulsatile flow of a Newtonian blood-analog fluid through a rigid 180-degree curved artery model. One of the most physiologically relevant forces within the cardiovascular system is the wall shear stress. This force is important because atherosclerotic regions are strongly correlated with curvature and branching in the human vasculature, where the shear stress is both oscillatory and multidirectional. Also, the combined effect of curvature and pulsatility in cardiovascular flows produces unsteady vortices. The aim of this research as it relates to cardiovascular fluid dynamics is to predict the spatial and temporal evolution of vortical structures generated by secondary flows, as well as to assess the correlation between multiple vortex pairs and wall shear stress. We use a physiologically (pulsatile) relevant flow rate and generate results using both fully developed and uniform entrance conditions, the latter being motivated by the fact that flow upstream of a curved artery may not have sufficient straight entrance length to become fully developed. Under the two pulsatile inflow conditions, we characterize the morphology and evolution of various vortex pairs and their subsequent effect on relevant haemodynamic wall shear stress metrics.

Rationale, scope, and 20-year experience of vascular surgical training with lifelike pulsatile flow models.

PubMed

Eckstein, Hans-Henning; Schmidli, Jürg; Schumacher, Hardy; Gürke, Lorenz; Klemm, Klaus; Duschek, Nikolaus; Meile, Toni; Assadian, Afshin

2013-05-01

Vascular surgical training currently has to cope with various challenges, including restrictions on work hours, significant reduction of open surgical training cases in many countries, an increasing diversity of open and endovascular procedures, and distinct expectations by trainees. Even more important, patients and the public no longer accept a "learning by doing" training philosophy that leaves the learning curve on the patient's side. The Vascular International (VI) Foundation and School aims to overcome these obstacles by training conventional vascular and endovascular techniques before they are applied on patients. To achieve largely realistic training conditions, lifelike pulsatile models with exchangeable synthetic arterial inlays were created to practice carotid endarterectomy and patch plasty, open abdominal aortic aneurysm surgery, and peripheral bypass surgery, as well as for endovascular procedures, including endovascular aneurysm repair, thoracic endovascular aortic repair, peripheral balloon dilatation, and stenting. All models are equipped with a small pressure pump inside to create pulsatile flow conditions with variable peak pressures of ~90 mm Hg. The VI course schedule consists of a series of 2-hour modules teaching different open or endovascular procedures step-by-step in a standardized fashion. Trainees practice in pairs with continuous supervision and intensive advice provided by highly experienced vascular surgical trainers (trainer-to-trainee ratio is 1:4). Several evaluations of these courses show that tutor-assisted training on lifelike models in an educational-centered and motivated environment is associated with a significant increase of general and specific vascular surgical technical competence within a short period of time. Future studies should evaluate whether these benefits positively influence the future learning curve of vascular surgical trainees and clarify to what extent sophisticated models are useful to assess the level of technical skills of vascular surgical residents at national or international board examinations. This article gives an overview of our experiences of >20 years of practical training of beginners and advanced vascular surgeons using lifelike pulsatile vascular surgical training models. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Computational solution of the velocity and wall shear stress distribution inside a left carotid artery under pulsatile flow conditions

NASA Astrophysics Data System (ADS)

Arslan, Nurullah; Turmuş, Hakan

2014-08-01

Stroke is still one of the leading causes for death after heart diseases and cancer in all over the world. Strokes happen because an artery that carries blood uphill from the heart to the head is clogged. Most of the time, as with heart attacks, the problem is atherosclerosis, hardening of the arteries, calcified buildup of fatty deposits on the vessel wall. In this study, the fluid dynamic simulations were done in a left carotid bifurcation under the pulsatile flow conditions computationally. Pulsatile flow waveform is given in the paper. In vivo geometry and boundary conditions were obtained from a patient who has stenosis located at external carotid artery (ECA) and internal carotid artery (ICA) of his common carotid artery (CCA). The location of critical flow fields such as low wall shear stress (WSS), stagnation regions and separation regions were detected near the highly stenosed region and at branching region.

Full dimensional computer simulations to study pulsatile blood flow in vessels, aortic arch and bifurcated veins: Investigation of blood viscosity and turbulent effects.

PubMed

Sultanov, Renat A; Guster, Dennis

2009-01-01

We report computational results of blood flow through a model of the human aortic arch and a vessel of actual diameter and length. A realistic pulsatile flow is used in all simulations. Calculations for bifurcation type vessels are also carried out and presented. Different mathematical methods for numerical solution of the fluid dynamics equations have been considered. The non-Newtonian behaviour of the human blood is investigated together with turbulence effects. A detailed time-dependent mathematical convergence test has been carried out. The results of computer simulations of the blood flow in vessels of three different geometries are presented: for pressure, strain rate and velocity component distributions we found significant disagreements between our results obtained with realistic non-Newtonian treatment of human blood and the widely used method in the literature: a simple Newtonian approximation. A significant increase of the strain rate and, as a result, the wall shear stress distribution, is found in the region of the aortic arch. Turbulent effects are found to be important, particularly in the case of bifurcation vessels.

Extracorporeal bypass model of blood circulation for the study of microvascular hemodynamics.

PubMed

Nam, Kweon-Ho; Yeom, Eunseop; Lee, Sang Joon

2012-05-01

Many studies have been performed to better understand the hemodynamics in microvessels, such as arterioles and venules. However, due to the heterogeneous features of size, shape, blood-flow velocity, and pulsatility of microvessels, conducting a systematic study on these factors has been almost impossible. Although in vitro studies have been performed for this purpose, the usefulness of in vitro data is limited by the fact that the rheological properties of blood are changed as blood is exposed to in vitro environments. The purpose of the present study is to investigate the feasibility of a rat extracorporeal bypass model that combines in vivo and in vitro models. An arteriovenous shunt loop with a sub-bypass loop of fluorinated ethylene propylene (FEP) microtube was constructed between the jugular vein and femoral artery of a rat. Three pinch valves were installed in the main loop. Microscopic images of the blood flow in the FEP tube were sequentially captured with a high-speed camera, and the whole velocity field information was obtained using a micro-particle image velocimetry technique. Experimental results reveal that the velocity fields of the blood flow inside the microtube are well measured because the FEP tube is transparent and has nearly the same refractive index as water. The flow velocity and the pulsatility index of the blood flow in the microtube can be controlled by adjusting the three pinch valves installed upstream, midstream, and downstream of the bypass loop. This hybrid model that combines in vivo and in vitro models can be useful in studying microvascular hemodynamics. Copyright © 2012 Elsevier Inc. All rights reserved.

Fast diffuse correlation spectroscopy (DCS) for non-invasive measurement of intracranial pressure (ICP) (Conference Presentation)

NASA Astrophysics Data System (ADS)

Farzam, Parisa; Sutin, Jason; Wu, Kuan-Cheng; Zimmermann, Bernhard B.; Tamborini, Davide; Dubb, Jay; Boas, David A.; Franceschini, Maria Angela

2017-02-01

Intracranial pressure (ICP) monitoring has a key role in the management of neurosurgical and neurological injuries. Currently, the standard clinical monitoring of ICP requires an invasive transducer into the parenchymal tissue or the brain ventricle, with possibility of complications such as hemorrhage and infection. A non-invasive method for measuring ICP, would be highly preferable, as it would allow clinicians to promptly monitor ICP during transport and allow for monitoring in a larger number of patients. We have introduced diffuse correlation spectroscopy (DCS) as a non-invasive ICP monitor by fast measurement of pulsatile cerebral blood flow (CBF). The method is similar to Transcranial Doppler ultrasound (TCD), which derives ICP from the amplitude of the pulsatile cerebral blood flow velocity, with respect to the amplitude of the pulsatile arterial blood pressure. We believe DCS measurement is superior indicator of ICP than TCD estimation because DCS directly measures blood flow, not blood flow velocity, and the small cortical vessels measured by DCS are more susceptible to transmural pressure changes than the large vessels. For fast DCS measurements to recover pulsatile CBF we have developed a custom high-power long-coherent laser and a strategy for delivering it to the tissue within ANSI standards. We have also developed a custom FPGA-based correlator board, which facilitates DCS data acquisitions at 50-100 Hz. We have tested the feasibility of measuring pulsatile CBF and deriving ICP in two challenging scenarios: humans and rats. SNR is low in human adults due to large optode distances. It is similarly low in rats because the fast heart rate in this setting requires a high repetition rate.

Pulsatility of Lenticulostriate Arteries Assessed by 7 Tesla Flow MRI-Measurement, Reproducibility, and Applicability to Aging Effect.

PubMed

Schnerr, Roald S; Jansen, Jacobus F A; Uludag, Kamil; Hofman, Paul A M; Wildberger, Joachim E; van Oostenbrugge, Robert J; Backes, Walter H

2017-01-01

Characterization of flow properties in cerebral arteries with 1.5 and 3 Tesla MRI is usually limited to large cerebral arteries and difficult to evaluate in the small perforating arteries due to insufficient spatial resolution. In this study, we assessed the feasibility to measure blood flow waveforms in the small lenticulostriate arteries with 7 Tesla velocity-sensitive MRI. The middle cerebral artery was included as reference. Imaging was performed in five young and five old healthy volunteers. Flow was calculated by integrating time-varying velocity values over the vascular cross-section. MRI acquisitions were performed twice in each subject to determine reproducibility. From the flow waveforms, the pulsatility index and damping factor were deduced. Reproducibility values, in terms of the intraclass correlation coefficients, were found to be good to excellent. Measured pulsatility index of the lenticulostriate arteries significantly increased and damping factor significantly decreased with age. In conclusion, we demonstrate that blood flow through the lenticostriate arteries can be precisely measured using 7 Tesla MRI and reveal effects of arterial stiffness due to aging. These findings hold promise to provide relevant insights into the pathologies involving perforating cerebral arteries.

DOE Office of Scientific and Technical Information (OSTI.GOV)

N, Gwilliam M; J, Collins D; O, Leach M

Purpose: To assess the feasibility of accurately quantifying the concentration of MRI contrast agent (CA) in pulsatile flowing blood by measuring its T{sub 1}, as is common for the purposes of obtaining a patientspecific arterial input function (AIF). Dynamic contrast enhanced (DCE) - MRI and pharmacokinetic (PK) modelling is widely used to produce measures of vascular function but accurate measurement of the AIF undermines their accuracy. A proposed solution is to measure the T{sub 1} of blood in a large vessel using the Fram double flip angle method during the passage of a bolus of CA. This work expands onmore » previous work by assessing pulsatile flow and the changes in T{sub 1} seen with a CA bolus. Methods: A phantom was developed which used a physiological pump to pass fluid of a known T{sub 1} (812ms) through the centre of a head coil of a clinical 1.5T MRI scanner. Measurements were made using high temporal resolution sequences suitable for DCE-MRI and were used to validate a virtual phantom that simulated the expected errors due to pulsatile flow and bolus of CA concentration changes typically found in patients. Results: : Measured and virtual results showed similar trends, although there were differences that may be attributed to the virtual phantom not accurately simulating the spin history of the fluid before entering the imaging volume. The relationship between T{sub 1} measurement and flow speed was non-linear. T{sub 1} measurement is compromised by new spins flowing into the imaging volume, not being subject to enough excitations to have reached steady-state. The virtual phantom demonstrated a range of recorded T{sub 1} for various simulated T{sub 1} / flow rates. Conclusion: T{sub 1} measurement of flowing blood using standard DCE-MRI sequences is very challenging. Measurement error is non-linear with relation to instantaneous flow speed. Optimising sequence parameters and lowering baseline T{sub 1} of blood should be considered.« less

Flow-mediated transport around a macroscopic arterial thrombus

NASA Astrophysics Data System (ADS)

Mukherjee, Debanjan; Garduno, Jocelyn; Shadden, Shawn

2017-11-01

Pathological blood clotting (thrombosis) is the acute cause of most major cardiovascular events including heart attack and stroke. Local blood and plasma transport in the neighborhood of a clot is thought to govern the thrombotic process (e.g. growth and consolidation), embolization, and the effectiveness of pharmacological treatments. To better understand the fluid mechanics near a clot it is necessary to resolve the dynamic interactions between a realistic thrombus with arbitrary shape and microstructure, and viscous, pulsatile flow. Here, we describe a computational technique to characterize flow-mediated transport phenomena in the vicinity of macro-scale arterial clots. The technique comprises (a) resolving unsteady flow around a thrombus model using a discrete particle fictitious domain finite element method; (b) identifying coherent transport features using finite time Lyapunov exponent fields, and (c) characterizing mixing using a particle-based approach. Numerical examples are discussed using realistic thrombus aggregates derived from experimental data, and pulsatile flow typical in human arteries. The results indicate the existence of local transport barriers and coherent regions in the vicinity of the clot with potential influence to local biochemical mechanics. National Science Foundation Award: 1354541; American Heart Association Award: 16POST27500023.

In Vitro MRV-based Hemodynamic Study of Complex Helical Flow in a Patient-specific Jugular Model

NASA Astrophysics Data System (ADS)

Kefayati, Sarah; Acevedo-Bolton, Gabriel; Haraldsson, Henrik; Saloner, David

2014-11-01

Neurointerventional Radiologists are frequently requested to evaluate the venous side of the intracranial circulation for a variety of conditions including: Chronic Cerebrospinal Venous Insufficiency thought to play a role in the development of multiple sclerosis; sigmoid sinus diverticulum which has been linked to the presence of pulsatile tinnitus; and jugular vein distension which is related to cardiac dysfunction. Most approaches to evaluating these conditions rely on structural assessment or two dimensional flow analyses. This study was designed to investigate the highly complex jugular flow conditions using magnetic resonance velocimetry (MRV). A jugular phantom was fabricated based on the geometry of the dominant jugular in a tinnitus patient. Volumetric three-component time-resolved velocity fields were obtained using 4D PC-MRI -with the protocol enabling turbulence acquisition- and the patient-specific pulsatile waveform. Flow was highly complex exhibiting regions of jet, high swirling strength, and strong helical pattern with the core originating from the focal point of the jugular bulb. Specifically, flow was analyzed for helicity and the level of turbulence kinetic energy elevated in the core of helix and distally, in the post-narrowing region.

Modelling carotid artery adaptations to dynamic alterations in pressure and flow over the cardiac cycle

PubMed Central

Cardamone, L.; Valentín, A.; Eberth, J. F.; Humphrey, J. D.

2010-01-01

Motivated by recent clinical and laboratory findings of important effects of pulsatile pressure and flow on arterial adaptations, we employ and extend an established constrained mixture framework of growth (change in mass) and remodelling (change in structure) to include such dynamical effects. New descriptors of cell and tissue behavior (constitutive relations) are postulated and refined based on new experimental data from a transverse aortic arch banding model in the mouse that increases pulsatile pressure and flow in one carotid artery. In particular, it is shown that there was a need to refine constitutive relations for the active stress generated by smooth muscle, to include both stress- and stress rate-mediated control of the turnover of cells and matrix and to account for a cyclic stress-mediated loss of elastic fibre integrity and decrease in collagen stiffness in order to capture the reported evolution, over 8 weeks, of luminal radius, wall thickness, axial force and in vivo axial stretch of the hypertensive mouse carotid artery. We submit, therefore, that complex aspects of adaptation by elastic arteries can be predicted by constrained mixture models wherein individual constituents are produced or removed at individual rates and to individual extents depending on changes in both stress and stress rate from normal values. PMID:20484365

Development of a microimpedance pump for pulsatile flow transport - Part : Flow characteristics of the microimpedance pump. Part 2: A systematic study of steady and pulsatile transport in microscale cavities

NASA Astrophysics Data System (ADS)

Rinderknecht, Derek

Microfluidics offers an effective means to carry out a wide range of transport processes within a controlled microenvironment by drawing on the benefits imparted by increasing surface area to volume ratio at the microscale. Critical to the impact of microfluidics on integrated devices in the fields of bioengineering and biomedicine is the ability to transport fluids and biomolecules effectively particularly at the size scales involved. In this context a bio-inspired pumping mechanism, the valveless impedance pump, was explored for applications in microfluidics ranging from micro total analysis systems to microchannel cooling. Adhering to the basic principles of the impedance pump mechanism, pumps have been constructed at a variety of size scales from a few centimeters to a few hundred microns. The micro impedance pump is valveless, bidirectional, and can be constructed simply from a wide range of materials. Depending on the size of the pump flow rates range from nL/min to mL/min and pressures can be generated that exceed 20 kPa. Another benefit of the impedance pump is the pulsatile flow output which can be used in the context of microfluidic applications to enhance transport at low Reynolds numbers as well as metering in drug delivery. Pulsatile flow was therefore investigated as a method of augmenting transport in microfluidic systems. Micro PIV was used to study the affect of both steady and pulsatile flows on transport at low Reynolds number was examined in microscale rectangular cavities. Ventilation of the cavity contents was examined in terms of the residence time or average time a particle remains in the cavity region. Lagrangian coherent structures (LCS) were applied to empirical velocity fields to determine the impact of unsteadiness on time dependent boundaries to fluid transport present in the flow. Experimental results show that there are both frequencies which are beneficial and detrimental to cavity ventilation as well as certain frequencies which more evenly distribute particles originating in the cavity throughout the freestream.

Fluid-structure interaction of a pulsatile flow with an aortic valve model: A combined experimental and numerical study.

PubMed

Sigüenza, Julien; Pott, Desiree; Mendez, Simon; Sonntag, Simon J; Kaufmann, Tim A S; Steinseifer, Ulrich; Nicoud, Franck

2018-04-01

The complex fluid-structure interaction problem associated with the flow of blood through a heart valve with flexible leaflets is investigated both experimentally and numerically. In the experimental test rig, a pulse duplicator generates a pulsatile flow through a biomimetic rigid aortic root where a model of aortic valve with polymer flexible leaflets is implanted. High-speed recordings of the leaflets motion and particle image velocimetry measurements were performed together to investigate the valve kinematics and the dynamics of the flow. Large eddy simulations of the same configuration, based on a variant of the immersed boundary method, are also presented. A massively parallel unstructured finite-volume flow solver is coupled with a finite-element solid mechanics solver to predict the fluid-structure interaction between the unsteady flow and the valve. Detailed analysis of the dynamics of opening and closure of the valve are conducted, showing a good quantitative agreement between the experiment and the simulation regarding the global behavior, in spite of some differences regarding the individual dynamics of the valve leaflets. A multicycle analysis (over more than 20 cycles) enables to characterize the generation of turbulence downstream of the valve, showing similar flow features between the experiment and the simulation. The flow transitions to turbulence after peak systole, when the flow starts to decelerate. Fluctuations are observed in the wake of the valve, with maximum amplitude observed at the commissure side of the aorta. Overall, a very promising experiment-vs-simulation comparison is shown, demonstrating the potential of the numerical method. Copyright © 2017 John Wiley & Sons, Ltd.

Evaluation of exercise-respiratory system modifications and integration schemes for physiological systems

NASA Technical Reports Server (NTRS)

Gallagher, R. R.

1974-01-01

Exercise subroutine modifications are implemented in an exercise-respiratory system model yielding improvement of system response to exercise forcings. A more physiologically desirable respiratory ventilation rate in addition to an improved regulation of arterial gas tensions and cerebral blood flow is observed. A respiratory frequency expression is proposed which would be appropriate as an interfacing element of the respiratory-pulsatile cardiovascular system. Presentation of a circulatory-respiratory system integration scheme along with its computer program listing is given. The integrated system responds to exercise stimulation for both nonstressed and stressed physiological states. Other integration possibilities are discussed with respect to the respiratory, pulsatile cardiovascular, thermoregulatory, and the long-term circulatory systems.

Analysis of high gradient magnetic field effects on distribution of nanoparticles injected into pulsatile blood stream

NASA Astrophysics Data System (ADS)

Reza Habibi, Mohammad; Ghassemi, Majid; Hossien Hamedi, Mohammad

2012-04-01

Magnetic nanoparticles are widely used in a wide range of applications including data storage materials, pharmaceutical industries as magnetic separation tools, anti-cancer drug carriers and micro valve applications. The purpose of the current study is to investigate the effect of a non-uniform magnetic field on bio-fluid (blood) with magnetic nanoparticles. The effect of particles as well as mass fraction on flow field and volume concentration is investigated. The governing non-linear differential equations, concentration and Navier-stokes are coupled with the magnetic field. To solve these equations, a finite volume based code is developed and utilized. A real pulsatile velocity is utilized as inlet boundary condition. This velocity is extracted from an actual experimental data. Three percent nanoparticles volume concentration, as drug carrier, is steadily injected in an unsteady, pulsatile and non-Newtonian flow. A power law model is considered for the blood viscosity. The results show that during the systole section of the heartbeat when the blood velocity increases, the magnetic nanoparticles near the magnetic source are washed away. This is due to the sudden increase of the hydrodynamic force, which overcomes the magnetic force. The probability of vein blockage increases when the blood velocity reduces during the diastole time. As nanoparticles velocity injection decreases (longer injection time) the wall shear stress (especially near the injection area) decreases and the retention time of the magnetic nanoparticles in the blood flow increases.

Safety and efficacy of the Aperio thrombectomy device when compared to the Solitaire AB/FR and the Revive devices in a pulsatile flow system.

PubMed

Saleh, Mahdi; Spence, John Nathan; Nayak, Sanjeev; Pearce, Gillian; Tennuci, Christopher; Roffe, Christine

2012-01-01

There are a limited number of studies comparing the Aperio mechanical thrombectomy device to other stent-based devices. In this paper, we compared the Aperio thrombectomy device to the Solitaire AB, FR and Revive devices in a model of the middle cerebral artery (MCA) within a modified pulsatile flow system. Thrombi made of lamb's blood were placed into a pulsatile flow system perfused with Hartmann's solution at 80 bpm with a mean pressure of 90 mm Hg. 30 experiments were run with each device. Recanalization rates were similar for all three devices (90% with the Solitaire AB, FR, 80% with the Revive, and 90% with the Aperio). The mean number of attempts to retrieve the thrombus was also similar for all three devices (1.7 with the Solitaire AB, FR, 2.1 with the Revive, 1.6 with the Aperio). Clot fragmentation and embolization rates revealed no statistical significance but there was a trend towards lower embolization rates with the Aperio (23% compared to 40% with the Solitaire AB, FR and 47% with the Revive). The Aperio was the fastest to recanalize the MCA (mean of 66 seconds compared to 186 seconds for the Solitaire AB, FR and 169 seconds for the Revive). In this in vitro setting, the Aperio device seems to be an efficacious and safe device when compared to other similar clinically used mechanical thrombectomy devices. Larger clinical trials are warranted.

Non-invasive assessment of pulsatile intracranial pressure with phase-contrast magnetic resonance imaging

PubMed Central

Lindstrøm, Erika Kristina; Vatnehol, Svein Are Sirirud; Mardal, Kent-André; Emblem, Kyrre Eeg; Eide, Per Kristian

2017-01-01

Invasive monitoring of pulsatile intracranial pressure can accurately predict shunt response in patients with idiopathic normal pressure hydrocephalus, but may potentially cause complications such as bleeding and infection. We tested how a proposed surrogate parameter for pulsatile intracranial pressure, the phase-contrast magnetic resonance imaging derived pulse pressure gradient, compared with its invasive counterpart. In 22 patients with suspected idiopathic normal pressure hydrocephalus, preceding invasive intracranial pressure monitoring, and any surgical shunt procedure, we calculated the pulse pressure gradient from phase-contrast magnetic resonance imaging derived cerebrospinal fluid flow velocities obtained at the upper cervical spinal canal using a simplified Navier-Stokes equation. Repeated measurements of the pulse pressure gradient were also undertaken in four healthy controls. Of 17 shunted patients, 16 responded, indicating high proportion of “true” normal pressure hydrocephalus in the patient cohort. However, there was no correlation between the magnetic resonance imaging derived pulse pressure gradient and pulsatile intracranial pressure (R = -.18, P = .43). Pulse pressure gradients were also similar in patients and healthy controls (P = .26), and did not differ between individuals with pulsatile intracranial pressure above or below established thresholds for shunt treatment (P = .97). Assessment of pulse pressure gradient at level C2 was therefore not found feasible to replace invasive monitoring of pulsatile intracranial pressure in selection of patients with idiopathic normal pressure hydrocephalus for surgical shunting. Unlike invasive, overnight monitoring, the pulse pressure gradient from magnetic resonance imaging comprises short-term pressure fluctuations only. Moreover, complexity of cervical cerebrospinal fluid flow and -pulsatility at the upper cervical spinal canal may render the pulse pressure gradient a poor surrogate marker for intracranial pressure pulsations. PMID:29190788

Non-invasive assessment of pulsatile intracranial pressure with phase-contrast magnetic resonance imaging.

PubMed

Ringstad, Geir; Lindstrøm, Erika Kristina; Vatnehol, Svein Are Sirirud; Mardal, Kent-André; Emblem, Kyrre Eeg; Eide, Per Kristian

2017-01-01

Invasive monitoring of pulsatile intracranial pressure can accurately predict shunt response in patients with idiopathic normal pressure hydrocephalus, but may potentially cause complications such as bleeding and infection. We tested how a proposed surrogate parameter for pulsatile intracranial pressure, the phase-contrast magnetic resonance imaging derived pulse pressure gradient, compared with its invasive counterpart. In 22 patients with suspected idiopathic normal pressure hydrocephalus, preceding invasive intracranial pressure monitoring, and any surgical shunt procedure, we calculated the pulse pressure gradient from phase-contrast magnetic resonance imaging derived cerebrospinal fluid flow velocities obtained at the upper cervical spinal canal using a simplified Navier-Stokes equation. Repeated measurements of the pulse pressure gradient were also undertaken in four healthy controls. Of 17 shunted patients, 16 responded, indicating high proportion of "true" normal pressure hydrocephalus in the patient cohort. However, there was no correlation between the magnetic resonance imaging derived pulse pressure gradient and pulsatile intracranial pressure (R = -.18, P = .43). Pulse pressure gradients were also similar in patients and healthy controls (P = .26), and did not differ between individuals with pulsatile intracranial pressure above or below established thresholds for shunt treatment (P = .97). Assessment of pulse pressure gradient at level C2 was therefore not found feasible to replace invasive monitoring of pulsatile intracranial pressure in selection of patients with idiopathic normal pressure hydrocephalus for surgical shunting. Unlike invasive, overnight monitoring, the pulse pressure gradient from magnetic resonance imaging comprises short-term pressure fluctuations only. Moreover, complexity of cervical cerebrospinal fluid flow and -pulsatility at the upper cervical spinal canal may render the pulse pressure gradient a poor surrogate marker for intracranial pressure pulsations.

Pulsatility Index as a Diagnostic Parameter of Reciprocating Wall Shear Stress Parameters in Physiological Pulsating Waveforms

PubMed Central

Avrahami, Idit; Kersh, Dikla

2016-01-01

Arterial wall shear stress (WSS) parameters are widely used for prediction of the initiation and development of atherosclerosis and arterial pathologies. Traditional clinical evaluation of arterial condition relies on correlations of WSS parameters with average flow rate (Q) and heart rate (HR) measurements. We show that for pulsating flow waveforms in a straight tube with flow reversals that lead to significant reciprocating WSS, the measurements of HR and Q are not sufficient for prediction of WSS parameters. Therefore, we suggest adding a third quantity—known as the pulsatility index (PI)—which is defined as the peak-to-peak flow rate amplitude normalized by Q. We examine several pulsating flow waveforms with and without flow reversals using a simulation of a Womersley model in a straight rigid tube and validate the simulations through experimental study using particle image velocimetry (PIV). The results indicate that clinically relevant WSS parameters such as the percentage of negative WSS (P[%]), oscillating shear index (OSI) and the ratio of minimum to maximum shear stress rates (min/max), are better predicted when the PI is used in conjunction with HR and Q. Therefore, we propose to use PI as an additional and essential diagnostic quantity for improved predictability of the reciprocating WSS. PMID:27893801

Analysis of Computational Fluid Dynamics and Particle Image Velocimetry Models of Distal-End Side-to-Side and End-to-Side Anastomoses for Coronary Artery Bypass Grafting in a Pulsatile Flow.

PubMed

Shintani, Yoshiko; Iino, Kenji; Yamamoto, Yoshitaka; Kato, Hiroki; Takemura, Hirofumi; Kiwata, Takahiro

2017-12-25

Intimal hyperplasia (IH) is a major cause of graft failure. Hemodynamic factors such as stagnation and disturbed blood flow are involved in IH formation. The aim of this study is to perform a comparative analysis of distal-end side-to-side (deSTS) and end-to-side (ETS) anastomoses using computational fluid dynamics (CFD) after validating the results via particle image velocimetry (PIV).Methods and Results:We investigated the characteristics of our target flow fields using CFD under steady and pulsatile flows. CFD via PIV under steady flow in a 10-times-actual-size model was validated. The CFD analysis revealed a recirculation zone in the heel region in the deSTS and ETS anastomoses and at the distal end of the graft, and just distal to the toe of the host artery in the deSTS anastomoses. The recirculation zone sizes changed with the phase shift. We found regions of low wall shear stress and high oscillating shear index in the same areas. The PIV and CFD results were similar. It was demonstrated that the hemodynamic characteristics of CFD and PIV is the difference between the deSTS and ETS anastomoses; that is, the deSTS flow peripheral to the distal end of the graft, at the distal end and just distal to the toe of the host artery is involved in the IH formation.

Performance characterization of a rotary centrifugal left ventricular assist device with magnetic suspension.

PubMed

Jahanmir, Said; Hunsberger, Andrew Z; Heshmat, Hooshang; Tomaszewski, Michael J; Walton, James F; Weiss, William J; Lukic, Branka; Pae, William E; Zapanta, Conrad M; Khalapyan, Tigran Z

2008-05-01

The MiTiHeart (MiTiHeart Corporation, Gaithersburg, MD, USA) left ventricular assist device (LVAD), a third-generation blood pump, is being developed for destination therapy for adult heart failure patients of small to medium frame that are not being served by present pulsatile devices. The pump design is based on a novel, patented, hybrid passive/active magnetic bearing system with backup hydrodynamic thrust bearing and exhibits low power loss, low vibration, and low hemolysis. Performance of the titanium alloy prototype was evaluated in a series of in vitro tests with blood analogue to map out the performance envelop of the pump. The LVAD prototype was implanted in a calf animal model, and the in vivo pump performance was evaluated. The animal's native heart imparted a strong pulsatility to the flow rate. These tests confirmed the efficacy of the MiTiHeart LVAD design and confirmed that the pulsatility does not adversely affect the pump performance.

Application of a novel particle tracking algorithm in the flow visualization of an artificial abdominal aortic aneurysm.

PubMed

Zhang, Yang; Wang, Yuan; He, Wenbo; Yang, Bin

2014-01-01

A novel Particle Tracking Velocimetry (PTV) algorithm based on Voronoi Diagram (VD) is proposed and briefed as VD-PTV. The robustness of VD-PTV for pulsatile flow is verified through a test that includes a widely used artificial flow and a classic reference algorithm. The proposed algorithm is then applied to visualize the flow in an artificial abdominal aortic aneurysm included in a pulsatile circulation system that simulates the aortic blood flow in human body. Results show that, large particles tend to gather at the upstream boundary because of the backflow eddies that follow the pulsation. This qualitative description, together with VD-PTV, has laid a foundation for future works that demand high-level quantification.

Fractality of pulsatile flow in speckle images

NASA Astrophysics Data System (ADS)

Nemati, M.; Kenjeres, S.; Urbach, H. P.; Bhattacharya, N.

2016-05-01

The scattering of coherent light from a system with underlying flow can be used to yield essential information about dynamics of the process. In the case of pulsatile flow, there is a rapid change in the properties of the speckle images. This can be studied using the standard laser speckle contrast and also the fractality of images. In this paper, we report the results of experiments performed to study pulsatile flow with speckle images, under different experimental configurations to verify the robustness of the techniques for applications. In order to study flow under various levels of complexity, the measurements were done for three in-vitro phantoms and two in-vivo situations. The pumping mechanisms were varied ranging from mechanical pumps to the human heart for the in vivo case. The speckle images were analyzed using the techniques of fractal dimension and speckle contrast analysis. The results of these techniques for the various experimental scenarios were compared. The fractal dimension is a more sensitive measure to capture the complexity of the signal though it was observed that it is also extremely sensitive to the properties of the scattering medium and cannot recover the signal for thicker diffusers in comparison to speckle contrast.

Can time-averaged flow boundary conditions be used to meet the clinical timeline for Fontan surgical planning?

PubMed

Wei, Zhenglun Alan; Trusty, Phillip M; Tree, Mike; Haggerty, Christopher M; Tang, Elaine; Fogel, Mark; Yoganathan, Ajit P

2017-01-04

Cardiovascular simulations have great potential as a clinical tool for planning and evaluating patient-specific treatment strategies for those suffering from congenital heart diseases, specifically Fontan patients. However, several bottlenecks have delayed wider deployment of the simulations for clinical use; the main obstacle is simulation cost. Currently, time-averaged clinical flow measurements are utilized as numerical boundary conditions (BCs) in order to reduce the computational power and time needed to offer surgical planning within a clinical time frame. Nevertheless, pulsatile blood flow is observed in vivo, and its significant impact on numerical simulations has been demonstrated. Therefore, it is imperative to carry out a comprehensive study analyzing the sensitivity of using time-averaged BCs. In this study, sensitivity is evaluated based on the discrepancies between hemodynamic metrics calculated using time-averaged and pulsatile BCs; smaller discrepancies indicate less sensitivity. The current study incorporates a comparison between 3D patient-specific CFD simulations using both the time-averaged and pulsatile BCs for 101 Fontan patients. The sensitivity analysis involves two clinically important hemodynamic metrics: hepatic flow distribution (HFD) and indexed power loss (iPL). Paired demographic group comparisons revealed that HFD sensitivity is significantly different between single and bilateral superior vena cava cohorts but no other demographic discrepancies were observed for HFD or iPL. Multivariate regression analyses show that the best predictors for sensitivity involve flow pulsatilities, time-averaged flow rates, and geometric characteristics of the Fontan connection. These predictors provide patient-specific guidelines to determine the effectiveness of analyzing patient-specific surgical options with time-averaged BCs within a clinical time frame. Copyright © 2016 Elsevier Ltd. All rights reserved.

Tissue vibration pulsatility for arterial bleeding detection using Doppler ultrasound.

PubMed

Xie, Zhiyong; Kim, Eung-Hun; Kim, Yongmin

2009-01-01

Trauma is the number one cause of death among Americans between 1 and 44 years old, and exsanguination due to internal bleeding resulting from arterial injuries is a major factor in trauma deaths. We have evaluated the feasibility of using tissue vibration pulsatility in arterial bleeding detection. Eight femoral arteries from four juvenile pigs were punctured transcutaneously with a 6 or 9-French catheter. Also, 11 silicone vessels wrapped with turkey breast were placed in a pulsatile flow phantom and penetrated with an 18-gauge needle. The tissue vibration pulsatility was derived as a ratio of the maximum spectral energy from 200 to 2500 Hz of tissue vibration in systole over a baseline value in diastole. Then, the tissue vibration pulsatility index (TVPI) was defined as the maximum tissue vibration pulsatility value for each experimental condition. Both in vitro and in vivo results showed that the TVPI from injured vessels is significantly higher (p<0.005) than that of intact vessels. In addition, we constructed the 2D map of tissue vibration pulsatility during in vitro studies and found that it could be used for spatial localization of the puncture site. Our preliminary results indicate that the tissue vibration pulsatility may be useful for detecting arterial bleeding and localizing the bleeding site.

Clinical impact of quantitative left atrial vortex flow analysis in patients with atrial fibrillation: a comparison with invasive left atrial voltage mapping.

PubMed

Lee, Jung Myung; Hong, Geu-Ru; Pak, Hui-Nam; Shim, Chi Young; Houle, Helene; Vannan, Mani A; Kim, Minji; Chung, Namsik

2015-08-01

Recently, left atrial (LA) vortex flow analysis using contrast transesophageal echocardiography (TEE) has been shown to be feasible and has demonstrated significant differences in vortex flow morphology and pulsatility between normal subjects and patients with atrial fibrillation (AF). However, the relationship between LA vortex flow and electrophysiological properties and the clinical significance of LA vortex flow are unknown. The aims of this study were (1) to compare LA vortex flow parameters with LA voltage and (2) to assess the predictive value of LA vortex flow parameters for the recurrence of AF after radiofrequency catheter ablation (RFCA). Thirty-nine patients with symptomatic non-valvular AF underwent contrast TEE before undergoing RFCA for AF. Quantitative LA vortex flow parameters were analyzed by Omega flow (Siemens Medical Solution, Mountain View, CA, USA). The morphology and pulsatility of LA vortex flow were compared with electrophysiologic parameters that were measured invasively. Hemodynamic, electrophysiological, and vortex flow parameters were compared between patients with and without early recurrence of AF after RFCA. Morphologic parameters, including LA vortex depth, length, width, and sphericity index were not associated with LA voltage or hemodynamic parameters. The relative strength (RS), which represents the pulsatility power of LA, was positively correlated with LA voltage (R = 0.53, p = 0.01) and LA appendage flow velocity (R = 0.73, p < 0.001) and negatively correlated with LA volume index (R = -0.56, p < 0.001). Patients with recurrent AF after RFCA showed significantly lower RS (1.7 ± 0.2 vs 1.9 ± 0.4, p = 0.048) and LA voltage (0.9 ± 0.7 vs 1.7 ± 0.8, p = 0.004) than patients without AF recurrence. In the relatively small LA dimension group (LA volume index ≤ 33 ml/m(2)), RS was significantly lower (2.1 ± 0.3 vs 1.7 ± 0.1, p = 0.029) in patients with the recurrent AF. Quantitative LA vortex flow analysis, especially RS, correlated well with LA voltage. Decreased pulsatility strength in the LA was associated with recurrent AF. LA vortex may have incremental value in predicting the recurrence of AF.

Control volume based hydrocephalus research

NASA Astrophysics Data System (ADS)

Cohen, Benjamin; Voorhees, Abram; Wei, Timothy

2008-11-01

Hydrocephalus is a disease involving excess amounts of cerebral spinal fluid (CSF) in the brain. Recent research has shown correlations to pulsatility of blood flow through the brain. However, the problem to date has presented as too complex for much more than statistical analysis and understanding. This talk will highlight progress on developing a fundamental control volume approach to studying hydrocephalus. The specific goals are to select physiologically control volume(s), develop conservation equations along with the experimental capabilities to accurately quantify terms in those equations. To this end, an in vitro phantom is used as a simplified model of the human brain. The phantom's design consists of a rigid container filled with a compressible gel. The gel has a hollow spherical cavity representing a ventricle and a cylindrical passage representing the aquaducts. A computer controlled piston pump supplies pulsatile volume fluctuations into and out of the flow phantom. MRI is used to measure fluid velocity, and volume change as functions of time. Independent pressure measurements and flow rate measurements are used to calibrate the MRI data. These data are used as a framework for future work with live patients.

Comparison of two types of neonatal extracorporeal life support systems with pulsatile and nonpulsatile flow.

PubMed

Haines, Nikkole; Wang, Shigang; Myers, John L; Undar, Akif

2009-11-01

We compared the effects of two neonatal extracorporeal life support (ECLS) systems on circuit pressures and surplus hemodynamic energy levels in a simulated ECLS model. The clinical set-up included the Jostra HL-20 heart-lung machine, either the Medtronic ECMO (0800) or the MEDOS 800LT systems with company-provided circuit components, a 10 Fr arterial cannula, and a pseudo-patient. We tested the system in nonpulsatile and pulsatile flow modes at two flow rates using a 40/60 glycerin/water blood analog, for a total of 48 trials, with n = 6 for each set-up. The pressure drops over the Medtronic ECLS were significantly higher than those over the MEDOS system regardless of the flow rate or perfusion mode (144.8 +/- 0.2 mm Hg vs. 35.7 +/- 0.2 mm Hg, respectively, at 500 mL/min in nonpulsatile mode, P < 0.001). The preoxygenator mean arterial pressures were significantly increased and the precannula hemodynamic energy values were decreased with the Medtronic ECLS circuit. These results suggest that the MEDOS ECLS circuit better transmits hemodynamic energy to the patient, keeps mean circuit pressures lower, and has lower pressure drops than the Medtronic Circuit.

Numerical analysis of the effect of turbulence transition on the hemodynamic parameters in human coronary arteries

PubMed Central

Gawandalkar, Udhav Ulhas; Kini, Girish; Buradi, Abdulrajak; Araki, Tadashi; Ikeda, Nobutaka; Nicolaides, Andrew; Laird, John R.; Saba, Luca; Suri, Jasjit S.

2016-01-01

Background Local hemodynamics plays an important role in atherogenesis and the progression of coronary atherosclerosis disease (CAD). The primary biological effect due to blood turbulence is the change in wall shear stress (WSS) on the endothelial cell membrane, while the local oscillatory nature of the blood flow affects the physiological changes in the coronary artery. In coronary arteries, the blood flow Reynolds number ranges from few tens to several hundreds and hence it is generally assumed to be laminar while calculating the WSS calculations. However, the pulsatile blood flow through coronary arteries under stenotic condition could result in transition from laminar to turbulent flow condition. Methods In the present work, the onset of turbulent transition during pulsatile flow through coronary arteries for varying degree of stenosis (i.e., 0%, 30%, 50% and 70%) is quantitatively analyzed by calculating the turbulent parameters distal to the stenosis. Also, the effect of turbulence transition on hemodynamic parameters such as WSS and oscillatory shear index (OSI) for varying degree of stenosis is quantified. The validated transitional shear stress transport (SST) k-ω model used in the present investigation is the best suited Reynolds averaged Navier-Stokes turbulence model to capture the turbulent transition. The arterial wall is assumed to be rigid and the dynamic curvature effect due to myocardial contraction on the blood flow has been neglected. Results Our observations shows that for stenosis 50% and above, the WSSavg, WSSmax and OSI calculated using turbulence model deviates from laminar by more than 10% and the flow disturbances seems to significantly increase only after 70% stenosis. Our model shows reliability and completely validated. Conclusions Blood flow through stenosed coronary arteries seems to be turbulent in nature for area stenosis above 70% and the transition to turbulent flow begins from 50% stenosis. PMID:27280084

Simulation of Local Blood Flow in Human Brain under Altered Gravity

NASA Technical Reports Server (NTRS)

Kim, Chang Sung; Kiris, Cetin; Kwak, Dochan

2003-01-01

In addition to the altered gravitational forces, specific shapes and connections of arteries in the brain vary in the human population (Cebral et al., 2000; Ferrandez et al., 2002). Considering the geometric variations, pulsatile unsteadiness, and moving walls, computational approach in analyzing altered blood circulation will offer an economical alternative to experiments. This paper presents a computational approach for modeling the local blood flow through the human brain under altered gravity. This computational approach has been verified through steady and unsteady experimental measurements and then applied to the unsteady blood flows through a carotid bifurcation model and an idealized Circle of Willis (COW) configuration under altered gravity conditions.

Comparison of pulsatile with nonpulsatile mechanical support in a porcine model of profound cardiogenic shock.

PubMed

Drakos, Stavros G; Charitos, Christos E; Ntalianis, Argirios; Terrovitis, John V; Siafakas, Kostas X; Dolou, Paraskevi; Pierrakos, Charalampos; Charitos, Efstratios; Karelas, John; Nanas, John N

2005-01-01

The aim of this study was to examine whether pulsatility by intraaortic balloon counterpulsation (IABP) is an important adjunct to the treatment of profound cardiogenic shock (CS) with a widely used, nonpulsatile centrifugal pump (CP). In each of 18 anesthetized, open chest pigs, the outflow cannula of the CP was inserted in the aortic arch through the right external carotid artery, and the inflow cannula of the CP was placed in the left atrium. A 40 cc IABP was subsequently placed in the descending aorta through the left external carotid artery. CS was induced by occlusion of coronary arteries and the infusion of propranolol and crystalloid fluid. Mean aortic pressure, pulse pressure, aortic end diastolic pressure, left ventricular end diastolic pressure, right atrial pressure, and heart rate were monitored. Cardiac output and left anterior descending artery flow were measured with a transit time ultrasound flowmeter. During profound CS, life sustaining hemodynamics were maintained only with the support of the assist devices. Hemodynamic support with the CP was associated with a nearly nonpulsatile flow and a pulse pressure of 7 +/- 4 mm Hg, which increased to 33 +/- 10 mm Hg (p = 0.000) after combining the CP with the IABP. Compared with the hemodynamic support offered by the CP alone, addition of the IABP increased mean aortic pressure from 40 +/- 15 to 50 +/- 16 mm Hg (p = 0.000), cardiac output from 810 +/- 194 to 1,200 +/- 234 ml/min (p = 0.003), and left anterior descending artery flow from 26 +/- 10 to 39 +/- 14 ml/min (p = 0.001). In profound CS, mechanical support provided by a continuous flow CP is enhanced by the added pulsatility of the IABP.

Relations of Arterial Stiffness and Brachial Flow-Mediated Dilation With New-Onset Atrial Fibrillation: The Framingham Heart Study.

PubMed

Shaikh, Amir Y; Wang, Na; Yin, Xiaoyan; Larson, Martin G; Vasan, Ramachandran S; Hamburg, Naomi M; Magnani, Jared W; Ellinor, Patrick T; Lubitz, Steven A; Mitchell, Gary F; Benjamin, Emelia J; McManus, David D

2016-09-01

The relations of measures of arterial stiffness, pulsatile hemodynamic load, and endothelial dysfunction to atrial fibrillation (AF) remain poorly understood. To better understand the pathophysiology of AF, we examined associations between noninvasive measures of vascular function and new-onset AF. The study sample included participants aged ≥45 years from the Framingham Heart Study offspring and third-generation cohorts. Using Cox proportional hazards regression models, we examined relations between incident AF and tonometry measures of arterial stiffness (carotid-femoral pulse wave velocity), wave reflection (augmentation index), pressure pulsatility (central pulse pressure), endothelial function (flow-mediated dilation), resting brachial arterial diameter, and hyperemic flow. AF developed in 407/5797 participants in the tonometry sample and 270/3921 participants in the endothelial function sample during follow-up (median 7.1 years, maximum 10 years). Higher augmentation index (hazard ratio, 1.16; 95% confidence interval, 1.02-1.32; P=0.02), baseline brachial artery diameter (hazard ratio, 1.20; 95% confidence interval, 1.01-1.43; P=0.04), and lower flow-mediated dilation (hazard ratio, 0.79; 95% confidence interval, 0.63-0.99; P=0.04) were associated with increased risk of incident AF. Central pulse pressure, when adjusted for age, sex, and hypertension (hazard ratio, 1.14; 95% confidence interval, 1.02-1.28; P=0.02) was associated with incident AF. Higher pulsatile load assessed by central pulse pressure and greater apparent wave reflection measured by augmentation index were associated with increased risk of incident AF. Vascular endothelial dysfunction may precede development of AF. These measures may be additional risk factors or markers of subclinical cardiovascular disease associated with increased risk of incident AF. © 2016 American Heart Association, Inc.

Early signs that predict later haemodynamically significant patent ductus arteriosus.

PubMed

Engür, Defne; Deveci, Murat; Türkmen, Münevver K

2016-03-01

Our aim was to determine the optimal cut-off values, sensitivity, specificity, and diagnostic power of 12 echocardiographic parameters on the second day of life to predict subsequent ductal patency. We evaluated preterm infants, born at ⩽32 weeks of gestation, starting on their second day of life, and they were evaluated every other day until ductal closure or until there were clinical signs of re-opening. We measured transductal diameter; pulmonary arterial diastolic flow; retrograde aortic diastolic flow; pulsatility index of the left pulmonary artery and descending aorta; left atrium and ventricle/aortic root ratio; left ventricular output; left ventricular flow velocity time integral; mitral early/late diastolic flow; and superior caval vein diameter and flow as well as performed receiver operating curve analysis. Transductal diameter (>1.5 mm); pulmonary arterial diastolic flow (>25.6 cm/second); presence of retrograde aortic diastolic flow; ductal diameter by body weight (>1.07 mm/kg); left pulmonary arterial pulsatility index (⩽0.71); and left ventricle to aortic root ratio (>2.2) displayed high sensitivity and specificity (p0.9). Parameters with moderate sensitivity and specificity were as follows: left atrial to aortic root ratio; left ventricular output; left ventricular flow velocity time integral; and mitral early/late diastolic flow ratio (p0.05) had low diagnostic value. Left pulmonary arterial pulsatility index, left ventricle/aortic root ratio, and ductal diameter by body weight are useful adjuncts offering a broader outlook for predicting ductal patency.

Bedside assistance in freehand ultrasonic diagnosis by real-time visual feedback of 3D scatter diagram of pulsatile tissue-motion

NASA Astrophysics Data System (ADS)

Fukuzawa, M.; Kawata, K.; Nakamori, N.; Kitsunezuka, Y.

2011-03-01

By real-time visual feedback of 3D scatter diagram of pulsatile tissue-motion, freehand ultrasonic diagnosis of neonatal ischemic diseases has been assisted at the bedside. The 2D ultrasonic movie was taken with a conventional ultrasonic apparatus (ATL HDI5000) and ultrasonic probes of 5-7 MHz with the compact tilt-sensor to measure the probe orientation. The real-time 3D visualization was realized by developing an extended version of the PC-based visualization system. The software was originally developed on the DirectX platform and optimized with the streaming SIMD extensions. The 3D scatter diagram of the latest pulsatile tissues has been continuously generated and visualized as projection image with the ultrasonic movie in the current section more than 15 fps. It revealed the 3D structure of pulsatile tissues such as middle and posterior cerebral arteries, Willis ring and cerebellar arteries, in which pediatricians have great interests in the blood flow because asphyxiated and/or low-birth-weight neonates have a high risk of ischemic diseases such as hypoxic-ischemic encephalopathy and periventricular leukomalacia. Since the pulsatile tissue-motion is due to local blood flow, it can be concluded that the system developed in this work is very useful to assist freehand ultrasonic diagnosis of ischemic diseases in the neonatal cranium.

Pulsatile flows and wall-shear stresses in models simulating normal and stenosed aortic arches

NASA Astrophysics Data System (ADS)

Huang, Rong Fung; Yang, Ten-Fang; Lan, Y.-K.

2010-03-01

Pulsatile aqueous glycerol solution flows in the models simulating normal and stenosed human aortic arches are measured by means of particle image velocimetry. Three transparent models were used: normal, 25% stenosed, and 50% stenosed aortic arches. The Womersley parameter, Dean number, and time-averaged Reynolds number are 17.31, 725, and 1,081, respectively. The Reynolds numbers based on the peak velocities of the normal, 25% stenosed, and 50% stenosed aortic arches are 2,484, 3,456, and 3,931, respectively. The study presents the temporal/spatial evolution processes of the flow pattern, velocity distribution, and wall-shear stress during the systolic and diastolic phases. It is found that the flow pattern evolving in the central plane of normal and stenosed aortic arches exhibits (1) a separation bubble around the inner arch, (2) a recirculation vortex around the outer arch wall upstream of the junction of the brachiocephalic artery, (3) an accelerated main stream around the outer arch wall near the junctions of the left carotid and the left subclavian arteries, and (4) the vortices around the entrances of the three main branches. The study identifies and discusses the reasons for the flow physics’ contribution to the formation of these features. The oscillating wall-shear stress distributions are closely related to the featured flow structures. On the outer wall of normal and slightly stenosed aortas, large wall-shear stresses appear in the regions upstream of the junction of the brachiocephalic artery as well as the corner near the junctions of the left carotid artery and the left subclavian artery. On the inner wall, the largest wall-shear stress appears in the region where the boundary layer separates.

Implantable physiologic controller for left ventricular assist devices with telemetry capability.

PubMed

Asgari, Siavash S; Bonde, Pramod

2014-01-01

Rotary type left ventricular assist devices have mitigated the problem of durability associated with earlier pulsatile pumps and demonstrated improved survival. However, the compromise is the loss of pulsatility due to continuous flow and retained percutaneous driveline leading to increased mortality and morbidity. Lack of pulsatility is implicated in increased gastrointestinal bleeding, aortic incompetence, and diastolic hypertension. We present a novel, wirelessly powered, ultra-compact, implantable physiologic controller capable of running a left ventricular assist device in a pulsatile mode with wireless power delivery. The schematic of our system was laid out on a circuit board to wirelessly receive power and run a left ventricular assist device with required safety and backup measures. We have embedded an antenna and wireless network for telemetry. Multiple signal processing steps and controlling algorithm were incorporated. The controller was tested in in vitro and in vivo experiments. The controller drove left ventricular assist devices continuously for 2 weeks in an in vitro setup and in vivo without any failure. Our controller is more power efficient than the current Food and Drug Administration-approved left ventricular assist device controllers. When used with electrocardiography synchronization, the controller allowed on-demand customization of operation with instantaneous flow and revolutions per minute changes, resulting in a pulsatile flow with adjustable pulse pressure. Our test results prove the system to be remarkably safe, accurate, and efficient. The unique combination of wireless powering and small footprint makes this system an ideal totally implantable physiologic left ventricular assist device system. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Effect of acute high-intensity resistance exercise on optic nerve sheath diameter and ophthalmic artery blood flow pulsatility.

PubMed

Lefferts, W K; Hughes, W E; Heffernan, K S

2015-12-01

Exertional hypertension associated with acute high-intensity resistance exercise (RE) increases both intravascular and intracranial pressure (ICP), maintaining cerebrovascular transmural pressure. Carotid intravascular pressure pulsatility remains elevated after RE. Whether ICP also remains elevated after acute RE in an attempt to maintain the vessel wall transmural pressure is unknown. Optic nerve sheath diameter (ONSD), a valid proxy of ICP, was measured in 20 participants (6 female; 24 ± 4 yr, 24.2 ± 3.9 kg m(-)(2)) at rest (baseline), following a time-control condition, and following RE (5 sets, 5 repetition maximum bench press, 5 sets 10 repetition maximum biceps curls) using ultrasound. Additionally, intracranial hemodynamic pulsatility index (PI) was assessed in the ophthalmic artery (OA) by using Doppler. Aortic pulse wave velocity (PWV) was obtained from synthesized aortic pressure waveforms obtained via a brachial oscillometric cuff and carotid pulse pressure was measured by using applanation tonometry. Aortic PWV (5.2 ± 0.5-6.0 ± 0.7 m s(-1), P < 0.05) and carotid pulse pressure (45 ± 17-59 ± 19 mm Hg, P < 0.05) were significantly elevated post RE compared with baseline. There were no significant changes in ONSD (5.09 ± 0.7-5.09 ± 0.7 mm, P > 0.05) or OA flow PI (1.35 ± 0.2-1.38 ± 0.3, P > 0.05) following acute RE. In conclusion, during recovery from acute high-intensity RE, there are increases in aortic stiffness and extracranial pressure pulsatility in the absence of changes in ICP and flow pulsatility. These findings may have implications for alterations in cerebral transmural pressure and cerebral aneurysmal wall stress following RE.

Dynamics of pulsatile flow in fractal models of vascular branching networks.

PubMed

Bui, Anh; Sutalo, Ilija D; Manasseh, Richard; Liffman, Kurt

2009-07-01

Efficient regulation of blood flow is critically important to the normal function of many organs, especially the brain. To investigate the circulation of blood in complex, multi-branching vascular networks, a computer model consisting of a virtual fractal model of the vasculature and a mathematical model describing the transport of blood has been developed. Although limited by some constraints, in particular, the use of simplistic, uniformly distributed model for cerebral vasculature and the omission of anastomosis, the proposed computer model was found to provide insights into blood circulation in the cerebral vascular branching network plus the physiological and pathological factors which may affect its functionality. The numerical study conducted on a model of the middle cerebral artery region signified the important effects of vessel compliance, blood viscosity variation as a function of the blood hematocrit, and flow velocity profile on the distributions of flow and pressure in the vascular network.

Safety and efficacy of the Aperio thrombectomy device when compared to the Solitaire AB/FR and the Revive devices in a pulsatile flow system

PubMed Central

Saleh, Mahdi; Spence, John Nathan; Nayak, Sanjeev; Pearce, Gillian; Tennuci, Christopher; Roffe, Christine

2012-01-01

Background and Purpose: There are a limited number of studies comparing the Aperio mechanical thrombectomy device to other stent-based devices. In this paper, we compared the Aperio thrombectomy device to the Solitaire AB, FR and Revive devices in a model of the middle cerebral artery (MCA) within a modified pulsatile flow system. Methods: Thrombi made of lamb’s blood were placed into a pulsatile flow system perfused with Hartmann’s solution at 80 bpm with a mean pressure of 90 mm Hg. 30 experiments were run with each device. Results: Recanalization rates were similar for all three devices (90% with the Solitaire AB, FR, 80% with the Revive, and 90% with the Aperio). The mean number of attempts to retrieve the thrombus was also similar for all three devices (1.7 with the Solitaire AB, FR, 2.1 with the Revive, 1.6 with the Aperio). Clot fragmentation and embolization rates revealed no statistical significance but there was a trend towards lower embolization rates with the Aperio (23% compared to 40% with the Solitaire AB, FR and 47% with the Revive). The Aperio was the fastest to recanalize the MCA (mean of 66 seconds compared to 186 seconds for the Solitaire AB, FR and 169 seconds for the Revive). Conclusions: In this in vitro setting, the Aperio device seems to be an efficacious and safe device when compared to other similar clinically used mechanical thrombectomy devices. Larger clinical trials are warranted. PMID:23173104

The influence of non-planar geometry on the flow within a distal end-to-side anastomosis

NASA Astrophysics Data System (ADS)

Sherwin, S. J.; Doorly, D. J.; Peiro, J.; Caro, C. G.

1998-11-01

The pattern of the flow in arteries is strongly influenced by the three-dimensional shape of the geometry. Curvature and torsion of the wall geometry alters the axial velocity distribution, and introduces cross flow velocity components. In this investigation we have considered flow in a model geometry of a fully occluded 45^o distal end-to-side anastomosis. Previous investigations have typically focused on planar end-to-side anastomoses where the bypass and host vessels have a plane of symmetry. We have increased the complexity of the model by considering a non-planar geometry produced by deforming the bypass vessel out of the plane of symmetry. The flows have been numerically and experimentally investigated using a spectral/hp element algorithm and magnetic resonance imaging. The significant effect of the non-planar geometry is to introduce a bulk rotation of the two secondary flow cells present in flow within a planar geometry. A reduction in wall shear stress is observed at the bed of the anastomosis and a larger absolute flux of velocity is seen within the occluded region proximal to the anastomosis. Current investigations have considered the role of pulsatility in the form of a non-reversing sinusoidal oscillation. In this case a separation bubble, not present in the steady case, is seen at the toe of the anastomosis during the systolic part of the cycle. The role of geometry and pulsatility on particle motion has also been addressed with a view to determining the shear exposure on particle within these types of flows.

Numerical modelling on pulsatile flow of Casson nanofluid through an inclined artery with stenosis and tapering under the influence of magnetic field and periodic body acceleration

NASA Astrophysics Data System (ADS)

Ponalagusamy, R.; Priyadharshini, S.

2017-11-01

The present study investigates the pulsatile flow of Casson nanofluid through an inclined and stenosed artery with tapering in the presence of magnetic field and periodic body acceleration. The iron oxide nanoparticles are allowed to flow along with it. The governing equations for the flow of Casson fluid when the artery is tapered slightly having mild stenosis are highly non-linear and the momentum equations for temperature and concentration are coupled and are solved using finite difference numerical schemes in order to find the solutions for velocity, temperature, concentration, wall shear stress, and resistance to blood flow. The aim of the present study is to analyze the effects of flow parameters on the flow of nanofluid through an inclined arterial stenosis with tapering. These effects are represented graphically and concluded that the wall shear stress profiles enhance with increase in yield stress, magnetic field, thermophoresis parameter and decreases with Brownian motion parameter, local temperature Grashof number, local nanoparticle Grashof number. The significance of the model is the existence of yield stress and it is examined that when the rheology of blood changes from Newtonian to Casson fluid, the percentage of decrease in the flow resistance is higher with respect to the increase in the parameters local temperature Grashof number, local nanoparticle Grashof number, Brownian motion parameter, and Prandtl number. It is pertinent to observe that increase in the Brownian motion parameter leads to increment in concentration and temperature profiles. It is observed that the concentration of nanoparticles decreases with increase in the value of thermophoresis parameter.

Unsteady flow motions in the supraglottal region during phonation

NASA Astrophysics Data System (ADS)

Luo, Haoxiang; Dai, Hu

2008-11-01

The highly unsteady flow motions in the larynx are not only responsible for producing the fundamental frequency tone in phonation, but also have a significant contribution to the broadband noise in the human voice. In this work, the laryngeal flow is modeled either as an incompressible pulsatile jet confined in a two-dimensional channel, or a pressure-driven flow modulated by a pair of viscoelastic vocal folds through the flow--structure interaction. The flow in the supraglottal region is found to be dominated by large-scale vortices whose unsteady motions significantly deflect the glottal jet. In the flow--structure interaction, a hybrid model based on the immersed-boundary method is developed to simulate the flow-induced vocal fold vibration, which involves a three-dimensional vocal fold prototype and a two-dimensional viscous flow. Both the flow behavior and the vibratory characteristics of the vocal folds will be presented.

A streaming birefringence study of the flow at the junction of the aorta and the renal arteries

NASA Astrophysics Data System (ADS)

Rankin, G. W.; Sabbah, H. N.; Stein, P. D.

1989-11-01

Streaming birefringence with an organic dye (Milling Yellow) was used to investigate the flow near the junction of the renal arteries and the descending aorta in a model of human vessels. The dye concentration was adjusted to give fluid rheological properties, typical of blood. Steady and pulsatile flow were investigated at branch-to-trunk flow ratios of 0.050 0.350. The flow ratio range over which flow separation and simple secondary flows were identified during systole near the renal ostia are reported. Streaming birefringence has the advantage of allowing visualization of the entire flow field. Also, the fluid rather than suspended particles are observed. An important disadvantage, however, is that three-dimensional flows make interpretation difficult.

Optimum Heart Rate to Minimize Pulsatile External Cardiac Power

NASA Astrophysics Data System (ADS)

Pahlevan, Niema; Gharib, Morteza

2011-11-01

The workload on the left ventricle is composed of steady and pulsatile components. Clinical investigations have confirmed that an abnormal pulsatile load plays an important role in the pathogenesis of left ventricular hypertrophy (LVH) and progression of LVH to congestive heart failure (CHF). The pulsatile load is the result of the complex dynamics of wave propagation and reflection in the compliant arterial vasculature. We hypothesize that aortic waves can be optimized to reduce the left ventricular (LV) pulsatile load. We used an in-vitro experimental approach to investigate our hypothesis. A unique hydraulic model was used for in-vitro experiments. This model has physical and dynamical properties similar to the heart-aorta system. Different compliant models of the artificial aorta were used to test the hypothesis under various aortic rigidities. Our results indicate that: i) there is an optimum heart rate that minimizes LV pulsatile power (this is in agreement with our previous computational study); ii) introducing an extra reflection site at the specific location along the aorta creates constructive wave conditions that reduce the LV pulsatile power.

The Influence of Different Operating Conditions on the Blood Damage of a Pulsatile Ventricular Assist Device.

PubMed

Xu, Zihao; Yang, Ming; Wang, Xianghui; Wang, Zhong

2015-01-01

Because of pulsatile blood flow's benefit for myocardial recovery, perfusion of coronary arteries and end organs, pulsatile ventricular assist devices (VADs) are still widely used as paracorporeal mechanical circulatory support devices in clinical applications, especially in pediatric heart failure patients. However, severe blood damage limits the VAD's service period. Besides optimizing the VAD geometry to reduce blood damage, the blood damage may also be decreased by changing the operating conditions. In this article, a pulsatile VAD was used to investigate the influence of operating conditions on its blood damage, including hemolysis, platelet activation, and platelet deposition. Three motion profiles of pusher plate (sine, cosine, and polynomial), three stroke volumes (ejection fractions) (56 ml [70%], 42 ml [52.5%], and 28 ml [35%]), three pulsatile rates (75, 100, and 150 bpm), and two assist modes (copulsation and counterpulsation) were implemented respectively in VAD fluid-structure interaction simulations to calculate blood damage. The blood damage indices indicate that cosine motion profile, higher ejection fraction, higher pulsatile rate, and counterpulsation can decrease platelet deposition whereas increase hemolysis and platelet activation, and vice versa. The results suggest that different operating conditions have different effects on pulsatile VAD's blood damage and may be beneficial to choose suitable operating condition to reduce blood damage in clinical applications.

Quantitative assessment of paravalvular leakage after transcatheter aortic valve replacement using a patient-specific pulsatile flow model.

PubMed

Tanaka, Yutaka; Saito, Shigeru; Sasuga, Saeko; Takahashi, Azuma; Aoyama, Yusuke; Obama, Kazuto; Umezu, Mitsuo; Iwasaki, Kiyotaka

2018-05-01

Quantitative assessment of post-transcatheter aortic valve replacement (TAVR) aortic regurgitation (AR) remains challenging. We developed patient-specific anatomical models with pulsatile flow circuit and investigated factors associated with AR after TAVR. Based on pre-procedural computed tomography (CT) data of the six patients who underwent transfemoral TAVR using a 23-mm SAPIEN XT, anatomically and mechanically equivalent aortic valve models were developed. Forward flow and heart rate of each patient in two days after TAVR were duplicated under mean aortic pressure of 80mmHg. Paravalvular leakage (PVL) volume in basal and additional conditions was measured for each model using an electromagnetic flow sensor. Incompletely apposed tract between the transcatheter and aortic valves was examined using a micro-CT. PVL volume in each patient-specific model was consistent with each patient's PVL grade, and was affected by hemodynamic conditions. PVL and total regurgitation volume increased with the mean aortic pressure, whereas closing volume did not change. In contrast, closing volume increased proportionately with heart rate, but PVL did not change. The minimal cross-sectional gap had a positive correlation with the PVL volumes (r=0.89, P=0.02). The gap areas typically occurred in the vicinity of the bulky calcified nodules under the native commissure. PVL volume, which could be affected by hemodynamic conditions, was significantly associated with the minimal cross-sectional gap area between the aortic annulus and the stent frame. These data may improve our understanding of the mechanism of the occurrence of post-TAVR PVL. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Particle image velocimetry study of pulsatile flow in bi-leaflet mechanical heart valves with image compensation method.

PubMed

Shi, Yubing; Yeo, Tony Joon Hock; Zhao, Yong; Hwang, Ned H C

2006-12-01

Particle Image Velocimetry (PIV) is an important technique in studying blood flow in heart valves. Previous PIV studies of flow around prosthetic heart valves had different research concentrations, and thus never provided the physical flow field pictures in a complete heart cycle, which compromised their pertinence for a better understanding of the valvular mechanism. In this study, a digital PIV (DPIV) investigation was carried out with improved accuracy, to analyse the pulsatile flow field around the bi-leaflet mechanical heart valve (MHV) in a complete heart cycle. For this purpose a pulsatile flow test rig was constructed to provide the necessary in vitro test environment, and the flow field around a St. Jude size 29 bi-leaflet MHV and a similar MHV model were studied under a simulated physiological pressure waveform with flow rate of 5.2 l/min and pulse rate at 72 beats/min. A phase-locking method was applied to gate the dynamic process of valve leaflet motions. A special image-processing program was applied to eliminate optical distortion caused by the difference in refractive indexes between the blood analogue fluid and the test section. Results clearly showed that, due to the presence of the two leaflets, the valvular flow conduit was partitioned into three flow channels. In the opening process, flow in the two side channels was first to develop under the presence of the forward pressure gradient. The flow in the central channel was developed much later at about the mid-stage of the opening process. Forward flows in all three channels were observed at the late stage of the opening process. At the early closing process, a backward flow developed first in the central channel. Under the influence of the reverse pressure gradient, the flow in the central channel first appeared to be disturbed, which was then transformed into backward flow. The backward flow in the central channel was found to be the main driving factor for the leaflet rotation in the valve closing process. After the valve was fully closed, local flow activities in the proximity of the valve region persisted for a certain time before slowly dying out. In both the valve opening and closing processes, maximum velocity always appeared near the leaflet trailing edges. The flow field features revealed in the present paper improved our understanding of valve motion mechanism under physiological conditions, and this knowledge is very helpful in designing the new generation of MHVs.

Pulsatile flow of non-Newtonian blood fluid inside stenosed arteries: Investigating the effects of viscoelastic and elastic walls, arteriosclerosis, and polycythemia diseases.

PubMed

Nejad, A Abbas; Talebi, Z; Cheraghali, D; Shahbani-Zahiri, A; Norouzi, M

2018-02-01

In this study, the interaction of pulsatile blood flow with the viscoelastic walls of the axisymmetric artery is numerically investigated for different severities of stenosis. The geometry of artery is modeled by an axisymmetric cylindrical tube with a symmetric stenosis in a two-dimensional case. The effects of stenosis severity on the axial velocity profile, pressure distribution, streamlines, wall shear stress, and wall radial displacement for the viscoelastic artery are also compared to the elastics artery. Furthermore, the effects of atherosclerosis and polycythemia diseases on the hemodynamics and the mechanical behavior of arterial walls are investigated. The pulsatile flow of non-Newtonian blood is simulated inside the viscoelastic artery using the COMSOL Multiphysics software (version 5) and by employing the fluid-structure interaction (FSI) method and the arbitrary Lagrangian-Eulerian (ALE) method. Moreover, finite element method (FEM) is used to solve the governing equations on the unstructured grids. For modeling the non-Newtonian blood fluid and the viscoelastic arterial wall, the modified Casson model, and generalized Maxwell model are used, respectively. According to the results, with stenosis severity increasing from 25% to 75% at the time of maximum volumetric flow rate, the maximum value of axial velocity and its gradient increase 7.9 and 19.6 times, and the maximum wall shear stress of viscoelastic wall increases 24.2 times in the constriction zone. With the progression of the atherosclerosis disease (fivefold growth of arterial elastic modulus), the wall radial displacement of viscoelastic arterial walls decreases nearly 40%. In this study, axial velocity profile, pressure distribution, streamlines, wall radial displacement, and wall shear stress were examined for different percentages of stenosis (25%, 50%, and 75%). The atherosclerosis disease was investigated by the fivefold growth of viscoelastic arterial elastic modulus and polycythemia disease was examined by the 21-fold increase in the yield stress of the blood fluid. Furthermore, the comparison of results between the elastic and viscoelastic arterial walls shows that the wall radial displacement for viscoelastic artery is lower than that for the elastic artery as much as 21.7% for the severe stenosis of 75%. Copyright © 2017 Elsevier B.V. All rights reserved.

Graft flow assessment using a transit time flow meter in fractional flow reserve-guided coronary artery bypass surgery.

PubMed

Honda, Kentaro; Okamura, Yoshitaka; Nishimura, Yoshiharu; Uchita, Shunji; Yuzaki, Mitsuru; Kaneko, Masahiro; Yamamoto, Nobuko; Kubo, Takashi; Akasaka, Takashi

2015-06-01

To evaluate the relationship between preoperative severity of coronary stenosis occurring with fractional flow reserve (FFR), and the intraoperative bypass graft flow pattern. In all, 72 patients were enrolled in this retrospective study. The FFR value of the left anterior descending artery was evaluated, and data on "in situ" bypass grafting from the internal thoracic artery to the left anterior descending artery were assessed. Patients were divided into 3 groups according to preoperative FFR values (Group S: FFR < 0.70; group M: 0.70 ≤ FFR < 0.75; and group N: FFR ≥ 0.75). In groups S, M, and N, respectively, mean graft flow was 24.7 ± 10.6 mL/minute, 19.2 ± 14.0 mL/minute, and 16.0 ± 9.7 mL mL/minute; pulsatility index was 2.35 ± 0.6, 3.02 ± 1.1, and 5.51 ± 8.20; and number of patients with systolic reverse flow was 3 (6.8%), 5 (35.7%), and 4 (28.6%). Significant differences were observed in graft flow (P = .009), pulsatility index (P = .038), and proportion of systolic reverse flow (P = .023) among the 3 groups. In all patients, graft patency was confirmed with intraoperative fluorescence imaging; postoperative graft patency was confirmed with multislice computed tomography or coronary angiography in 69 patients (follow-up interval: 213 days). Early graft failure occurred in 1 patient. As coronary stenosis severity increased, graft flow increased, pulsatility index decreased, and proportion of patients with systolic reverse flow increased. In mild coronary artery stenosis, the chance of flow competition between the native coronary artery and the bypass graft increased. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Viscosity-adjusted estimation of pressure head and pump flow with quasi-pulsatile modulation of rotary blood pump for a total artificial heart.

PubMed

Yurimoto, Terumi; Hara, Shintaro; Isoyama, Takashi; Saito, Itsuro; Ono, Toshiya; Abe, Yusuke

2016-09-01

Estimation of pressure and flow has been an important subject for developing implantable artificial hearts. To realize real-time viscosity-adjusted estimation of pressure head and pump flow for a total artificial heart, we propose the table estimation method with quasi-pulsatile modulation of rotary blood pump in which systolic high flow and diastolic low flow phased are generated. The table estimation method utilizes three kinds of tables: viscosity, pressure and flow tables. Viscosity is estimated from the characteristic that differential value in motor speed between systolic and diastolic phases varies depending on viscosity. Potential of this estimation method was investigated using mock circulation system. Glycerin solution diluted with salty water was used to adjust viscosity of fluid. In verification of this method using continuous flow data, fairly good estimation could be possible when differential pulse width modulation (PWM) value of the motor between systolic and diastolic phases was high. In estimation under quasi-pulsatile condition, inertia correction was provided and fairly good estimation was possible when the differential PWM value was high, which was not different from the verification results using continuous flow data. In the experiment of real-time estimation applying moving average method to the estimated viscosity, fair estimation could be possible when the differential PWM value was high, showing that real-time viscosity-adjusted estimation of pressure head and pump flow would be possible with this novel estimation method when the differential PWM value would be set high.

Scaling the low-shear pulsatile TORVAD for pediatric heart failure

PubMed Central

Gohean, Jeffrey R.; Larson, Erik R.; Hsi, Brian H.; Kurusz, Mark; Smalling, Richard W.; Longoria, Raul G.

2016-01-01

This article provides an overview of the design challenges associated with scaling the low-shear pulsatile TORVAD ventricular assist device (VAD) for treating pediatric heart failure. A cardiovascular system model was used to determine that a 15 ml stroke volume device with a maximum flow rate of 4 L/min can provide full support to pediatric patients with body surface areas between 0.6 to 1.5 m2. Low shear stress in the blood is preserved as the device is scaled down and remains at least two orders of magnitude less than continuous flow VADs. A new magnetic linkage coupling the rotor and piston has been optimized using a finite element model (FEM) resulting in increased heat transfer to the blood while reducing the overall size of TORVAD. Motor FEM has also been used to reduce motor size and improve motor efficiency and heat transfer. FEM analysis predicts no more than 1°C temperature rise on any blood or tissue contacting surface of the device. The iterative computational approach established provides a methodology for developing a TORVAD platform technology with various device sizes for supporting the circulation of infants to adults. PMID:27832001

Scaling the Low-Shear Pulsatile TORVAD for Pediatric Heart Failure.

PubMed

Gohean, Jeffrey R; Larson, Erik R; Hsi, Brian H; Kurusz, Mark; Smalling, Richard W; Longoria, Raul G

This article provides an overview of the design challenges associated with scaling the low-shear pulsatile TORVAD ventricular assist device (VAD) for treating pediatric heart failure. A cardiovascular system model was used to determine that a 15 ml stroke volume device with a maximum flow rate of 4 L/min can provide full support to pediatric patients with body surface areas between 0.6 and 1.5 m. Low-shear stress in the blood is preserved as the device is scaled down and remains at least two orders of magnitude less than continuous flow VADs. A new magnetic linkage coupling the rotor and piston has been optimized using a finite element model (FEM) resulting in increased heat transfer to the blood while reducing the overall size of TORVAD. Motor FEM has also been used to reduce motor size and improve motor efficiency and heat transfer. FEM analysis predicts no more than 1°C temperature rise on any blood or tissue contacting surface of the device. The iterative computational approach established provides a methodology for developing a TORVAD platform technology with various device sizes for supporting the circulation of infants to adults.

Lattice Boltzmann method for simulating the viscous flow in large distensible blood vessels

NASA Astrophysics Data System (ADS)

Fang, Haiping; Wang, Zuowei; Lin, Zhifang; Liu, Muren

2002-05-01

A lattice Boltzmann method for simulating the viscous flow in large distensible blood vessels is presented by introducing a boundary condition for elastic and moving boundaries. The mass conservation for the boundary condition is tested in detail. The viscous flow in elastic vessels is simulated with a pressure-radius relationship similar to that of the pulmonary blood vessels. The numerical results for steady flow agree with the analytical prediction to very high accuracy, and the simulation results for pulsatile flow are comparable with those of the aortic flows observed experimentally. The model is expected to find many applications for studying blood flows in large distensible arteries, especially in those suffering from atherosclerosis, stenosis, aneurysm, etc.

Numerical Prediction of Turbulent Oscillating Flow and Heat Transfer in Pipes with Various End Geometries. Ph.D. Thesis, Final Report

NASA Technical Reports Server (NTRS)

Oseid, Kirk Leroi

1995-01-01

Unsteady flow is present in man, machine and nature. The flow of blood in arteries and capillaries in the human body is pulsatile-composed of a mean flow superposed with an oscillating component. The tides that wash in and out of rivers, harbors and estuaries are unsteady flows with very long periods of oscillation. Many engineering devices employ pulsatile and oscillating flow. Pulsating flow is defined here as a periodic flow with a net displacement of fluid over each flow cycle. Oscillating flow is defined as a period flow with a zero mean over each cycle. The subject of this thesis is oscillating flow and heat transfer in pipes which make up the heater and cooler sections of the NASA Space Power Research Engine (SPRE) currently under development. This engine uses the Stirling cycle as the thermal energy converter in a power plant for future space applications. The information presented in this thesis will of course be applicable to the design of many types of machinery which employ oscillating flow and heat transfer.

Arachnoid Cyst in the Middle Cranial Fossa Presenting with Pulsatile Exophthalmos: Case Report and Literature Review

PubMed Central

SAITO, Atsushi; KON, Hiroyuki; HARYU, Shinya; MINO, Masaki; SASAKI, Tatsuya; NISHIJIMA, Michiharu

2014-01-01

A 20-year-old woman suffered gradual progression of right pulsatile exophthalmos and slight headache. Computed tomography (CT) demonstrated outward and downward displacement of the right globe and an arachnoid cyst in the right middle cranial fossa associated with thinned and anterior protrusion of a bony orbit. Microscopic cystocisternotomy was performed and the cerebrospinal fluid (CSF) inside of the cyst communicated into the carotid cistern and cistern in the posterior cranial fossa. Pulsatile exophthalmos improved immediately after surgery. Arachnoid cyst in the middle cranial fossa presenting with exophthalmos is rare. Microscopic cystocisternotomy might successfully improve CSF flow and relieve exophthalmos. PMID:24305013

Flow in Atherosclerotic Blood Vessels

NASA Astrophysics Data System (ADS)

Berger, Stanley A.; Stroud, Jenn S.

2000-11-01

Atherosclerotic lesions occur in arteries where there are major changes in flow structure, e.g. bifurcations and junctions. The reduction of vessel lumen alters the flow, including the mechanical forces on the walls. We have examined the flow in carotid artery bifurcations with realistic plaque contours. The unsteady, incompressible, Navier-Stokes equations are solved in finite-volume form. Steady and pulsatile flows have been analyzed for laminar and turbulent flows, using for the latter a low-Reynolds number k- ɛ model and a k-ω model. Non-Newtonian viscosity is also considered using a power-law model. In general the very irregular contours of the vessels lead to recirculating regions, strong spatial variations of wall shear stresses, and in some cases, vortex shedding. Even steady inlet flow exhibits fluctuating, unsteady behavior. Neither turbulence models captures all the physics of the flow. The flow, in fact, appears to be transitional and not fully turbulent. For unsteady flow, there are also strong temporal variations of normal and shear stresses, which together with the strong spatial variations, has important implications for the onset and progression of atherosclerotic disease.

Brain tissue pulsatility mediates cognitive and electrophysiological changes in normal aging: Evidence from ultrasound tissue pulsatility imaging (TPI).

PubMed

Angel, Lucie; Bouazzaoui, Badiâa; Isingrini, Michel; Fay, Séverine; Taconnat, Laurence; Vanneste, Sandrine; Ledoux, Moïse; Gissot, Valérie; Hommet, Caroline; Andersson, Fréderic; Barantin, Laurent; Cottier, Jean-Philippe; Pasco, Jérémy; Desmidt, Thomas; Patat, Frédéric; Camus, Vincent; Remenieras, Jean-Pierre

2018-06-01

Aging is characterized by a cognitive decline of fluid abilities and is also associated with electrophysiological changes. The vascular hypothesis proposes that brain is sensitive to vascular dysfunction which may accelerate age-related brain modifications and thus explain age-related neurocognitive decline. To test this hypothesis, cognitive performance was measured in 39 healthy participants from 20 to 80 years, using tests assessing inhibition, fluid intelligence, attention and crystallized abilities. Brain functioning associated with attentional abilities was assessed by measuring the P3b ERP component elicited through an auditory oddball paradigm. To assess vascular health, we used an innovative measure of the pulsatility of deep brain tissue, due to variations in cerebral blood flow over the cardiac cycle. Results showed (1) a classical effect of age on fluid neurocognitive measures (inhibition, fluid intelligence, magnitude and latency of the P3b) but not on crystallized measures, (2) that brain pulsatility decreases with advancing age, (3) that brain pulsatility is positively correlated with fluid neurocognitive measures and (4) that brain pulsatility strongly mediated the age-related variance in cognitive performance and the magnitude of the P3b component. The mediating role of the brain pulsatility in age-related effect on neurocognitive measures supports the vascular hypothesis of cognitive aging. Copyright © 2018 Elsevier Inc. All rights reserved.

[Cerebral blood flow assessment of preterm infants during respiratory therapy with the expiratory flow increase technique].

PubMed

Bassani, Mariana Almada; Caldas, Jamil Pedro Siqueira; Netto, Abimael Aranha; Marba, Sérgio Tadeu Martins

2016-06-01

To assess the impact of respiratory therapy with the expiratory flow increase technique on cerebral hemodynamics of premature newborns. This is an intervention study, which included 40 preterm infants (≤34 weeks) aged 8-15 days of life, clinically stable in ambient air or oxygen catheter use. Children with heart defects, diagnosis of brain lesion and/or those using vasoactive drugs were excluded. Ultrasonographic assessments with transcranial Doppler flowmetry were performed before, during and after the increase in expiratory flow session, which lasted 5minutes. Cerebral blood flow velocity and resistance and pulsatility indices in the pericallosal artery were assessed. Respiratory physical therapy did not significantly alter flow velocity at the systolic peak (p=0.50), the end diastolic flow velocity (p=0.17), the mean flow velocity (p=0.07), the resistance index (p=0.41) and the pulsatility index (p=0.67) over time. The expiratory flow increase technique did not affect cerebral blood flow in clinically-stable preterm infants. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

EXTRACORPOREAL MEMBRANE OXYGENATION vs. COUNTERPULSATILE, PULSATILE, AND CONTINUOUS LEFT VENTRICULAR UNLOADING FOR PEDIATRIC MECHANICAL CIRCULATORY SUPPORT

PubMed Central

Bartoli, Carlo R.; Koenig, Steven C.; Ionan, Constantine; Gillars, Kevin J.; Mitchell, Mike E.; Austin, Erle H.; Gray, Laman A.; Pantalos, George M.

2014-01-01

OBJECTIVE Despite progress with adult ventricular assist devices (VADs), limited options exist to support pediatric patients with life-threatening heart disease. Extracorporeal membrane oxygenation (ECMO) remains the clinical standard. To characterize (patho)physiologic responses to different modes of mechanical unloading of the failing pediatric heart, ECMO was compared to either intraaortic balloon pump (IABP), pulsatile-flow (PF)VAD, or continuous-flow (CF)VAD support in a pediatric heart failure model. DESIGN Experimental. SETTING Large animal laboratory operating room. SUBJECTS Yorkshire piglets (n=47, 11.7±2.6 kg). INTERVENTIONS In piglets with coronary ligation-induced cardiac dysfunction, mechanical circulatory support devices were implanted and studied during maximum support. MEASUREMENTS and MAIN RESULTS Left ventricular, right ventricular, coronary, carotid, systemic arterial, and pulmonary arterial hemodynamics were measured with pressure and flow transducers. Myocardial oxygen consumption and total-body oxygen consumption (VO2) were calculated from arterial, venous, and coronary sinus blood sampling. Blood flow was measured in 17 organs with microspheres. Paired student t-tests compared baseline and heart failure conditions. One-way repeated-measures ANOVA compared heart failure, device support mode(s), and ECMO. Statistically significant (p<0.05) findings included: 1) improved left ventricular blood supply/demand ratio during PFVAD, CFVAD, and ECMO but not IABP support, 2) improved global myocardial blood supply/demand ratio during PFVAD, and CFVAD but not IABP or ECMO support, and 3) diminished pulsatility during ECMO and CFVAD but not IABP and PFVAD support. A profile of systems-based responses was established for each type of support. CONCLUSIONS Each type of pediatric VAD provided hemodynamic support by unloading the heart with a different mechanism that created a unique profile of physiological changes. These data contribute novel, clinically relevant insight into pediatric mechanical circulatory support and establish an important resource for pediatric device development and patient selection. PMID:24108116

Physiological system integrations with emphasis on the respiratory-cardiovascular system

NASA Technical Reports Server (NTRS)

Gallagher, R. R.

1975-01-01

The integration of two types of physiological system simulations is presented. The long term model is a circulatory system model which simulates long term blood flow variations and compartmental fluid shifts. The short term models simulate transient phenomena of the respiratory, thermoregulatory, and pulsatile cardiovascular systems as they respond to stimuli such as LBNP, exercise, and environmental gaseous variations. An overview of the interfacing approach is described. Descriptions of the variable interface for long term to short term and between the three short term models are given.

Volumetric velocimetry downstream of a percutaneous heart valve

NASA Astrophysics Data System (ADS)

Raghav, Vrishank; Clifford, Christopher; Midha, Prem; Okafor, Ikechukwu; Thurow, Brian; Yoganathan, Ajit; Auburn University Collaboration; Georgia Institute of Technology Collaboration

2017-11-01

Transcatheter aortic valve replacement has emerged as a safe and effective treatment for severe, symptomatic aortic stenosis in intermediate or greater surgical risk patients. However, despite excellent short-term outcomes, improved imaging and awareness has led to the identification of leaflet thrombosis on the aortic side of the prosthesis. Upon implantation, the transcatheter heart valve (THV) becomes enclosed in the native aortic valve leaflet tissue dividing the native sinus into two regions - a smaller anatomical sinus and a neo-sinus. To understand the causes for thrombosis, plenoptic Particle Image Velocimetry (PIV) is used to investigate the pulsatile three-dimensional flow in the sinus and neo-sinus region of the THV. Experiments are conducted on both a real and a transparent THV model in a pulsatile flow loop capable of replicating physiological hemodynamics. Comparisons with planar PIV results demonstrate the feasibility of using Plenoptic PIV to study heart valve fluid dynamics. Large three-dimensional regions of low velocity magnitude and low viscous shear stress were observed near the heart valve which could increase particle residence time potentially leading to formation of clots the THV leaflet.

Development of an in-vitro circulatory system with known resistance and capacitance

NASA Technical Reports Server (NTRS)

Offerdahl, C. D.; Schaub, J. D.; Koenig, S. C.; Swope, R. D.; Ewert, D. L.; Convertino, V. A. (Principal Investigator)

1996-01-01

An in-vitro (hydrodynamic) model of the circulatory system was developed. The model consisted of a pump, compliant tubing, and valves for resistance. The model is used to simulate aortic pressure and flow. These parameters were measured using a Konigsburg Pressure transducer and a Triton ART2 flow probe. In addition, venous pressure and flow were measured on the downstream side of the resistance. The system has a known compliance and resistance. Steady and pulsatile flow tests were conducted to determine the resistance of the model. A static compliance test was used to determine the compliance of the system. The aortic pressure and flow obtained from the hydrodynamic model will be used to test the accuracy of parameter estimation models such as the 2-element and 4-element Windkessel models and the 3-element Westkessel model. Verifying analytical models used in determining total peripheral resistance (TPR) and systemic arterial compliance (SAC) is important because it provides insight into hemodynamic parameters that indicate baroreceptor responsiveness to situations such as changes in gravitational acceleration.

Suppressing Taylor vortices in a Taylor-Couette flow system with free surface

NASA Astrophysics Data System (ADS)

Bouabdallah, A.; Oualli, H.; Mekadem, M.; Gad-El-Hak, M.

2016-11-01

Taylor-Couette flows have been extensively investigated due to their many industrial applications, such as catalytic reactors, electrochemistry, photochemistry, biochemistry, and polymerization. Mass transfer applications include extraction, tangential filtration, crystallization, and dialysis. A 3D study is carried out to simulate a Taylor-Couette flow with a rotating and pulsating inner cylinder. We utilize FLUENT to simulate the incompressible flow with a free surface. The study reveals that flow structuring is initiated with the development of an Ekman vortex at low Taylor number, Ta = 0 . 01 . For all encountered flow regimes, the Taylor vortices are systematically inhibited by the pulsatile motion of the inner cylinder. A spectral analysis shows that this pulsatile motion causes a rapid decay of the free surface oscillations, from a periodic wavy movement to a chaotic one, then to a fully turbulent motion. This degenerative free surface behavior is interpreted as the underlying mechanism responsible for the inhibition of the Taylor vortices.

Fast blood flow monitoring in deep tissues with real-time software correlators

PubMed Central

Wang, Detian; Parthasarathy, Ashwin B.; Baker, Wesley B.; Gannon, Kimberly; Kavuri, Venki; Ko, Tiffany; Schenkel, Steven; Li, Zhe; Li, Zeren; Mullen, Michael T.; Detre, John A.; Yodh, Arjun G.

2016-01-01

We introduce, validate and demonstrate a new software correlator for high-speed measurement of blood flow in deep tissues based on diffuse correlation spectroscopy (DCS). The software correlator scheme employs standard PC-based data acquisition boards to measure temporal intensity autocorrelation functions continuously at 50 – 100 Hz, the fastest blood flow measurements reported with DCS to date. The data streams, obtained in vivo for typical source-detector separations of 2.5 cm, easily resolve pulsatile heart-beat fluctuations in blood flow which were previously considered to be noise. We employ the device to separate tissue blood flow from tissue absorption/scattering dynamics and thereby show that the origin of the pulsatile DCS signal is primarily flow, and we monitor cerebral autoregulation dynamics in healthy volunteers more accurately than with traditional instrumentation as a result of increased data acquisition rates. Finally, we characterize measurement signal-to-noise ratio and identify count rate and averaging parameters needed for optimal performance. PMID:27231588

The effect of the pulsatile electromagnetic field in children suffering from bronchial asthma.

PubMed

Sadlonova, J; Korpas, J; Salat, D; Miko, L; Kudlicka, J

2003-01-01

From the bibliography it is well known that pulsatile electromagnetic field has an anti-inflammatory and analgesic effect. It causes vasodilatation, myorelaxation, hyper-production of connective tissue and activation of the cell membrane. Therefore our aim was to study the possible therapeutic effect of pulsatile electromagnetic field in asthmatic children. Forty-two children participating in this study were divided in two groups. The 1st group consisting of 21 children (11 females, 10 males, aged 11.8 +/- 0.4 yr) was treated by pulsatile electromagnetic field and pharmacologically. The 2nd group served as control, consisting also of 21 children (11 females, 10 males, aged 11.7 +/- 0.3 yr) and was treated only pharmacologically. Therapeutic effect of the pulsatile electromagnetic field was assessed on the basis of pulmonary tests performed by means of a Spirometer 100 Handi (Germany). The indexes FVC, IVC, ERV, IRV, FEV1, FEV1/FVC%, MEF75,50,25, PEF, PIF and the changes of the flow-volume loop were also registered. The pulsatile electromagnetic field was applied by means of the device MTU 500H, Therapy System (Brno, Czech Republic) for 5 days, two times daily for 30 minutes (magnetic induction: 3 mT, frequency: 4 Hz as recommended by the manufacturer). The results in children of the 1st group showed an improvement of FVC of about 70 ml, IVC of about 110 ml, FEV1 of about 80 ml, MEF75 of about 30 ml, PEF of about 480 ml, PIF of about 550 ml. The increases of ERV, IRV and FEV1/FVC and decreases of MEF25,50 were statistically insignificant. The results in the 2nd group were less clear. The flow-volume loop showed a mild improvement in 14 children. This improvement in the 2nd group was less significant. The clinical status of children and their mood became better. We believe that the pulsatile electro-magnetotherapy in children suffering from asthma is effective. On the basis of our results we can recommend it as a complementary therapy.

An agent-based model of leukocyte transendothelial migration during atherogenesis.

PubMed

Bhui, Rita; Hayenga, Heather N

2017-05-01

A vast amount of work has been dedicated to the effects of hemodynamics and cytokines on leukocyte adhesion and trans-endothelial migration (TEM) and subsequent accumulation of leukocyte-derived foam cells in the artery wall. However, a comprehensive mechanobiological model to capture these spatiotemporal events and predict the growth and remodeling of an atherosclerotic artery is still lacking. Here, we present a multiscale model of leukocyte TEM and plaque evolution in the left anterior descending (LAD) coronary artery. The approach integrates cellular behaviors via agent-based modeling (ABM) and hemodynamic effects via computational fluid dynamics (CFD). In this computational framework, the ABM implements the diffusion kinetics of key biological proteins, namely Low Density Lipoprotein (LDL), Tissue Necrosis Factor alpha (TNF-α), Interlukin-10 (IL-10) and Interlukin-1 beta (IL-1β), to predict chemotactic driven leukocyte migration into and within the artery wall. The ABM also considers wall shear stress (WSS) dependent leukocyte TEM and compensatory arterial remodeling obeying Glagov's phenomenon. Interestingly, using fully developed steady blood flow does not result in a representative number of leukocyte TEM as compared to pulsatile flow, whereas passing WSS at peak systole of the pulsatile flow waveform does. Moreover, using the model, we have found leukocyte TEM increases monotonically with decreases in luminal volume. At critical plaque shapes the WSS changes rapidly resulting in sudden increases in leukocyte TEM suggesting lumen volumes that will give rise to rapid plaque growth rates if left untreated. Overall this multi-scale and multi-physics approach appropriately captures and integrates the spatiotemporal events occurring at the cellular level in order to predict leukocyte transmigration and plaque evolution.

An agent-based model of leukocyte transendothelial migration during atherogenesis

PubMed Central

Bhui, Rita; Hayenga, Heather N.

2017-01-01

A vast amount of work has been dedicated to the effects of hemodynamics and cytokines on leukocyte adhesion and trans-endothelial migration (TEM) and subsequent accumulation of leukocyte-derived foam cells in the artery wall. However, a comprehensive mechanobiological model to capture these spatiotemporal events and predict the growth and remodeling of an atherosclerotic artery is still lacking. Here, we present a multiscale model of leukocyte TEM and plaque evolution in the left anterior descending (LAD) coronary artery. The approach integrates cellular behaviors via agent-based modeling (ABM) and hemodynamic effects via computational fluid dynamics (CFD). In this computational framework, the ABM implements the diffusion kinetics of key biological proteins, namely Low Density Lipoprotein (LDL), Tissue Necrosis Factor alpha (TNF-α), Interlukin-10 (IL-10) and Interlukin-1 beta (IL-1β), to predict chemotactic driven leukocyte migration into and within the artery wall. The ABM also considers wall shear stress (WSS) dependent leukocyte TEM and compensatory arterial remodeling obeying Glagov’s phenomenon. Interestingly, using fully developed steady blood flow does not result in a representative number of leukocyte TEM as compared to pulsatile flow, whereas passing WSS at peak systole of the pulsatile flow waveform does. Moreover, using the model, we have found leukocyte TEM increases monotonically with decreases in luminal volume. At critical plaque shapes the WSS changes rapidly resulting in sudden increases in leukocyte TEM suggesting lumen volumes that will give rise to rapid plaque growth rates if left untreated. Overall this multi-scale and multi-physics approach appropriately captures and integrates the spatiotemporal events occurring at the cellular level in order to predict leukocyte transmigration and plaque evolution. PMID:28542193

Dynamic Effect of Rolling Massage on Blood Flow

NASA Astrophysics Data System (ADS)

Chen, Yan-Yan; Yi, Hou-Hui; Li, Hua-Bing; Fang, Hai-Ping

2009-02-01

The Chinese traditional medical massage has been used as a natural therapy to eliminate some diseases. Here, the effect of the rolling massage frequency to the blood flow in the blood vessels under the rolling massage manipulation is studied by the lattice Boltzmann simulation. The simulation results show that when the frequency is smaller than or comparable to the pulsatile frequency of the blood flow, the effect on the blood flux by the rolling massage is small. On the contrast, if the frequency is twice or more times of the pulsatile frequency of the blood flow, the blood flux is greatly enhanced and increases linearly with respect to the frequency. Similar behavior has also been observed on the shear stress on the blood vessel walls. The result is helpful for understanding that the rolling massage has the function of promoting the blood circulation and removing the blood stasis.

Resistance Training Augments Cerebral Blood Flow Pulsatility: Cross-Sectional Study.

PubMed

Nakamura, Nobuhiro; Muraoka, Isao

2018-06-11

Increased central arterial stiffness and/or decreased compliance reduces buffer function and increases cerebral blood flow (CBF) pulsatility, which leads to increased cerebral microvascular damage, resulting in the augmentation of the risk of cerebrovascular diseases. Resistance-trained men showed higher central arterial stiffness and lower arterial compliance than age-matched, sedentary men. This study examined the effect of increased central arterial stiffness and/or decreased arterial compliance on CBF pulsatility. The study participants included 31 young healthy men (15 resistance-trained men, aged 21 ± 1 years; and 16 controls, aged 23 ± 1 years). β-Stiffness index and arterial compliance were measured in the right carotid artery as index of central arterial stiffness and compliance, respectively. The pulsatility index (PI) was measured in the middle cerebral artery as index of CBF pulsatility. β-Stiffness index and PI were significantly higher in the resistance-trained group than in the control group (β-stiffness index: 5.3 ± 0.3 vs. 3.5 ± 0.3 a.u., P < 0.05, PI: 0.80 ± 0.02 vs. 0.70 ± 0.02, P < 0.05). The resistance-trained group showed significantly lower arterial compliance than the control group (0.16 ± 0.01 vs. 0.23 ± 0.01 mm2/mm Hg, P < 0.05). Positive and negative correlations were observed between β-stiffness index and PI (r = 0.39, P < 0.05), and between arterial compliance and PI (r = -0.59, P < 0.05), respectively. The resistance-trained group showed higher central arterial stiffness and PI and lower arterial compliance. Central arterial stiffness and arterial compliance were associated with PI. Increased arterial stiffness and decreased arterial compliance with resistance training impair buffer function, resulting in increased CBF pulsatility. Trial Number UMIN000023816 URL: http://www.umin.ac.jp/icdr/index.html Official scientific title of the study: effect of increase arterial stiffness by resistance training on cerebral hemodynamic.

A Numerical Method for Solving the 3D Unsteady Incompressible Navier-Stokes Equations in Curvilinear Domains with Complex Immersed Boundaries.

PubMed

Ge, Liang; Sotiropoulos, Fotis

2007-08-01

A novel numerical method is developed that integrates boundary-conforming grids with a sharp interface, immersed boundary methodology. The method is intended for simulating internal flows containing complex, moving immersed boundaries such as those encountered in several cardiovascular applications. The background domain (e.g the empty aorta) is discretized efficiently with a curvilinear boundary-fitted mesh while the complex moving immersed boundary (say a prosthetic heart valve) is treated with the sharp-interface, hybrid Cartesian/immersed-boundary approach of Gilmanov and Sotiropoulos [1]. To facilitate the implementation of this novel modeling paradigm in complex flow simulations, an accurate and efficient numerical method is developed for solving the unsteady, incompressible Navier-Stokes equations in generalized curvilinear coordinates. The method employs a novel, fully-curvilinear staggered grid discretization approach, which does not require either the explicit evaluation of the Christoffel symbols or the discretization of all three momentum equations at cell interfaces as done in previous formulations. The equations are integrated in time using an efficient, second-order accurate fractional step methodology coupled with a Jacobian-free, Newton-Krylov solver for the momentum equations and a GMRES solver enhanced with multigrid as preconditioner for the Poisson equation. Several numerical experiments are carried out on fine computational meshes to demonstrate the accuracy and efficiency of the proposed method for standard benchmark problems as well as for unsteady, pulsatile flow through a curved, pipe bend. To demonstrate the ability of the method to simulate flows with complex, moving immersed boundaries we apply it to calculate pulsatile, physiological flow through a mechanical, bileaflet heart valve mounted in a model straight aorta with an anatomical-like triple sinus.

A Numerical Method for Solving the 3D Unsteady Incompressible Navier-Stokes Equations in Curvilinear Domains with Complex Immersed Boundaries

PubMed Central

Ge, Liang; Sotiropoulos, Fotis

2008-01-01

A novel numerical method is developed that integrates boundary-conforming grids with a sharp interface, immersed boundary methodology. The method is intended for simulating internal flows containing complex, moving immersed boundaries such as those encountered in several cardiovascular applications. The background domain (e.g the empty aorta) is discretized efficiently with a curvilinear boundary-fitted mesh while the complex moving immersed boundary (say a prosthetic heart valve) is treated with the sharp-interface, hybrid Cartesian/immersed-boundary approach of Gilmanov and Sotiropoulos [1]. To facilitate the implementation of this novel modeling paradigm in complex flow simulations, an accurate and efficient numerical method is developed for solving the unsteady, incompressible Navier-Stokes equations in generalized curvilinear coordinates. The method employs a novel, fully-curvilinear staggered grid discretization approach, which does not require either the explicit evaluation of the Christoffel symbols or the discretization of all three momentum equations at cell interfaces as done in previous formulations. The equations are integrated in time using an efficient, second-order accurate fractional step methodology coupled with a Jacobian-free, Newton-Krylov solver for the momentum equations and a GMRES solver enhanced with multigrid as preconditioner for the Poisson equation. Several numerical experiments are carried out on fine computational meshes to demonstrate the accuracy and efficiency of the proposed method for standard benchmark problems as well as for unsteady, pulsatile flow through a curved, pipe bend. To demonstrate the ability of the method to simulate flows with complex, moving immersed boundaries we apply it to calculate pulsatile, physiological flow through a mechanical, bileaflet heart valve mounted in a model straight aorta with an anatomical-like triple sinus. PMID:19194533

Hemodynamics of a functional centrifugal-flow total artificial heart with functional atrial contraction in goats.

PubMed

Shiga, Takuya; Shiraishi, Yasuyuki; Sano, Kyosuke; Taira, Yasunori; Tsuboko, Yusuke; Yamada, Akihiro; Miura, Hidekazu; Katahira, Shintaro; Akiyama, Masatoshi; Saiki, Yoshikatsu; Yambe, Tomoyuki

2016-03-01

Implantation of a total artificial heart (TAH) is one of the therapeutic options for the treatment of patients with end-stage biventricular heart failure. There is no report on the hemodynamics of the functional centrifugal-flow TAH with functional atrial contraction (fCFTAH). We evaluated the effects of pulsatile flow by atrial contraction in acute animal models. The goats received fCFTAH that we created from two centrifugal-flow ventricular assist devices. Some hemodynamic parameters maintained acceptable levels: heart rate 115.5 ± 26.3 bpm, aortic pressure 83.5 ± 10.1 mmHg, left atrial pressure 18.0 ± 5.9 mmHg, pulmonary pressure 28.5 ± 9.7 mmHg, right atrial pressure 13.6 ± 5.2 mmHg, pump flow 4.0 ± 1.1 L/min (left) 3.9 ± 1.1 L/min (right), and cardiac index 2.13 ± 0.14 L/min/m(2). fCFTAH with atrial contraction was able to maintain the TAH circulation by forming a pulsatile flow in acute animal experiments. Taking the left and right flow rate balance using the low internal pressure loss of the VAD pumps may be easier than by other pumps having considerable internal pressure loss. We showed that the remnant atrial contraction effected the flow rate change of the centrifugal pump, and the atrial contraction waves reflected the heart rate. These results indicate that remnant atria had the possibility to preserve autonomic function in fCFTAH. We may control fCFTAH by reflecting the autonomic function, which is estimated with the flow rate change of the centrifugal pump.

Spatial probabilistic pulsatility model for enhancing photoplethysmographic imaging systems

NASA Astrophysics Data System (ADS)

Amelard, Robert; Clausi, David A.; Wong, Alexander

2016-11-01

Photoplethysmographic imaging (PPGI) is a widefield noncontact biophotonic technology able to remotely monitor cardiovascular function over anatomical areas. Although spatial context can provide insight into physiologically relevant sampling locations, existing PPGI systems rely on coarse spatial averaging with no anatomical priors for assessing arterial pulsatility. Here, we developed a continuous probabilistic pulsatility model for importance-weighted blood pulse waveform extraction. Using a data-driven approach, the model was constructed using a 23 participant sample with a large demographic variability (11/12 female/male, age 11 to 60 years, BMI 16.4 to 35.1 kg·m-2). Using time-synchronized ground-truth blood pulse waveforms, spatial correlation priors were computed and projected into a coaligned importance-weighted Cartesian space. A modified Parzen-Rosenblatt kernel density estimation method was used to compute the continuous resolution-agnostic probabilistic pulsatility model. The model identified locations that consistently exhibited pulsatility across the sample. Blood pulse waveform signals extracted with the model exhibited significantly stronger temporal correlation (W=35,p<0.01) and spectral SNR (W=31,p<0.01) compared to uniform spatial averaging. Heart rate estimation was in strong agreement with true heart rate [r2=0.9619, error (μ,σ)=(0.52,1.69) bpm].

A computational model-based validation of Guyton's analysis of cardiac output and venous return curves

NASA Technical Reports Server (NTRS)

Mukkamala, R.; Cohen, R. J.; Mark, R. G.

2002-01-01

Guyton developed a popular approach for understanding the factors responsible for cardiac output (CO) regulation in which 1) the heart-lung unit and systemic circulation are independently characterized via CO and venous return (VR) curves, and 2) average CO and right atrial pressure (RAP) of the intact circulation are predicted by graphically intersecting the curves. However, this approach is virtually impossible to verify experimentally. We theoretically evaluated the approach with respect to a nonlinear, computational model of the pulsatile heart and circulation. We developed two sets of open circulation models to generate CO and VR curves, differing by the manner in which average RAP was varied. One set applied constant RAPs, while the other set applied pulsatile RAPs. Accurate prediction of intact, average CO and RAP was achieved only by intersecting the CO and VR curves generated with pulsatile RAPs because of the pulsatility and nonlinearity (e.g., systemic venous collapse) of the intact model. The CO and VR curves generated with pulsatile RAPs were also practically independent. This theoretical study therefore supports the validity of Guyton's graphical analysis.

Arduino control of a pulsatile flow rig.

PubMed

Drost, S; de Kruif, B J; Newport, D

2018-01-01

This note describes the design and testing of a programmable pulsatile flow pump using an Arduino micro-controller. The goal of this work is to build a compact and affordable system that can relatively easily be programmed to generate physiological waveforms. The system described here was designed to be used in an in-vitro set-up for vascular access hemodynamics research, and hence incorporates a gear pump that delivers a mean flow of 900 ml/min in a test flow loop, and a peak flow of 1106 ml/min. After a number of simple identification experiments to assess the dynamic behaviour of the system, a feed-forward control routine was implemented. The resulting system was shown to be able to produce the targeted representative waveform with less than 3.6% error. Finally, we outline how to further increase the accuracy of the system, and how to adapt it to specific user needs. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

Technical Breakthroughs in the Wearable Artificial Kidney (WAK)

PubMed Central

Macy, Alexandra S.; Beizai, Masoud; Ezon, Carlos; Golper, Thomas A.

2009-01-01

Background: The wearable artificial kidney (WAK) has been a holy grail in kidney failure for decades. Described herein are the breakthroughs that made possible the creation of the WAK V1.0 and its advanced versions V 1.1 and 1.2. Design: The battery-powered WAK pump has a double channel pulsatile counter phase flow. This study clarifies the role of pulsatile blood and dialysate flow, a high-flux membrane with a larger surface area, and the optimization of the dialysate pH. Flows and clearances from the WAK pump were compared with conventional pumps and with gravity steady flow. Results: Raising dialysate pH to 7.4 increased adsorption of ammonia. Clearances were higher with pulsatile flow as compared with steady flow. The light WAK pump, geometrically suitable for wearability, delivered the same clearances as larger and heavier pumps that cannot be battery operated. Beta2 microglobulin (β2M) was removed from human blood in vitro. Activated charcoal adsorbed most β2M in the dialysate. The WAK V1.0 delivered an effective creatinine clearance of 18.5 ± 3.2 ml/min and the WAK V1.1 27.0 ± 4.0 ml/min in uremic pigs. Conclusions: Half-cycle differences between blood and dialysate, alternating transmembrane pressures (TMP), higher amplitude pulsations, and a push-pull flow increased convective transport. This creates a yet undescribed type of hemodiafiltration. Further improvements were achieved with a larger surface area high-flux dialyzer and a higher dialysate pH. The data suggest that the WAK might be an efficient way of providing daily dialysis and optimizing end stage renal disease (ESRD) treatment. PMID:19696219

Restoration of Pulsatile Flow Reduces Sympathetic Nerve Activity Among Individuals With Continuous-Flow Left Ventricular Assist Devices.

PubMed

Cornwell, William K; Tarumi, Takashi; Stickford, Abigail; Lawley, Justin; Roberts, Monique; Parker, Rosemary; Fitzsimmons, Catherine; Kibe, Julius; Ayers, Colby; Markham, David; Drazner, Mark H; Fu, Qi; Levine, Benjamin D

2015-12-15

Current-generation left ventricular assist devices provide circulatory support that is minimally or entirely nonpulsatile and are associated with marked increases in muscle sympathetic nerve activity (MSNA), likely through a baroreceptor-mediated pathway. We sought to determine whether the restoration of pulsatile flow through modulations in pump speed would reduce MSNA through the arterial baroreceptor reflex. Ten men and 3 women (54 ± 14 years) with Heartmate II continuous-flow left ventricular assist devices underwent hemodynamic and sympathetic neural assessment. Beat-to-beat blood pressure, carotid ultrasonography at the level of the arterial baroreceptors, and MSNA via microneurography were continuously recorded to determine steady-state responses to step changes (200-400 revolutions per minute) in continuous-flow left ventricular assist device pump speed from a maximum of 10,480 ± 315 revolutions per minute to a minimum of 8500 ± 380 revolutions per minute. Reductions in pump speed led to increases in pulse pressure (high versus low speed: 17 ± 7 versus 26 ± 12 mm Hg; P<0.01), distension of the carotid artery, and carotid arterial wall tension (P<0.05 for all measures). In addition, MSNA was reduced (high versus low speed: 41 ± 15 versus 33 ± 16 bursts per minute; P<0.01) despite a reduction in mean arterial pressure and was inversely related to pulse pressure (P=0.037). Among subjects with continuous-flow left ventricular assist devices, the restoration of pulsatile flow through modulations in pump speed leads to increased distortion of the arterial baroreceptors with a subsequent decline in MSNA. Additional study is needed to determine whether reduction of MSNA in this setting leads to improved outcomes. © 2015 American Heart Association, Inc.

Investigation of pulsatile flowfield in healthy thoracic aorta models.

PubMed

Wen, Chih-Yung; Yang, An-Shik; Tseng, Li-Yu; Chai, Jyh-Wen

2010-02-01

Cardiovascular disease is the primary cause of morbidity and mortality in the western world. Complex hemodynamics plays a critical role in the development of aortic dissection and atherosclerosis, as well as many other diseases. Since fundamental fluid mechanics are important for the understanding of the blood flow in the cardiovascular circulatory system of the human body aspects, a joint experimental and numerical study was conducted in this study to determine the distributions of wall shear stress and pressure and oscillatory WSS index, and to examine their correlation with the aortic disorders, especially dissection. Experimentally, the Phase-Contrast Magnetic Resonance Imaging (PC-MRI) method was used to acquire the true geometry of a normal human thoracic aorta, which was readily converted into a transparent thoracic aorta model by the rapid prototyping (RP) technique. The thoracic aorta model was then used in the in vitro experiments and computations. Simulations were performed using the computational fluid dynamic (CFD) code ACE+((R)) to determine flow characteristics of the three-dimensional, pulsatile, incompressible, and Newtonian fluid in the thoracic aorta model. The unsteady boundary conditions at the inlet and the outlet of the aortic flow were specified from the measured flowrate and pressure results during in vitro experiments. For the code validation, the predicted axial velocity reasonably agrees with the PC-MRI experimental data in the oblique sagittal plane of the thoracic aorta model. The thorough analyses of the thoracic aorta flow, WSSs, WSS index (OSI), and wall pressures are presented. The predicted locations of the maxima of WSS and the wall pressure can be then correlated with that of the thoracic aorta dissection, and thereby may lead to a useful biological significance. The numerical results also suggest that the effects of low WSS and high OSI tend to cause wall thickening occurred along the inferior wall of the aortic arch and the anterior wall of the brachiocephalic artery, similar implication reported in a number of previous studies.

The effects of recirculation flows on mass transfer from the arterial wall to flowing blood.

PubMed

Zhang, Zhiguo; Deng, Xiaoyan; Fan, Yubo; Guidoin, Robert

2008-01-01

Using a sudden tubular expansion as a model of an arterial stenosis, the effect of disturbed flow on mass transfer from the arterial wall to flowing blood was studied theoretically and tested experimentally by measuring the dissolution rate of benzoic acid disks forming the outer tube of a sudden tubular expansion. The study revealed that mass transfer from vessel wall to flowing fluid in regions of disturbed flow is independent of wall shear rates. The rate of mass transfer is significantly higher in regions of disturbed flow with a local maximum around the reattachment point where the wall shear rate is zero. The experimental study also revealed that the rate of mass transfer from the vessel wall to a flowing fluid is much higher in the presence of microspheres (as models of blood cells) in the flowing fluid and under the condition of pulsatile flow than in steady flow. These results imply that flow disturbance may enhance the transport of biochemicals and macromolecules, such as plasma proteins and lipoproteins synthesized within the blood vessel wall, from the blood vessel wall to flowing blood.

The reversibility of reduced cortical vein compliance in normal-pressure hydrocephalus following shunt insertion.

PubMed

Bateman, G A

2003-02-01

Superficial cortical venous compression secondary to alterations in craniospinal compliance is implicated in the pathogenesis of normal pressure hydrocephalus (NPH). A reduction in the pulsation in the outflow of the cortical veins would be expected to occur following compression of these veins and this has been shown in NPH. If cortical vein compression is a causative factor in NPH, it would be expected that cortical vein compliance as measured by pulsatility would be significantly altered by a curative procedure i.e. shunt tube insertion. My purpose is to compare the blood flow pulsatility characteristics in a group of patients with NPH before and after shunt tube insertion. I initially studied 18 subjects without pathology with MRI flow quantification studies of the cerebral arteries and veins to define the range of normality. The main study involved 18 patients with idiopathic dementia and mild leukoaraiosis who served as controls and seven patients with NPH studied before and after shunt insertion. Arterial, superior sagittal and straight sinus pulsatility was not significantly different between the patients with idiopathic dementia and those NPH patients before or after shunting. Cortical vein pulsatility before shunting in the patients with NPH was 43% lower than in those with idiopathic dementia ( P=0.006). Following shunting, cortical vein pulsatility increased by 186% ( P=0.007). There is thus reduced compliance in cortical veins in NPH which is significantly increased in patients who respond to insertion of a shunt tube. These findings suggest that reversible elevation in cortical vein pressure and reversal of the normal absorption pathway for cerebrospinal fluid may be behind the pathophysiology of NPH.

Velocity field measurements in oblique static divergent vocal fold models

NASA Astrophysics Data System (ADS)

Erath, Byron

2005-11-01

During normal phonation, the vocal fold cycle is characterized by the glottal opening transitioning from a convergent to a divergent passage and then closing before the cycle is repeated. Under ordinary phonatory conditions, both vocal folds, which form the glottal passage, move in phase with each other, creating a time-varying symmetric opening. However, abnormal pathological conditions, such as unilateral paralysis, and polyps, can result in geometrical asymmetries between the vocal folds throughout the phonatory cycle. This study investigates pulsatile flow fields through 7.5 times life-size vocal fold models with included divergence angles of 5 to 30 degrees, and obliquities between the vocal folds of up to 15 degrees. Flow conditions were scaled to match physiological parameters. Data were taken at the anterior posterior mid-plane using phase-averaged Particle Image Velocimetry (PIV). Viscous flow phenomena including the Coanda effect, flow separation points, and jet "flapping" were investigated. The results are compared to previously reported work of flow through symmetric divergent vocal fold models.

Multiphase simulation of blood flow within main thoracic arteries of 8-year-old child with coarctation of the aorta

NASA Astrophysics Data System (ADS)

Melka, Bartlomiej; Gracka, Maria; Adamczyk, Wojciech; Rojczyk, Marek; Golda, Adam; Nowak, Andrzej J.; Białecki, Ryszard A.; Ostrowski, Ziemowit

2017-08-01

In the research, a numerical Computational Fluid Dynamics (CFD) model of the pulsatile blood flow was created and analysed. A real geometry of aorta and its thoracic branches of an 8-year old patient diagnosed with a congenital heart defect - coarctation of the aorta was used. The inlet boundary condition was implemented as the User Define Function according to measured values of volumetric blood flow. The blood flow was treated as multiphase using Euler-Euler approach. Plasma was set as the primary and dominant fluid phase, with the volume fraction of 0.585. The morphological elements (RBC and WBC) were set as dispersed phases being the remaining volume fraction.

The cerebral hemodynamics of normotensive hypovolemia during lower-body negative pressure

NASA Technical Reports Server (NTRS)

Giller, C. A.; Levine, B. D.; Meyer, Y.; Buckey, J. C.; Lane, L. D.; Borchers, D. J.

1992-01-01

Although severe hypovolemia can lead to hypotension and neurological decline, many patients with neurosurgical disorders experience a significant hypovolemia while autonomic compensatory mechanisms maintain a normal blood pressure. To assess the effects of normotensive hypovolemia upon cerebral hemodynamics, transcranial Doppler ultrasound monitoring of 13 healthy volunteers was performed during graded lower-body negative pressure of up to -50 mm Hg, an accepted laboratory model for reproducing the physiological effects of hypovolemia. Middle cerebral artery flow velocity declined by 16% +/- 4% (mean +/- standard error of the mean) and the ratio between transcranial Doppler ultrasound pulsatility and systemic pulsatility rose 22% +/- 8%, suggesting cerebral small-vessel vasoconstriction in response to the sympathetic activation unmasked by lower-body negative pressure. This vasoconstriction may interfere with the autoregulatory response to a sudden fall in blood pressure, and may explain the common observation of neurological deficit during hypovolemia even with a normal blood pressure.

Pulsatile operation of a continuous-flow right ventricular assist device (RVAD) to improve vascular pulsatility

PubMed Central

Ng, Boon C.; Timms, Daniel; Cohn, William E.

2018-01-01

Despite the widespread acceptance of rotary blood pump (RBP) in clinical use over the past decades, the diminished flow pulsatility generated by a fixed speed RBP has been regarded as a potential factor that may lead to adverse events such as vasculature stiffening and hemorrhagic strokes. In this study, we investigate the feasibility of generating physiological pulse pressure in the pulmonary circulation by modulating the speed of a right ventricular assist device (RVAD) in a mock circulation loop. A rectangular pulse profile with predetermined pulse width has been implemented as the pump speed pattern with two different phase shifts (0% and 50%) with respect to the ventricular contraction. In addition, the performance of the speed modulation strategy has been assessed under different cardiovascular states, including variation in ventricular contractility and pulmonary arterial compliance. Our results indicated that the proposed pulse profile with optimised parameters (Apulse = 10000 rpm and ωmin = 3000 rpm) was able to generate pulmonary arterial pulse pressure within the physiological range (9–15 mmHg) while avoiding undesirable pump backflow under both co- and counter-pulsation modes. As compared to co-pulsation, stroke work was reduced by over 44% under counter-pulsation, suggesting that mechanical workload of the right ventricle can be efficiently mitigated through counter-pulsing the pump speed. Furthermore, our results showed that improved ventricular contractility could potentially lead to higher risk of ventricular suction and pump backflow, while stiffening of the pulmonary artery resulted in increased pulse pressure. In conclusion, the proposed speed modulation strategy produces pulsatile hemodynamics, which is more physiologic than continuous blood flow. The findings also provide valuable insight into the interaction between RVAD speed modulation and the pulmonary circulation under various cardiovascular states. PMID:29677212

Influence of blood flow velocity on arterial distensibility of carotid artery in healthy men.

PubMed

Tomoto, Tsubasa; Maeda, Seiji; Sugawara, Jun

2017-01-01

Decreased distensibility of carotid artery is independently associated with the incidence of cardiovascular and cerebrovascular events. Arterial distensibility is determined by vascular tone. Since shear stress is an important driving force of vasodilatory substances production form endothelial cells, we hypothesized that local basal (i.e., resting) arterial blood flow velocity is associated with regional arterial distensibility. To test this hypothesis, we determined the influence of local blood flow velocity on carotid arterial distensibility in cross-sectional study design. In a total of 73 apparent healthy men (18-64 years), carotid arterial properties, including measures of carotid arterial distensibility and BFV at rest, were evaluated via B-mode and Doppler ultrasound imaging and applanation tonometry system. Carotid arterial peak BFV and the absolute and normalized pulsatile BFV significantly correlated with age (r = -0.453 to -0.600, p < 0.0001), whereas mean and minimum BFV were not influenced by age. Distensibility coefficient of carotid artery correlated with peak BFV (r = 0.305, p < 0.01) and more strongly with pulsatile (i.e., systolic minus end-diastolic) BFV (r = 0.406, p < 0.0001) and the normalized pulsatile BFV by time-averaged velocity (r = 0.591, p < 0.0001). Multi-regression analysis revealed that age (β = -0.57, p < 0.0001) was the primary independent determinant for distensibility coefficient. In addition with this, carotid lumen diameter (β = -0.202, p < 0.01) and the normalized pulsatile BFV (β = 0.237, p < 0.05) were significant independent determinants of distensibility coefficient. Qualitatively similar results (although inverse in direction) were obtained by use of β-stiffness index. These results suggest that greater gradient of blood flow velocity during a cardiac cycle are favorably associated with distensibility of carotid artery.

Prediction of blood pressure and blood flow in stenosed renal arteries using CFD

NASA Astrophysics Data System (ADS)

Jhunjhunwala, Pooja; Padole, P. M.; Thombre, S. B.; Sane, Atul

2018-04-01

In the present work an attempt is made to develop a diagnostive tool for renal artery stenosis (RAS) which is inexpensive and in-vitro. To analyse the effects of increase in the degree of severity of stenosis on hypertension and blood flow, haemodynamic parameters are studied by performing numerical simulations. A total of 16 stenosed models with varying degree of stenosis severity from 0-97.11% are assessed numerically. Blood is modelled as a shear-thinning, non-Newtonian fluid using the Carreau model. Computational Fluid Dynamics (CFD) analysis is carried out to compute the values of flow parameters like maximum velocity and maximum pressure attained by blood due to stenosis under pulsatile flow. These values are further used to compute the increase in blood pressure and decrease in available blood flow to kidney. The computed available blood flow and secondary hypertension for varying extent of stenosis are mapped by curve fitting technique using MATLAB and a mathematical model is developed. Based on these mathematical models, a quantification tool is developed for tentative prediction of probable availability of blood flow to the kidney and severity of stenosis if secondary hypertension is known.

Experiments On Flow In A Coronary Artery

NASA Technical Reports Server (NTRS)

Back, Lloyd H.; Kwack, Eug-Yon; Liem, Timothy K.; Crawford, Donald W.

1993-01-01

Report describes experiments on simulated flow of blood in atherosclerotic human coronary artery. Experiments performed on polyurethane cast made from S-shaped coronary artery of cadaver. Sucrose solution with viscosity of blood pumped through cast at physiologically realistic rates, and flow made pulsatile by mechanism alternately compressing and releasing elastic tube just upstream of cast.

Relationship between Aortic Compliance and Impact of Cerebral Blood Flow Fluctuation to Dynamic Orthostatic Challenge in Endurance Athletes.

PubMed

Tomoto, Tsubasa; Imai, Tomoko; Ogoh, Shigehiko; Maeda, Seiji; Sugawara, Jun

2018-01-01

Aorta effectively buffers cardiac pulsatile fluctuation generated from the left ventricular (LV) which could be a mechanical force to high blood flow and low-resistance end-organs such as the brain. A dynamic orthostatic challenge may evoke substantial cardiac pulsatile fluctuation via the transient increases in venous return and stroke volume (SV). Particularly, this response may be greater in endurance-trained athletes (ET) who exhibit LV eccentric remodeling. The aim of this study was to determine the contribution of aortic compliance to the response of cerebral blood flow fluctuation to dynamic orthostatic challenge in ET and age-matched sedentary (SED) young healthy men. ET ( n = 10) and SED ( n = 10) underwent lower body negative pressure (LBNP) (-30 mmHg for 4 min) stimulation and release the pressure that initiates a rapid regain of limited venous return and consequent increase in SV. The recovery responses of central and middle cerebral arterial (MCA) hemodynamics from the release of LBNP (~15 s) were evaluated. SV (via Modeflow method) and pulsatile and systolic MCA (via transcranial Doppler) normalized by mean MCA velocity (MCAv) significantly increased after the cessation of LBNP in both groups. ET exhibited the higher ratio of SV to aortic pulse pressure (SV/ Ao PP), an index of aortic compliance, at the baseline compared with SED ( P < 0.01). Following the LBNP release, SV was significantly increased in SED by 14 ± 7% (mean ± SD) and more in ET by 30 ± 15%; nevertheless, normalized pulsatile, systolic, and diastolic MCAv remained constant in both groups. These results might be attributed to the concomitant with the increase in aortic compliance assessed by SV/ Ao PP. Importantly, the increase in SV/ Ao PP following the LBNP release was greater in ET than in SED ( P < 0.01), and significantly correlated with the baseline SV/ Ao PP ( r = 0.636, P < 0.01). These results suggest that the aortic compliance in the endurance athletes is able to accommodate the additional SV and buffer the potential increase in pulsatility at end-organs such as the brain.

Differences in aortic vortex flow pattern between normal and patients with stroke: qualitative and quantitative assessment using transesophageal contrast echocardiography.

PubMed

Son, Jang-Won; Hong, Geu-Ru; Hong, Woosol; Kim, Minji; Houle, Helene; Vannan, Mani A; Pedrizzetti, Gianni; Chung, Namsik

2016-06-01

The flow in the aorta forms a vortex, which is a critical determinant of the flow dynamics in the aorta. Arteriosclerosis can alter the blood flow pattern of the aorta and cause characteristic alterations of the vortex. However, this change in aortic vortex has not yet been studied. This study aimed to characterize aortic vortex flow pattern using transesophageal contrast echocardiography in normal and stroke patients. A total of 85 patients who diagnosed with ischemic stroke and 16 normal controls were recruited for this study. The 16 normal control subjects were designated as the control group, and the 85 ischemic stroke patients were designated as the stroke group. All subjects underwent contrast transesophageal echocardiography (TEE), and particle image velocimetry was used to assess aortic vortex flow. Qualitative and quantitative analyses of vortex flow morphology, location, phasic variation, and pulsatility were undertaken and compared between the groups. In the control group, multiple irregularly-shaped vortices were observed in a peripheral location in the descending thoracic aorta. In contrast, the stroke group had a single, round, merged, and more centrally located aortic vortex flow. In the quantitative analysis of vortex, vortex depth, which represents the location of the major vortex in the aorta, was significantly higher in the control group than in the stroke group (0.599 ± 0.159 vs. 0.522 ± 0.101, respectively, P = 0.013). Vortex relative strength, which is the pulsatility parameter of the vortex itself, was significantly higher in the stroke group than in the control group (0.367 ± 0.148 vs. 0.304 ± 0.087, respectively, P = 0.025). It was feasible to visualize and quantify the characteristic morphology and pulsatility of the aortic vortex flow using contrast TEE, and aortic vortex pattern significantly differed between normal and stroke patients.

Correlation mapping for visualizing propagation of pulsatile CSF motion in intracranial space based on magnetic resonance phase contrast velocity images: preliminary results.

PubMed

Yatsushiro, Satoshi; Hirayama, Akihiro; Matsumae, Mitsunori; Kajiwara, Nao; Abdullah, Afnizanfaizal; Kuroda, Kagayaki

2014-01-01

Correlation time mapping based on magnetic resonance (MR) velocimetry has been applied to pulsatile cerebrospinal fluid (CSF) motion to visualize the pressure transmission between CSF at different locations and/or between CSF and arterial blood flow. Healthy volunteer experiments demonstrated that the technique exhibited transmitting pulsatile CSF motion from CSF space in the vicinity of blood vessels with short delay and relatively high correlation coefficients. Patient and healthy volunteer experiments indicated that the properties of CSF motion were different from the healthy volunteers. Resultant images in healthy volunteers implied that there were slight individual difference in the CSF driving source locations. Clinical interpretation for these preliminary results is required to apply the present technique for classifying status of hydrocephalus.

Numerical and experimental studies on pulsatile flow in aneurysms arising laterally from a curved parent vessel at various angles.

PubMed

Liou, Tong-Miin; Li, Yi-Chen; Juan, Wei-Cheng

2007-01-01

Both numerical and experimental studies have been performed to characterize the fluid flow inside the lateral aneurysms arising from the curved parent vessels at various angles gamma. The implicit solver was based on the time-dependent Navier-Stokes equations of incompressible laminar flow. Solutions were generated by a cell-center finite-volume method that used second order upwind and second order center flux difference splitting for the convection and diffusion term, respectively. The second order Crank-Nicolson method was used in the time integration term while the SIMPLEC algorithm was adopted to handle the pressure-velocity coupling. Complementarily, the particle tracking velocimetry (PTV) was used to measure the velocity fields. The conditions selected were to simulate an internal carotid artery with a diameter of 5 mm by similarity rules. The values of gamma explored were 0 degrees, 45 degrees, 90 degrees, and 135 degrees. Pulsatile flow with Wormersley number 3.9 and Reynolds numbers varying from 350 to 850 was considered. The computed results are firstly verified by the PTV measured ones. Discussion of the results is in terms of pulsatile main and secondary velocity vector fields, inflow rates into the aneurysm, and the distributions of wall shear stress and static pressure. It is found that among the angles examined gamma=45( composite function) is the riskiest angle from a fluid dynamics point of view and the aneurysmal dome is at risk.

Utility of color Doppler indices of dominant follicular blood flow for prediction of clinical factors in in vitro fertilization-embryo transfer cycles.

PubMed

Ozaki, T; Hata, K; Xie, H; Takahashi, K; Miyazaki, K

2002-12-01

To investigate the relationship between color Doppler indices of dominant follicular blood flow and clinical factors in in vitro fertilization-embryo transfer cycles. This was a prospective study involving 26 patients completing a total of 33 in vitro fertilization cycles. Dominant follicular blood flow indices, peak systolic velocities, the resistance index and the pulsatility index were evaluated using transvaginal color Doppler. The indices were compared to the clinical outcomes of in vitro fertilization-embryo transfer. There was a significant correlation between dominant follicular peak systolic velocities and the number of oocytes retrieved, as well as the number of mature oocytes obtained. There was no significant correlation between dominant follicular resistance index or pulsatility index and the number of follicles > 10 mm in diameter, the number of oocytes retrieved or the number of mature oocytes. There were no significant differences between dominant follicular peak systolic velocities, resistance index or pulsatility index, and fertilization rate or the ratio of good quality embryos. However, significant differences were found between the number of oocytes retrieved, as well as the number of mature oocytes for those patients in which the peak systolic velocity was below 25 cm/s. Doppler assessment of dominant follicle blood flow alone is useful for predicting the number of retrievable oocytes. However, morphological quality of the embryo produced or the pregnancy rate cannot be predicted by this method.

Quantification of wall shear stress in large blood vessels using Lagrangian interpolation functions with cine phase-contrast magnetic resonance imaging.

PubMed

Cheng, Christopher P; Parker, David; Taylor, Charles A

2002-09-01

Arterial wall shear stress is hypothesized to be an important factor in the localization of atherosclerosis. Current methods to compute wall shear stress from magnetic resonance imaging (MRI) data do not account for flow profiles characteristic of pulsatile flow in noncircular vessel lumens. We describe a method to quantify wall shear stress in large blood vessels by differentiating velocity interpolation functions defined using cine phase-contrast MRI data on a band of elements in the neighborhood of the vessel wall. Validation was performed with software phantoms and an in vitro flow phantom. At an image resolution corresponding to in vivo imaging data of the human abdominal aorta, time-averaged, spatially averaged wall shear stress for steady and pulsatile flow were determined to be within 16% and 23% of the analytic solution, respectively. These errors were reduced to 5% and 8% with doubling in image resolution. For the pulsatile software phantom, the oscillation in shear stress was predicted to within 5%. The mean absolute error of circumferentially resolved shear stress for the nonaxisymmetric phantom decreased from 28% to 15% with a doubling in image resolution. The irregularly shaped phantom and in vitro investigation demonstrated convergence of the calculated values with increased image resolution. We quantified the shear stress at the supraceliac and infrarenal regions of a human abdominal aorta to be 3.4 and 2.3 dyn/cm2, respectively.

Mechanical circulatory support in pediatrics.

PubMed

Steffen, Robert J; Miletic, Kyle G; Schraufnagel, Dean P; Vargo, Patrick R; Fukamachi, Kiyotaka; Stewart, Robert D; Moazami, Nader

2016-05-01

End-stage heart failure affects thousands of children yearly and mechanical circulatory support is used at many points in their care. Extracorporeal membrane oxygenation supports both the failing heart and lungs, which has led to its use as an adjunct to cardiopulmonary resuscitation as well as in post-operative cardiogenic shock. Continuous-flow ventricular assist devices (VAD) have replaced pulsatile-flow devices in adults and early studies have shown promising results in children. The Berlin paracorporeal pulsatile VAD recently gained U.S. Food and Drug Administration approval and remains the only VAD approved in pediatrics. Failing univentricular hearts and other congenitally corrected lesions are new areas for mechanical support. Finding novel uses, improving durability, and minimizing complications are areas of growth in pediatric mechanical circulatory support.

Classification of Unsteady Flow Patterns in a Rotodynamic Blood Pump: Introduction of Non-Dimensional Regime Map.

PubMed

Shu, Fangjun; Vandenberghe, Stijn; Brackett, Jaclyn; Antaki, James F

2015-09-01

Rotodynamic blood pumps (also known as rotary or continuous flow blood pumps) are commonly evaluated in vitro under steady flow conditions. However, when these devices are used clinically as ventricular assist devices (VADs), the flow is pulsatile due to the contribution of the native heart. This study investigated the influence of this unsteady flow upon the internal hemodynamics of a centrifugal blood pump. The flow field within the median axial plane of the flow path was visualized with particle image velocimetry (PIV) using a transparent replica of the Levacor VAD. The replica was inserted in a dynamic cardiovascular simulator that synchronized the image acquisition to the cardiac cycle. As compared to steady flow, pulsatile conditions produced periodic, transient recirculation regions within the impeller and separation in the outlet diffuser. Dimensional analysis revealed that the flow characteristics could be uniquely described by the non-dimensional flow coefficient (Φ) and its time derivative ([Formula: see text]), thereby eliminating impeller speed from the experimental matrix. Four regimes within the Φ-[Formula: see text] plane were found to classify the flow patterns, well-attached or disturbed. These results and methods can be generalized to provide insights for both design and operation of rotodynamic blood pumps for safety and efficacy.

The Influence of Oscillatory Fractions on Mass Transfer of Non-Newtonian Fluid in Wavy-Walled Tubes for Pulsatile Flow

NASA Astrophysics Data System (ADS)

Zhu, Donghui; Bian, Yongning

2018-03-01

The shape of pipeline structure, fluid medium and flow state have important influence on the heat transfer and mass effect of fluid. In this paper, we investigated the mass transfer behavior of Non-Newtonian fluid CMC solution with 700ppm concentration in five different-sized axisymmetric wave-walled tubes for pulsatile flow. It is revealed that the effect of mass transfer is enhanced with the increase of oscillatory fractions P based on the PIV measurements. Besides, mass transfer rate was measured by the electrochemical method in the larger oscillatory points rate range. It is observed that mass transfer rate increases with the increase in P and reached the maximum mass transfer rate at the most optimal oscillatory fractions P opt. After reaching the optimal oscillatory fractions P opt, the mass transfer rate decreases with increasing P.

Fluid dynamic characteristics of the VentrAssist rotary blood pump.

PubMed

Tansley, G; Vidakovic, S; Reizes, J

2000-06-01

The VentrAssist pump has no shaft or seal, and the device is unique in design because the rotor is suspended passively by hydrodynamic forces, and urging is accomplished by an integrated direct current motor rotor that also acts as the pump impeller. This device has led to many challenges in its fluidic design, namely large flow-blockage from impeller blades, low stiffness of bearings with concomitant impeller displacement under pulsatile load conditions, and very small running clearances. Low specific speed and radial blade off-flow were selected in order to minimize the hemolysis. Pulsatile and steady-flow tests show the impeller is stable under normal operating conditions. Computational fluid dynamics (CFD) has been used to optimize flow paths and reduce net axial force imbalance to acceptably small values. The latest design of the pump achieved a system efficiency of 18% (in 30% hematocrit of red blood cells suspended in phosphate-buffered saline), and efficiency was optimized over the range of operating conditions. Parameters critical to improving pump efficiency were investigated.

Using a laser-Doppler flowmetry to measure pulsatile microcirculation on the kidney in rats

NASA Astrophysics Data System (ADS)

Jan, Ming-Yie; Chao, Pin-Tsun; Hsu, Tse-Lin; Wang, Yuh-Yin L.; Wang, Wei-Kung

2001-10-01

Although Laser Doppler flowmetery (LDF) been extensively used in measurement of microvascular blood flow of different tissues. However, due to some physiological vibrations, fast oscillations of the renal cortical flux (RCF) are hard to be measured. In the study, a commercial 3mW 780nm Laser Doppler flowmetery, with a single fiber and a de-vibration holder, was used to measure the pulsatile RCF in rats. Considering the fast response due to the heart rate of rats, the time constant (TC) was set to 0.05 second and thus the frequency response is up to 20Hz. Furthermore, a calibration standard and a static blood sample were also measured as the references without the pulsatile driving force. In order not to perturb the RCF with tiny momentum, the applying force that the fiber exerted on the renal surface was controlled below 100 dyne. To enhance the signal to noise ratio (SNR), an averaged periodogram was used to estimate the frequency components of the pulsatile microcirculation. It is found that the dominating fast oscillation of RCF is pulsatile and its harmonic components are directly correlated with those of the heartbeat (correlation coefficient =0.999, P<0.001, n=17). The result shows that, in the kidney, the pulsatile RCF is the dominating component of microcirculation oscillation and driven by the fast propagating blood pressure. This technique could be further utilized to analyze the pharmacological effect and hemodynamic parameters on renal function.

New intravascular flow sensor using fiber optics

NASA Astrophysics Data System (ADS)

Stenow, Erik N. D.

1994-12-01

A new sensor using fiber optics is suggested for blood flow measurements in small vessels. The sensor principle and a first evaluation on a flow model are presented. The new sensor uses small CO2 gas bubbles as flow markers for optical detection. When the bubbles pass an optical window, light emitted from one fiber is reflected and scattered into another fiber. The sensor has been proven to work in a 3 mm flow model using two 110 micrometers optical fibers and a 100 micrometers steel capillary inserted into a 1 mm guide wire. The evaluation of a sensor archetype shows that the new sensor provides a promising method for intravascular blood flow measurement in small vessels. The linearity for steady state flow is studied in the flow interval 30 - 130 ml/min. comparison with ultrasound Doppler flowmetry was performed for pulsatile flow in the interval 25 - 125 ml/min. with a pulse length between 0.5 and 2 s. The use of intravascular administered CO2 in small volumes is harmless because the gas is rapidly dissolved in whole blood.

A numerical method for solving the 3D unsteady incompressible Navier Stokes equations in curvilinear domains with complex immersed boundaries

NASA Astrophysics Data System (ADS)

Ge, Liang; Sotiropoulos, Fotis

2007-08-01

A novel numerical method is developed that integrates boundary-conforming grids with a sharp interface, immersed boundary methodology. The method is intended for simulating internal flows containing complex, moving immersed boundaries such as those encountered in several cardiovascular applications. The background domain (e.g. the empty aorta) is discretized efficiently with a curvilinear boundary-fitted mesh while the complex moving immersed boundary (say a prosthetic heart valve) is treated with the sharp-interface, hybrid Cartesian/immersed-boundary approach of Gilmanov and Sotiropoulos [A. Gilmanov, F. Sotiropoulos, A hybrid cartesian/immersed boundary method for simulating flows with 3d, geometrically complex, moving bodies, Journal of Computational Physics 207 (2005) 457-492.]. To facilitate the implementation of this novel modeling paradigm in complex flow simulations, an accurate and efficient numerical method is developed for solving the unsteady, incompressible Navier-Stokes equations in generalized curvilinear coordinates. The method employs a novel, fully-curvilinear staggered grid discretization approach, which does not require either the explicit evaluation of the Christoffel symbols or the discretization of all three momentum equations at cell interfaces as done in previous formulations. The equations are integrated in time using an efficient, second-order accurate fractional step methodology coupled with a Jacobian-free, Newton-Krylov solver for the momentum equations and a GMRES solver enhanced with multigrid as preconditioner for the Poisson equation. Several numerical experiments are carried out on fine computational meshes to demonstrate the accuracy and efficiency of the proposed method for standard benchmark problems as well as for unsteady, pulsatile flow through a curved, pipe bend. To demonstrate the ability of the method to simulate flows with complex, moving immersed boundaries we apply it to calculate pulsatile, physiological flow through a mechanical, bileaflet heart valve mounted in a model straight aorta with an anatomical-like triple sinus.

Dense concentric circle scanning protocol for measuring pulsatile retinal blood flow in rats with Doppler optical coherence tomography

NASA Astrophysics Data System (ADS)

Tan, Bingyao; Hosseinaee, Zohreh; Bizheva, Kostadinka

2017-11-01

The variability in the spatial orientation of retinal blood vessels near the optic nerve head (ONH) results in imprecision of the measured Doppler angle and therefore the pulsatile blood flow (BF), when those parameters are evaluated using Doppler OCT imaging protocols based on dual-concentric circular scans. Here, we utilized a dense concentric circle scanning protocol and evaluated its precision for measuring pulsatile retinal BF in rats for different numbers of the circular scans. An spectral domain optical coherence tomography (SD-OCT) system operating in the 1060-nm spectral range with image acquisition rate of 47,000 A-scans/s was used to acquire concentric circular scans centered at the rat's ONH, with diameters ranging from 0.8 to 1.0 mm. A custom, automatic blood vessel segmentation algorithm was used to track the spatial orientation of the retinal blood vessels in three dimensions, evaluate the spatially dependent Doppler angle and calculate more accurately the axial BF for each major retinal blood vessel. Metrics such as retinal BF, pulsatility index, and resistance index were evaluated for each and all of the major retinal blood vessels. The performance of the proposed dense concentric circle scanning protocols was compared with that of the dual-circle scanning protocol. Results showed a 3.8±2.2 deg difference in the Doppler angle calculation between the two approaches, which resulted in ˜7% difference in the calculated retinal BF.

Cerebral arterial pulsation drives paravascular CSF-interstitial fluid exchange in the murine brain.

PubMed

Iliff, Jeffrey J; Wang, Minghuan; Zeppenfeld, Douglas M; Venkataraman, Arun; Plog, Benjamin A; Liao, Yonghong; Deane, Rashid; Nedergaard, Maiken

2013-11-13

CSF from the subarachnoid space moves rapidly into the brain along paravascular routes surrounding penetrating cerebral arteries, exchanging with brain interstitial fluid (ISF) and facilitating the clearance of interstitial solutes, such as amyloid β, in a pathway that we have termed the "glymphatic" system. Prior reports have suggested that paravascular bulk flow of CSF or ISF may be driven by arterial pulsation. However, cerebral arterial pulsation could not be directly assessed. In the present study, we use in vivo two-photon microscopy in mice to visualize vascular wall pulsatility in penetrating intracortical arteries. We observed that unilateral ligation of the internal carotid artery significantly reduced arterial pulsatility by ~50%, while systemic administration of the adrenergic agonist dobutamine increased pulsatility of penetrating arteries by ~60%. When paravascular CSF-ISF exchange was evaluated in real time using in vivo two-photon and ex vivo fluorescence imaging, we observed that internal carotid artery ligation slowed the rate of paravascular CSF-ISF exchange, while dobutamine increased the rate of paravascular CSF-ISF exchange. These findings demonstrate that cerebral arterial pulsatility is a key driver of paravascular CSF influx into and through the brain parenchyma, and suggest that changes in arterial pulsatility may contribute to accumulation and deposition of toxic solutes, including amyloid β, in the aging brain.

CFD analysis of multiphase blood flow within aorta and its thoracic branches of patient with coarctation of aorta using multiphase Euler - Euler approach

NASA Astrophysics Data System (ADS)

Ostrowski, Z.; Melka, B.; Adamczyk, W.; Rojczyk, M.; Golda, A.; Nowak, A. J.

2016-09-01

In the research a numerical Computational Fluid Dynamics (CFD) model of the pulsatile blood flow was created and analyzed. A real geometry of aorta and its thoracic branches of 8-year old patient diagnosed with a congenital heart defect - coarctation of aorta was used. The inlet boundary condition were implemented as the User Define Function according to measured values of volumetric blood flow. The blood flow was treated as multiphase: plasma, set as the primary fluid phase, was dominant with volume fraction of 0.585 and morphological elements of blood were treated in Euler-Euler approach as dispersed phases (with 90% Red Blood Cells and White Blood Cells as remaining solid volume fraction).

Functional importance of blood flow dynamics and partial oxygen pressure in the anterior pituitary.

PubMed

Schaeffer, Marie; Hodson, David J; Lafont, Chrystel; Mollard, Patrice

2010-12-01

The pulsatile release of hormone is obligatory for the control of a range of important body homeostatic functions. To generate these pulses, endocrine organs have developed finely regulated mechanisms to modulate blood flow both to meet the metabolic demand associated with intense endocrine cell activity and to ensure the temporally precise uptake of secreted hormone into the bloodstream. With a particular focus on the pituitary gland as a model system, we review here the importance of the interplay between blood flow regulation and oxygen tensions in the functioning of endocrine systems, and the known regulatory signals involved in the modification of flow patterns under both normal physiological and pathological conditions. © 2010 The Authors. European Journal of Neuroscience © 2010 Federation of European Neuroscience Societies and Blackwell Publishing Ltd.

Dynamic three-dimensional phase-contrast technique in MRI: application to complex flow analysis around the artificial heart valve

NASA Astrophysics Data System (ADS)

Kim, Soo Jeong; Lee, Dong Hyuk; Song, Inchang; Kim, Nam Gook; Park, Jae-Hyeung; Kim, JongHyo; Han, Man Chung; Min, Byong Goo

1998-07-01

Phase-contrast (PC) method of magnetic resonance imaging (MRI) has bee used for quantitative measurements of flow velocity and volume flow rate. It is a noninvasive technique which provides an accurate two-dimensional velocity image. Moreover, Phase Contrast Cine magnetic resonance imaging combines the flow dependent contrast of PC-MRI with the ability of cardiac cine imaging to produce images throughout the cardiac cycle. However, the accuracy of the data acquired from the single through-plane velocity encoding can be reduced by the effect of flow direction, because in many practical cases flow directions are not uniform throughout the whole region of interest. In this study, we present dynamic three-dimensional velocity vector mapping method using PC-MRI which can visualize the complex flow pattern through 3D volume rendered images displayed dynamically. The direction of velocity mapping can be selected along any three orthogonal axes. By vector summation, the three maps can be combined to form a velocity vector map that determines the velocity regardless of the flow direction. At the same time, Cine method is used to observe the dynamic change of flow. We performed a phantom study to evaluate the accuracy of the suggested PC-MRI in continuous and pulsatile flow measurement. Pulsatile flow wave form is generated by the ventricular assistant device (VAD), HEMO-PULSA (Biomedlab, Seoul, Korea). We varied flow velocity, pulsatile flow wave form, and pulsing rate. The PC-MRI-derived velocities were compared with Doppler-derived results. The velocities of the two measurements showed a significant linear correlation. Dynamic three-dimensional velocity vector mapping was carried out for two cases. First, we applied to the flow analysis around the artificial heart valve in a flat phantom. We could observe the flow pattern around the valve through the 3-dimensional cine image. Next, it is applied to the complex flow inside the polymer sac that is used as ventricle in totally implantable artificial heart (TAH). As a result we could observe the flow pattern around the valves of the sac, though complex flow can not be detected correctly in the conventional phase contrast method. In addition, we could calculate the cardiac output from TAH sac by quantitative measurement of the volume of flow across the outlet valve.

A modeling study on the influence of blood flow regulation on skin temperature pulsations

NASA Astrophysics Data System (ADS)

Tang, Yanliang; Mizeva, Irina; He, Ying

2017-04-01

Nowadays together with known optic techniques of microcirculation blood flow monitoring, skin temperature measurements are developed as well. In this paper, a simple one-dimensional bioheat transfer model was developed to analyse the heat wave transport in biological tissue, where an arteriole vessel with pulsatile blood is located. The simulated results show that the skin temperature oscillation amplitudes attenuate with the increase of blood flow oscillation frequency which gives the same tendency as that in the experiments. The parameter analyses further show that the amplitude of oscillation is also influenced by oscillation amplitude of blood and effective thermal conductivity. When oscillation amplitude of blood flow and effective thermal conductivity increase, the amplitude of skin temperature oscillation increases nonlinearly. Variation of effective thermal convective influence to the time delay of the thermal wave on the skin surface and distort it. Combination of two measurement techniques: one for estimation blood flow oscillations in the microvessels and other to the skin temperature measurement can produce additional information about the skin properties.

Multiple independent autonomous hydraulic oscillators driven by a common gravity head.

PubMed

Kim, Sung-Jin; Yokokawa, Ryuji; Lesher-Perez, Sasha Cai; Takayama, Shuichi

2015-06-15

Self-switching microfluidic circuits that are able to perform biochemical experiments in a parallel and autonomous manner, similar to instruction-embedded electronics, are rarely implemented. Here, we present design principles and demonstrations for gravity-driven, integrated, microfluidic pulsatile flow circuits. With a common gravity head as the only driving force, these fluidic oscillator arrays realize a wide range of periods (0.4 s-2 h) and flow rates (0.10-63 μl min(-1)) with completely independent timing between the multiple oscillator sub-circuits connected in parallel. As a model application, we perform systematic, parallel analysis of endothelial cell elongation response to different fluidic shearing patterns generated by the autonomous microfluidic pulsed flow generation system.

Non-contact hemodynamic imaging reveals the jugular venous pulse waveform

NASA Astrophysics Data System (ADS)

Amelard, Robert; Hughson, Richard L.; Greaves, Danielle K.; Pfisterer, Kaylen J.; Leung, Jason; Clausi, David A.; Wong, Alexander

2017-01-01

Cardiovascular monitoring is important to prevent diseases from progressing. The jugular venous pulse (JVP) waveform offers important clinical information about cardiac health, but is not routinely examined due to its invasive catheterisation procedure. Here, we demonstrate for the first time that the JVP can be consistently observed in a non-contact manner using a photoplethysmographic imaging system. The observed jugular waveform was strongly negatively correlated to the arterial waveform (r = -0.73 ± 0.17), consistent with ultrasound findings. Pulsatile venous flow was observed over a spatially cohesive region of the neck. Critical inflection points (c, x, v, y waves) of the JVP were observed across all participants. The anatomical locations of the strongest pulsatile venous flow were consistent with major venous pathways identified through ultrasound.

Non-contact hemodynamic imaging reveals the jugular venous pulse waveform

PubMed Central

Amelard, Robert; Hughson, Richard L.; Greaves, Danielle K.; Pfisterer, Kaylen J.; Leung, Jason; Clausi, David A.; Wong, Alexander

2017-01-01

Cardiovascular monitoring is important to prevent diseases from progressing. The jugular venous pulse (JVP) waveform offers important clinical information about cardiac health, but is not routinely examined due to its invasive catheterisation procedure. Here, we demonstrate for the first time that the JVP can be consistently observed in a non-contact manner using a photoplethysmographic imaging system. The observed jugular waveform was strongly negatively correlated to the arterial waveform (r = −0.73 ± 0.17), consistent with ultrasound findings. Pulsatile venous flow was observed over a spatially cohesive region of the neck. Critical inflection points (c, x, v, y waves) of the JVP were observed across all participants. The anatomical locations of the strongest pulsatile venous flow were consistent with major venous pathways identified through ultrasound. PMID:28065933

Ocular Perfusion Pressure and Pulsatile Ocular Blood Flow in Normal and Systemic Hypertensive Patients.

PubMed

Kanadani, Fabio N; Figueiredo, Carlos R; Miranda, Rafaela Morais; Cunha, Patricia Lt; M Kanadani, Tereza Cristina; Dorairaj, Syril

2015-01-01

Glaucomatous neuropathy can be a consequence of insufficient blood supply, increase in intraocular pressure (IOP), or other risk factors that diminish the ocular blood flow. To determine the ocular perfusion pressure (OPP) in normal and systemic hypertensive patients. One hundred and twenty-one patients were enrolled in this prospective and comparative study and underwent a complete ophthalmologic examination including slit lamp examination, Goldmann applanation tonometry, stereoscopic fundus examination, and pulsatile ocular blood flow (POBF) measurements. The OPP was calculated as being the medium systemic arterial pressure (MAP) less the IOP. Only right eye values were considered for calculations using Student's t-test. The mean age of the patients was 57.5 years (36-78), and 68.5% were women. There was a statistically significant difference in the OPP of the normal and systemic hypertensive patients (p < 0.05). The difference in the OPP between these groups varied between 8.84 and 17.9 mm Hg. The results of this study suggest that although the systemic hypertensive patients have a higher OPP in comparison to normal patients, this increase does not mean that they also have a higher OBF (as measured by POBF tonograph). This may be caused by chronic changes in the vascular network and in the blood hemodynamics in patients with systemic hypertension. How to cite this article: Kanadani FN, Figueiredo CR, Miranda RM, Cunha PLT, Kanadani TCM, Dorairaj S. Ocular Perfusion Pressure and Pulsatile Ocular Blood Flow in Normal and Systemic Hypertensive Patients. J Curr Glaucoma Pract 2015;9(1):16-19.

Experience With a Long-term Pulsatile Ventricular Assist Device as a Bridge to Heart Transplant in Adults.

PubMed

Gómez Bueno, Manuel; Segovia Cubero, Javier; Serrano Fiz, Santiago; Ugarte Basterrechea, Juan; Hernández Pérez, Francisco José; Goirigolzarri Artaza, Josebe; Castedo Mejuto, Evaristo; Burgos Lázaro, Raúl; García Montero, Carlos; Moñivas Palomero, Vanessa; Mingo Santos, Susana; González Román, Ana Isabel; Álvarez Avelló, José Manuel; Vidal Fernández, Mercedes; Forteza Gil, Alberto; Alonso-Pulpón, Luis

2017-09-01

Most long-term ventricular assist devices (VADs) that are currently implanted are intracorporeal continuous-flow devices. Their main limitations include their high cost and inability to provide biventricular support. The aim of this study was to describe the results of using paracorporeal pulsatile-flow VADs as a bridge to transplant (BTT) in adult patients. Retrospective analysis of the characteristics, complications, and outcomes of a single-center case series of consecutive patients treated with the EXCOR VAD as BTT between 2009 and 2015. During the study period, 25 VADs were implanted, 6 of them biventricular. Ventricular assist devices were indicated directly as a BTT in 12 patients and as a bridge to decision in 13 due to the presence of potentially reversible contraindications or chance of heart function recovery. Twenty patients (80%) were successfully bridged to heart transplant after a median of 112 days (range, 8-239). The main complications included infectious (52% of patients), neurological events (32%, half of them fatal), bleeding (28%), and VAD malfunction requiring component replacement (28%). Eighty percent of patients with the EXCOR VAD as BTT achieved the goal after an average of almost 4 months of support. The most frequent complications were infectious, and the most severe were neurological. In our enivonment, the use of these pulsatile-flow VAD as BTT is a feasible strategy that obtains similar outcomes to those of intracorporeal continuous-flow devices. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Flow Patterns in the Jugular Veins of Pulsatile Tinnitus Patients

PubMed Central

Kao, Evan; Kefayati, Sarah; Amans, Matthew R.; Faraji, Farshid; Ballweber, Megan; Halbach, Van; Saloner, David

2017-01-01

Pulsatile Tinnitus (PT) is a pulse-synchronous sound heard in the absence of an external source. PT is often related to abnormal flow in vascular structures near the cochlea. One vascular territory implicated in PT is the internal jugular vein (IJV). Using computational fluid dynamics (CFD) based on patient-specific Magnetic Resonance Imaging (MRI), we investigated the flow within the IJV of seven subjects, four symptomatic and three asymptomatic of PT. We found that there were two extreme anatomic types classified by the shape and position of the jugular bulbs: elevated and rounded. PT patients had elevated jugular bulbs that led to a distinctive helical flow pattern within the proximal internal jugular vein. Asymptomatic subjects generally had rounded jugular bulbs that neatly redirected flow from the sigmoid sinus directly into the jugular vein. These two flow patterns were quantified by calculating the length-averaged streamline curvature of the flow within the proximal jugular vein: 130.3 ± 8.1 m-1 for geometries with rounded bulbs, 260.7 ± 29.4 m-1 for those with elevated bulbs (P < 0.005). Our results suggest that variations in the jugular bulb geometry lead to distinct flow patterns that are linked to PT, but further investigation is needed to determine if the vortex pattern is causal to sound generation. PMID:28057349

Training model for control of an internal carotid artery injury during transsphenoidal surgery.

PubMed

Muto, Jun; Carrau, Ricardo L; Oyama, Kenichi; Otto, Brad A; Prevedello, Daniel M

2017-01-01

As the adoption of endoscopic endonasal approaches (EEA) continues to proliferate, increasing numbers of internal carotid artery (ICA) injuries are reported. The objective of this study was to develop a synthetic ICA injury-training model that could mimic this clinical scenario and be portable, repeatable, reproducible, and without risk of biological contamination. Based on computed tomography of a human head, we constructed a synthetic model using selective laser sintering with polyamide nylon and glass beads. Subsequently, the model was connected to a pulsatile pump using 6-mm silicon tubing. The pump maintains a pulsatile flow of an artificial blood-like fluid at a variable pressure to simulate heart beats. Volunteer surgeons with different levels of training and experience were provided simulation training sessions with the models. Pre- and posttraining questionnaires were completed by each of the participants. Pre- and posttraining questionnaires suggest that repeated simulation sessions improve the surgical skills and self-confidence of trainees. This ICA injury model is portable; reproducible; and avoids ethical, biohazard, religious, and legal problems associated with cadaveric models. A synthetic ICA injury model for EEA allows recurring training that may improve the surgeon's ability to maintain endoscopic visualization, control catastrophic bleeding, decrease psychomotor stress, and develop effective team strategies to achieve hemostasis. NA Laryngoscope, 127:38-43, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

[Pulsatile total cavopulmonary shunt for hypoplastic right heart syndrome with abnormal systemic venous return--a case report].

PubMed

Oiwa, H; Kawauchi, M; Chikada, M; Yagyu, K; Kotsuka, Y; Furuse, A

1995-01-01

A pulsatile total cavopulmonary shunt was successfully performed on a 5-year-old girl with hypoplastic right heart syndrome associated with abnormal systemic venous return; at the same time, modified mitral valve replacement was performed for mitral regurgitation. The right atrium, tricuspid valve and right ventricle were all extremely dimunitive. The diameter of the tricuspid valve was 50% of normal and the volume of the right ventricle was 8.6% of normal. In addition, there were severe subpumonary stenosis, a restrictive ventricular septal defect (VSD) and an atrial septal defect (ASD). The bilateral superior venae cavae (SVCs) and the hepatic vein drained to the left atrium, and the inferior vena cava was infrahepatically interrupted with a hemiazygos connection to the left superior vena cava. At the operation, each SVC was anastomosed end-to-side to each branch of the pulmonary artery (PA). The restrictive ventricular septal defect and stenotic subpulmonary lesion were left. The diameter of the ASD was reduced from 12 mm to 7 mm. The main PA was neither divided nor banded. The pulsatile blood flow from the left heart to the PA was regurated by a native restrictive VSD and stenotic subpulmonary lesion, and that from the right heart via the ASD was limited by reducing the size of the ASD. These described anatomic arrangements produced adequate antegrade pulsatile flow in the PA, which might prevent the development of pulmonary arteriovenous fistulae and, besides permit transfer of drainage of the hepatic vein from the left to the right atrium via the ASD in future.

Analysis of pressure head-flow loops of pulsatile rotodynamic blood pumps.

PubMed

Jahren, Silje E; Ochsner, Gregor; Shu, Fangjun; Amacher, Raffael; Antaki, James F; Vandenberghe, Stijn

2014-04-01

The clinical importance of pulsatility is a recurring topic of debate in mechanical circulatory support. Lack of pulsatility has been identified as a possible factor responsible for adverse events and has also demonstrated a role in myocardial perfusion and cardiac recovery. A commonly used method for restoring pulsatility with rotodynamic blood pumps (RBPs) is to modulate the speed profile, synchronized to the cardiac cycle. This introduces additional parameters that influence the (un)loading of the heart, including the timing (phase shift) between the native cardiac cycle and the pump pulses, and the amplitude of speed modulation. In this study, the impact of these parameters upon the heart-RBP interaction was examined in terms of the pressure head-flow (HQ) diagram. The measurements were conducted using a rotodynamic Deltastream DP2 pump in a validated hybrid mock circulation with baroreflex function. The pump was operated with a sinusoidal speed profile, synchronized to the native cardiac cycle. The simulated ventriculo-aortic cannulation showed that the level of (un)loading and the shape of the HQ loops strongly depend on the phase shift. The HQ loops displayed characteristic shapes depending on the phase shift. Increased contribution of native contraction (increased ventricular stroke work [WS ]) resulted in a broadening of the loops. It was found that the previously described linear relationship between WS and the area of the HQ loop for constant pump speeds becomes a family of linear relationships, whose slope depends on the phase shift. © 2013 Wiley Periodicals, Inc. and International Center for Artificial Organs and Transplantation.

4D spiral imaging of flows in stenotic phantoms and subjects with aortic stenosis.

PubMed

Negahdar, M J; Kadbi, Mo; Kendrick, Michael; Stoddard, Marcus F; Amini, Amir A

2016-03-01

The utility of four-dimensional (4D) spiral flow in imaging of stenotic flows in both phantoms and human subjects with aortic stenosis is investigated. The method performs 4D flow acquisitions through a stack of interleaved spiral k-space readouts. Relative to conventional 4D flow, which performs Cartesian readout, the method has reduced echo time. Thus, reduced flow artifacts are observed when imaging high-speed stenotic flows. Four-dimensional spiral flow also provides significant savings in scan times relative to conventional 4D flow. In vitro experiments were performed under both steady and pulsatile flows in a phantom model of severe stenosis (one inch diameter at the inlet, with 87% area reduction at the throat of the stenosis) while imaging a 6-cm axial extent of the phantom, which included the Gaussian-shaped stenotic narrowing. In all cases, gradient strength and slew rate for standard clinical acquisitions, and identical field of view and resolution were used. For low steady flow rates, quantitative and qualitative results showed a similar level of accuracy between 4D spiral flow (echo time [TE] = 2 ms, scan time = 40 s) and conventional 4D flow (TE = 3.6 ms, scan time = 1:01 min). However, in the case of high steady flow rates, 4D spiral flow (TE = 1.57 ms, scan time = 38 s) showed better visualization and accuracy as compared to conventional 4D flow (TE = 3.2 ms, scan time = 51 s). At low pulsatile flow rates, a good agreement was observed between 4D spiral flow (TE = 2 ms, scan time = 10:26 min) and conventional 4D flow (TE = 3.6 ms, scan time = 14:20 min). However, in the case of high flow-rate pulsatile flows, 4D spiral flow (TE = 1.57 ms, scan time = 10:26 min) demonstrated better visualization as compared to conventional 4D flow (TE = 3.2 ms, scan time = 14:20 min). The feasibility of 4D spiral flow was also investigated in five normal volunteers and four subjects with mild-to-moderate aortic stenosis. The approach achieved TE = 1.68 ms and scan time = 3:44 min. The conventional sequence achieved TE = 2.9 ms and scan time = 5:23 min. In subjects with aortic stenosis, we also compared both MRI methods with Doppler ultrasound (US) in the measurement of peak velocity, time to peak systolic velocity, and eject time. Bland-Altman analysis revealed that, when comparing peak velocities, the discrepancy between Doppler US and 4D spiral flow was significantly less than the discrepancy between Doppler and 4D Cartesian flow (2.75 cm/s vs. 10.25 cm/s), whereas the two MR methods were comparable (-5.75 s vs. -6 s) for time to peak. However, for the estimation of eject time, relative to Doppler US, the discrepancy for 4D conventional flow was smaller than that of 4D spiral flow (-16.25 s vs. -20 s). Relative to conventional 4D flow, 4D spiral flow achieves substantial reductions in both the TE and scan times; therefore, utility for it should be sought in a variety of in vivo and complex flow imaging applications. © 2015 Wiley Periodicals, Inc.

Development of an Experimental and Digital Cardiovascular Arterial Model for Transient Hemodynamic and Postural Change Studies: "A Preliminary Framework Analysis".

PubMed

Hewlin, Rodward L; Kizito, John P

2018-03-01

The ultimate goal of the present work is to aid in the development of tools to assist in the treatment of cardiovascular disease. Gaining an understanding of hemodynamic parameters for medical implants allow clinicians to have some patient-specific proposals for intervention planning. In the present work an experimental and digital computational fluid dynamics (CFD) arterial model consisting of a number of major arteries (aorta, carotid bifurcation, cranial, femoral, jejunal, and subclavian arteries) were fabricated to study: (1) the effects of local hemodynamics (flow parameters) on global hemodynamics (2) the effects of transition from bedrest to upright position (postural change) on hemodynamics, and (3) diffusion of dye (medical drug diffusion simulation) in the arterial system via experimental and numerical techniques. The experimental and digital arterial models used in the present study are the first 3-D systems reported in literature to incorporate the major arterial vessels that deliver blood from the heart to the cranial and femoral arteries. These models are also the first reported in literature to be used for flow parameter assessment via medical drug delivery and orthostatic postural change studies. The present work addresses the design of the experimental and digital arterial model in addition to the design of measuring tools used to measure hemodynamic parameters. The experimental and digital arterial model analyzed in the present study was developed from patient specific computed tomography angiography (CTA) scans and simplified geometric data. Segments such as the aorta (ascending and descending) and carotid bifurcation arteries of the experimental and digital arterial model was created from online available patient-specific CTA scan data provided by Charite' Clinical and Research Hospital. The cranial and coronary arteries were simplified arterial geometries developed from dimensional specification data used in previous work. For the patient specific geometries, a MATLAB code was written to upload the CTA scans of each artery, calculate the centroids, and produce surface splines at each discrete cross section along the lumen centerline to create the patient specific arterial geometries. The MATLAB code worked in conjunction with computer aided software (CAD) Solidworks to produce solid models of the patient specific geometries and united them with the simplified geometries to produce the full arterial model (CAD model). The CAD model was also used as a blueprint to fabricate the experimental model which was used for flow visualization via particle imaging velocimetry (PIV) and postural change studies. A custom pulse duplicator (pulsatile pump) was also designed and developed for the present work. The pulse duplicator is capable of producing patient-specific volumetric waveforms for inlet flow to the experimental arterial model. A simple fluid structure interaction (FSI) study was also conducted via optical techniques to establish the magnitude of vessel diameter change due to the pulsatile flow. A medical drug delivery (dye dispersion and tracing) case was simulated via a dye being dispersed into the pulsatile flow stream to measure the transit time of the dye front. Pressure waveforms for diseased cases (hypertension & stenotic cases) were also obtained from the experimental arterial model during postural changes from bedrest (0°) to upright position (90°). The postural changes were simulated via attaching the experimental model to a tile table the can transition from 0° to 90°. The PIV results obtained from the experimental model provided parametric data such as velocity and wall shear stress data. The medical drug delivery simulations (experimental and numerical) studies produce time dependent data which is useful for predicting flow trajectory and transit time of medical drug dispersion. In the case of postural change studies, pressure waveforms were obtained from the common carotid artery and the femoral sections to yield pressure difference data useful for orthostatic hypotension analysis. Flow parametric data such as vorticity (flow reversal), wall shear stress, normal stress, and medical drug transit data was also obtained from the digital arterial model CFD simulations. Although the present work is preliminary work, the experimental and digital models proves to be useful in providing flow parametric data of interest such as: (1) normal stress which is useful for predicting the magnitude of forces which could promote arterial rupture or dislodging of medical implants, (2) wall shear stress which is useful for analyzing the magnitude of drug transport at the arterial wall, (3) vorticity which is useful for predicting the magnitude of flow reversal, and (4) arterial compliance in the case of the experimental model which could be useful in the efforts of developing FSI numerical simulations that incorporates compliance which realistically models the flow in the arterial system.

Tissue Pulsatility Imaging of Cerebral Vasoreactivity during Hyperventilation

PubMed Central

Kucewicz, John C.; Dunmire, Barbrina; Giardino, Nicholas D.; Leotta, Daniel F.; Paun, Marla; Dager, Stephen R.; Beach, Kirk W.

2008-01-01

Tissue Pulsatility Imaging (TPI) is an ultrasonic technique that is being developed at the University of Washington to measure tissue displacement or strain due to blood flow over the cardiac and respiratory cycles. This technique is based in principle on plethysmography, an older non-ultrasound technology for measuring expansion of a whole limb or body part due to perfusion. TPI adapts tissue Doppler signal processing methods to measure the “plethysmographic” signal from hundreds or thousands of sample volumes in an ultrasound image plane. This paper presents a feasibility study to determine if TPI can be used to assess cerebral vasoreactivity. Ultrasound data were collected transcranially through the temporal acoustic window from four subjects before, during, and after voluntary hyperventilation. In each subject, decreases in tissue pulsatility during hyperventilation were observed that were statistically correlated with the subject’s end-tidal CO2 measurements. PMID:18336991

PLATELET ADHESION TO POLYURETHANE UREA UNDER PULSATILE FLOW CONDITIONS

PubMed Central

Navitsky, Michael A.; Taylor, Joshua O.; Smith, Alexander B.; Slattery, Margaret J.; Deutsch, Steven; Siedlecki, Christopher A.; Manning, Keefe B.

2014-01-01

Platelet adhesion to a polyurethane urea surface is a precursor to thrombus formation within blood-contacting cardiovascular devices, and platelets have been found to adhere strongly to polyurethane surfaces below a shear rate of approximately 500 s−1. The aim of the current work is to determine platelet adhesion properties to the polyurethane urea surface as a function of time varying shear exposure. A rotating disk system is used to study the influence of steady and pulsatile flow conditions (e.g. cardiac inflow and sawtooth waveforms) for platelet adhesion to the biomaterial surface. All experiments retain the same root mean square angular rotation velocity (29.63 rad/s) and waveform period. The disk is rotated in platelet rich bovine plasma for two hours with adhesion quantified by confocal microscopy measurements of immunofluorescently labeled bovine platelets. Platelet adhesion under pulsating flow is found to exponentially decay with increasing shear rate. Adhesion levels are found to depend upon peak platelet flux and shear rate regardless of rotational waveform. In combination with flow measurements, these results may be useful for predicting regions susceptible to thrombus formation within ventricular assist devices. PMID:24721222

A study of the pulsatile flow and its interaction with rectangular leaflets

NASA Astrophysics Data System (ADS)

Ledesma, Rene; Zenit, Roberto; Pulos, Guillermo

2009-11-01

To avoid the complexity and limited understanding of the 3D pulsatile flow field through heart valves, a cardiac-like flow circuit and a test channel were designed to study the behavior of bidimensional leaflets made of hyperelastic materials. We study a simple 2D arrangement to understand the basic physics of the flow-leaflet interaction. Creating a periodic pressure gradient, measurements of leaflet deflection were obtained for different flow conditions, geometries and materials. Using PIV and Phase Locking techniques, we have obtained the leaflet motion and the time-dependent flow velocity fields. The results show that two dimensionless parameters determine the performance of a simple bi-dimensional valve, in accordance with the flow conditions applied: π1=f(sw)^1/2(E/ρ)^1/2 and π2=V/(2slw), where f is the pulsation frequency, V is the stroke volume, s, w and l are the dimensions on the leaftlet and E and ρ are the elastic modulus and density of the material, respectively. Furthermore, we have identified the conditions for which the fluid stresses can be minimized. With these results we propose a new set of parameters to improve the performance of prosthetic heart valves and, in consequence, to reduce blood damage.

Blood Flow Modulation of Vascular Dynamics

PubMed Central

Lee, Juhyun; Sevag Packard, René R.; Hsiai, Tzung K.

2015-01-01

Purpose of review Blood flow is intimately linked with cardiovascular development, repair, and dysfunction. The current review will build on the fluid mechanical principle underlying hemodynamic shear forces, mechanotransduction, and metabolic effects. Recent findings Pulsatile flow produces both time- (∂τ /∂t)and spatial-varying shear stress (∂τ /∂x) to modulate vascular oxidative stress and inflammatory response with pathophysiological significance to atherosclerosis. The characteristics of hemodynamic shear forces; namely, steady laminar (∂τ /∂t= 0), pulsatile (PSS: unidirectional forward flow), and oscillatory shear stress (OSS: bidirectional with a near net 0 forward flow) modulate mechano-signal transduction to influence metabolic effects on vascular endothelial function. Atheroprotective PSS promotes anti-oxidant, anti-inflammatory, and anti-thrombotic responses, whereas atherogenic OSS induces NADPH oxidase–JNK signaling to increase mitochondrial superoxide production, protein degradation of manganese superoxide dismutase (MnSOD), and post-translational protein modifications of LDL particles in the disturbed flow-exposed regions of vasculature. In the era of tissue regeneration, shear stress has been implicated in re-activation of developmental genes; namely, Wnt and Notch signaling, for vascular development and repair. Summary Blood flow imparts a dynamic continuum from vascular development to repair. Augmentation of PSS confers atheroprotection and re-activation of developmental signaling pathways for regeneration. PMID:26218416

Fluid dynamic aspects of cardiovascular behavior during low-frequency whole-body vibration

NASA Technical Reports Server (NTRS)

Nerem, R. M.

1973-01-01

The behavior of the cardiovascular system during low frequency whole-body vibration, such as encountered by astronauts during launch and reentry, is examined from a fluid mechanical viewpoint. The vibration characteristics of typical manned spacecraft and other vibration environments are discussed, and existing results from in vivo studies of the hemodynamic aspects of this problem are reviewed. Recent theoretical solutions to related fluid mechanical problems are then used in the interpretation of these results and in discussing areas of future work. The results are included of studies of the effects of vibration on the work done by the heart and on pulsatile flow in blood vessels. It is shown that important changes in pulse velocity, the instantaneous velocity profile, mass flow rate, and wall shear stress may occur in a pulsatile flow due to the presence of vibration. The significance of this in terms of changes in peripheral vascular resistance and possible damage to the endothelium of blood vessels is discussed.

Quantitative photoacoustic assessment of red blood cell aggregation under pulsatile blood flow: experimental and theoretical approaches

NASA Astrophysics Data System (ADS)

Bok, Tae-Hoon; Hysi, Eno; Kolios, Michael C.

2017-03-01

In the present paper, the optical wavelength dependence on the photoacoustic (PA) assessment of the pulsatile blood flow was investigated by means of the experimental and theoretical approaches analyzing PA radiofrequency spectral parameters such as the spectral slope (SS) and mid-band fit (MBF). For the experimental approach, the pulsatile flow of human whole blood at 60 bpm was imaged using the VevoLAZR system (40-MHz-linear-array probe, 700-900 nm illuminations). For the theoretical approach, a Monte Carlo simulation for the light transmit into a layered tissue phantom and a Green's function based method for the PA wave generation was implemented for illumination wavelengths of 700, 750, 800, 850 and 900 nm. The SS and MBF for the experimental results were compared to theoretical ones as a function of the illumination wavelength. The MBF increased with the optical wavelength in both theory and experiments. This was expected because the MBF is representative of the PA magnitude, and the PA signal from red blood cell (RBC) is dependent on the molar extinction coefficient of oxyhemoglobin. On the other hand, the SS decreased with the wavelength, even though the RBC size (absorber size which is related to the SS) cannot depend on the illumination wavelength. This conflicting result can be interpreted by means of the changes of the fluence pattern for different illumination wavelengths. The SS decrease with the increasing illumination wavelength should be further investigated.

CFD and PIV Analysis of Hemodynamics in a Growing Intracranial Aneurysm

PubMed Central

Raschi, Marcelo; Mut, Fernando; Byrne, Greg; Putman, Christopher M.; Tateshima, Satoshi; Viñuela, Fernando; Tanoue, Tetsuya; Tanishita, Kazuo; Cebral, Juan R.

2011-01-01

Hemodynamics is thought to be a fundamental factor in the formation, progression and rupture of cerebral aneurysms. Understanding these mechanisms is important to improve their rupture risk assessment and treatment. In this study we analyze the blood flow field in a growing cerebral aneurysm using experimental particle image velocimetry (PIV) and computational fluid dynamics (CFD) techniques. Patient-specific models were constructed from longitudinal 3D computed tomography angiography (CTA) images acquired at one-year intervals. Physical silicone models were constructed from the CTA images using rapid prototyping techniques and pulsatile flow fields were measured with PIV. Corresponding CFD models were created and run under matching flow conditions. Both flow fields were aligned, interpolated, and compared qualitatively by inspection and quantitatively by defining similarity measures between the PIV and CFD vector fields. Results showed that both flow fields were in good agreement. Specifically, both techniques provided consistent representations of the main intra-aneurysmal flow structures, and their change during the geometric evolution of the aneurysm. Despite differences observed mainly in the near wall region and the inherent limitations of each technique, the information derived is consistent and can be used to study the role of hemodynamics in the natural history of intracranial aneurysms. PMID:22548127

The effects of non-Newtonian blood flow on curved stenotic coronary artery

NASA Astrophysics Data System (ADS)

Li, Shuang; Chin, Cheng; Monty, Jason; Barlis, Peter; Ooi, Andrew

2017-11-01

Direct numerical simulations (DNS) are carried out using both Newtonian and non-Newtonian viscosity models under a pulsatile physiological flow condition to study the influences of the non-Newtonian blood property on the flow fields in the idealised curved stenotic artery model. Quemada model is adopted to simulate the non-Newtonian blood in the simulations. Both time-averaged and selected instantaneous velocity, vorticity and pressure data are examined and the differences between the Newtonian and non-Newtonian flows are examined. The non-Newtonian simulations tend to have blunted axial velocity profile compared to the Newtonian cases. In the proximal of post-stenotic region, smaller recirculation bubbles are observed because of the non-Newtonian effects. Decreased secondary flow strengths are observed upstream of stenosis while higher magnitudes of secondary flows are found out downstream of stenosis. The deviation of mean cross-sectionally axial vorticity is minimal except at the peak systole, where an additional vortice appears near the centre of the 90 degrees plane that is more pronounced in the Newtonian case. The influence of blood-analog viscosity increases the mean pressure drops. However, lower instantaneous pressure losses at peak systole are observed in contrast to the Newtonian blood analog fluid.

Non-Newtonian blood flow dynamics in a right internal carotid artery with a saccular aneurysm

NASA Astrophysics Data System (ADS)

Valencia, Alvaro; Zarate, Alvaro; Galvez, Marcelo; Badilla, Lautaro

2006-02-01

Flow dynamics plays an important role in the pathogenesis and treatment of cerebral aneurysms. The temporal and spatial variations of wall shear stress in the aneurysm are hypothesized to be correlated with its growth and rupture. In addition, the assessment of the velocity field in the aneurysm dome and neck is important for the correct placement of endovascular coils. This work describes the flow dynamics in a patient-specific model of carotid artery with a saccular aneurysm under Newtonian and non-Newtonian fluid assumptions. The model was obtained from three-dimensional rotational angiography image data and blood flow dynamics was studied under physiologically representative waveform of inflow. The three-dimensional continuity and momentum equations for incompressible and unsteady laminar flow were solved with a commercial software using non-structured fine grid with 283 115 tetrahedral elements. The intra-aneurysmal flow shows complex vortex structure that change during one pulsatile cycle. The effect of the non-Newtonian properties of blood on the wall shear stress was important only in the arterial regions with high velocity gradients, on the aneurysmal wall the predictions with the Newtonian and non-Newtonian blood models were similar.

Pulsatile blood flow and oxygen transport past a circular cylinder.

PubMed

Zierenberg, Jennifer R; Fujioka, Hideki; Hirschl, Ronald B; Bartlett, Robert H; Grotberg, James B

2007-04-01

The fundamental study of blood flow past a circular cylinder filled with an oxygen source is investigated as a building block for an artificial lung. The Casson constitutive equation is used to describe the shear-thinning and yield stress properties of blood. The presence of hemoglobin is also considered. Far from the cylinder, a pulsatile blood flow in the x direction is prescribed, represented by a time periodic (sinusoidal) component superimposed on a steady velocity. The dimensionless parameters of interest for the characterization of the flow and transport are the steady Reynolds number (Re), Womersley parameter (alpha), pulsation amplitude (A), and the Schmidt number (Sc). The Hill equation is used to describe the saturation curve of hemoglobin with oxygen. Two different feed-gas mixtures were considered: pure O(2) and air. The flow and concentration fields were computed for Re=5, 10, and 40, 0< or =A< or =0.75, alpha=0.25, 0.4, and Schmidt number, Sc=1000. The Casson fluid properties result in reduced recirculations (when present) downstream of the cylinder as compared to a Newtonian fluid. These vortices oscillate in size and strength as A and alpha are varied. Hemoglobin enhances mass transport and is especially important for an air feed which is dominated by oxyhemoglobin dispersion near the cylinder. For a pure O(2) feed, oxygen transport in the plasma dominates near the cylinder. Maximum oxygen transport is achieved by operating near steady flow (small A) for both feed-gas mixtures. The time averaged Sherwood number, Sh, is found to be largely influenced by the steady Reynolds number, increasing as Re increases and decreasing with A. Little change is observed with varying alpha for the ranges investigated. The effect of pulsatility on Sh is greater at larger Re. Increasing Re aids transport, but yields a higher cylinder drag force and shear stresses on the cylinder surface which are potentially undesirable.

In-vitro model for evaluation of pulse oximetry

NASA Astrophysics Data System (ADS)

Vegfors, Magnus; Lindberg, Lars-Goeran; Lennmarken, Claes; Oberg, P. Ake

1991-06-01

An in vitro model with blood circulating in a silicon tubing system and including an artificial arterial bed is an important tool for evaluation of the pulse oximetry technique. The oxygen saturation was measured on an artificial finger using a pulse oximeter (SpO2) and on blood samples using a hemoximeter (SaO2). Measurements were performed at different blood flows and at different blood hematocrits. An increase in steady as well as in pulsatile blood flow was followed by an increase in pulse oximeter readings and a better agreement between SpO2 and SaO2 readings. After diluting the blood with normal saline (decreased hematocrit) the agreement was further improved. These results indicate that the pulse oximeter signal is related to blood hematocrit and the velocity of blood. The flow-related dependance of SpO2 was also evaluated in a human model. These results provided evidence that the pulse oximeter signal is dependent on vascular changes.

Abnormal arterial flows by a distributed model of the fetal circulation.

PubMed

van den Wijngaard, Jeroen P H M; Westerhof, Berend E; Faber, Dirk J; Ramsay, Margaret M; Westerhof, Nico; van Gemert, Martin J C

2006-11-01

Modeling the propagation of blood pressure and flow along the fetoplacental arterial tree may improve interpretation of abnormal flow velocity waveforms in fetuses. The current models, however, either do not include a wide range of gestational ages or do not account for variation in anatomical, vascular, or rheological parameters. We developed a mathematical model of the pulsating fetoumbilical arterial circulation using Womersley's oscillatory flow theory and viscoelastic arterial wall properties. Arterial flow waves are calculated at different arterial locations from which the pulsatility index (PI) can be determined. We varied blood viscosity, placental and brain resistances, placental compliance, heart rate, stiffness of the arterial wall, and length of the umbilical arteries. The PI increases in the umbilical artery and decreases in the cerebral arteries, as a result of increasing placental resistance or decreasing brain resistance. Both changes in resistance decrease the flow through the placenta. An increased arterial stiffness increases the PIs in the entire fetoplacental circulation. Blood viscosity and peripheral bed compliance have limited influence on the flow profiles. Bradycardia and tachycardia increase and decrease the PI in all arteries, respectively. Umbilical arterial length has limited influence on the PI but affects the mean arterial pressure at the placental cord insertion. The model may improve the interpretation of arterial flow pulsations and thus may advance both the understanding of pathophysiological processes and clinical management.

A durability study of a paracorporeal pulsatile electro-mechanical pneumatic biventricular assist device.

PubMed

Choi, Hyuk; Lee, Heung-Man; Nam, Kyoung Won; Choi, Jaesoon; Lee, Jung-Joo; Kim, Ho Chul; Song, Seung Joon; Ahn, Chi Bum; Son, Ho Sung; Lim, Choon Hak; Son, Kuk Hui; Park, Yong Doo; Jeong, Gi Seok; Sun, Kyung

2011-06-01

In 2002, the paracorporeal pulsatile electro-mechanical pneumatic ventricular assist device (VAD) began to be developed by the Korea Artificial Organ Center at Korea University under a Health & Medical Technology Research and Development program which finished in 2008. In vitro durability testing was conducted on the paracorporeal pulsatile pneumatic VAD to determine device durability and to evaluate device failures. The 1- and 2-year reliability of the paracorporeal pulsatile pneumatic VAD was shown to be 91.2% and 54.9%, respectively, with an 80% confidence level. Failure modes were analyzed using fault tree analysis, with customized software continuously acquiring data during the test period. After this period, 21 in vivo animal tests were done, with 14 cases of left atrium to left ventricle (LV) inflow cannulation (36Fr)/outflow grafting to descending aorta, and seven cases of apex cannulation of LV to descending aorta (12 mm). The longest postoperative day (182 days) in Korea was recently recorded in in vivo animal testing (bovine, 90 kg, male, 3.5-4.0 L/min flow rate, and 55 bpm). © 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Central Pulsatile Pressure and Flow Relationship in the Time and Frequency Domain to Characterise Hydraulic Input to the Brain and Cerebral Vascular Impedance.

PubMed

Kim, Mi Ok; O'Rourke, Michael F; Adji, Audrey; Avolio, Alberto P

2016-01-01

In the time domain, pulsatile flow and pressure can be characterised as the ratio of the late systolic boost of flow or pressure to the pulse amplitude so as to estimate the hydraulic input to the brain. While vascular impedance has been widely used to represent the load presented to the heart by the systemic circulation, it has not been applied to the cerebral circulation.We set out to study the relationship between the pressure and the flow augmentation index (AIx) in the time domain and to determine cerebral vascular impedance using aortic blood pressure and cerebral blood flow waveforms in the frequency domain. Twenty-four young subjects (aged 21-39 years) were recruited; aortic pressure was derived using SphygmoCor from radial pressure. Flow waveforms were recorded from the middle cerebral artery. In three subjects, we performed the Valsalva manoeuvre to investigate their response to physiological intervention. There was a linear relationship between flow and pressure AIx, and cerebral impedance values were similar to those estimated for low resistance vascular beds. Substantial change in pressure and flow wave contour was observed during the Valsalva manoeuvre; however, the relationship in both the time and the frequency domains were unchanged. This confirms that aortic pressure and cerebral flow waveform can be used to study cerebral impedance.

Ventricular flow dynamics with varying LVAD inflow cannula lengths: In-silico evaluation in a multiscale model.

PubMed

Liao, Sam; Neidlin, Michael; Li, Zhiyong; Simpson, Benjamin; Gregory, Shaun D

2018-04-27

Left ventricular assist devices are associated with thromboembolic events, which are potentially caused by altered intraventricular flow. Due to patient variability, differences in apical wall thickness affects cannula insertion lengths, potentially promoting unfavourable intraventricular flow patterns which are thought to be correlated to the risk of thrombosis. This study aimed to present a 3D multiscale computational fluid dynamic model of the left ventricle (LV) developed using a commercial software, Ansys, and evaluate the risk of thrombosis with varying inflow cannula insertion lengths in a severely dilated LV. Based on a HeartWare HVAD inflow cannula, insertion lengths of 5, 19, 24 and 50 mm represented cases of apical hypertrophy, typical ranges of apical thicknesses and an experimental length, respectively. The risk of thrombosis was evaluated based on blood washout, residence time, instantaneous blood stagnation and a pulsatility index. By introducing fresh blood to displace pre-existing blood in the LV, after 5 cardiac cycles, 46.7%, 45.7%, 45.1% and 41.8% of pre-existing blood remained for insertion lengths of 5, 19, 24 and 50 mm, respectively. Compared to the 50 mm insertion, blood residence time was at least 9%, 7% and 6% higher with the 5, 19 and 24 mm insertion lengths, respectively. No instantaneous stagnation at the apex was observed directly after the E-wave. Pulsatility indices adjacent to the cannula increased with shorter insertion lengths. For the specific scenario studied, a longer insertion length, relative to LV size, may be advantageous to minimise thrombosis by increasing LV washout and reducing blood residence time. Copyright © 2018 Elsevier Ltd. All rights reserved.

Modelling of subarachnoid space width changes in apnoea resulting as a function of blood flow parameters.

PubMed

Kalicka, Renata; Mazur, Kamila; Wolf, Jacek; Frydrychowski, Andrzej F; Narkiewicz, Krzysztof; Winklewski, Pawel J

2017-09-01

During apnoea, the pial artery is subjected to two opposite physiological processes: vasoconstriction due to elevated blood pressure and vasorelaxation driven by rising pH in the brain parenchyma. We hypothesized that the pial artery response to apnoea may vary, depending on which process dominate. Apnoea experiments were performed in a group of 19 healthy, non-smoking volunteers (9 men and 10 women). The following parameters were obtained for further analysis: blood pressure, the cardiac (from 0.5 to 5.0Hz) and slow (<0.5Hz) components of subarachnoid space width, heart rate, mean cerebral blood flow velocity in the internal carotid artery, pulsatility and resistivity index, internal carotid artery diameter, blood oxygen saturation and end-tidal carbon dioxide. The experiment consisted of three apnoeas, sequentially: 30s, 60s and maximal apnoea. The breath-hold was separated for 5minute rest. The control process is sophisticated, involving internal cross-couplings and cross-dependences. The aim of work was to find a mathematical dependence between data. Unexpectedly, the modelling revealed two different reactions, on the same experimental procedure. As a consequence, there are two subsets of cardiac subarachnoid space width responses to breath-hold in humans. A positive cardiac subarachnoid space width change to apnoea depends on changes in heart rate and cerebral blood flow velocity. A negative cardiac subarachnoid space width change to apnoea is driven by heart rate, mean arterial pressure and pulsatility index changes. The described above two different reactions to experimental breath-hold provides new insights into our understanding of the complex mechanisms governing the adaptation to apnoea in humans. We proposed a mathematical methodology that can be used in further clinical research. Copyright © 2017 Elsevier Inc. All rights reserved.

White matter hyperintensities in migraine: Clinical significance and central pulsatile hemodynamic correlates.

PubMed

Cheng, Chun-Yu; Cheng, Hao-Min; Chen, Shih-Pin; Chung, Chih-Ping; Lin, Yung-Yang; Hu, Han-Hwa; Chen, Chen-Huan; Wang, Shuu-Jiun

2018-06-01

Background The role of central pulsatile hemodynamics in the pathogenesis of white matter hyperintensities in migraine patients has not been clarified. Methods Sixty patients with migraine (20-50 years old; women, 68%) without overt vascular risk factors and 30 demographically-matched healthy controls were recruited prospectively. Cerebral white matter hyperintensities volume was determined by T1-weighted magnetic resonance imaging with CUBE-fluid-attenuated-inversion-recovery sequences. Central systolic blood pressure, carotid-femoral pulse wave velocity, and carotid augmentation index were measured by applanation tonometry. Carotid pulsatility index was derived from Doppler ultrasound carotid artery flow analysis. Results Compared to the controls, the migraine patients had higher white matter hyperintensities frequency (odds ratio, 2.75; p = 0.04) and greater mean white matter hyperintensities volume (0.174 vs. 0.049, cm 3 , p = 0.04). Multivariable regression analysis showed that white matter hyperintensities volume in migraine patients was positively associated with central systolic blood pressure ( p = 0.04) and carotid-femoral pulse wave velocity ( p < 0.001), but negatively associated with carotid pulsatility index ( p = 0.04) after controlling for potential confounding factors. The interaction effects observed indicated that the influence of carotid-femoral pulse wave velocity ( p = 0.004) and central systolic blood pressure ( p = 0.03) on white matter hyperintensities formation was greater for the lower-carotid pulsatility index subgroup of migraine patients. White matter hyperintensities volume in migraine patients increased with decreasing carotid pulsatility index and with increasing central systolic blood pressure or carotid-femoral pulse wave velocity. Conclusions White matter hyperintensities are more common in patients with migraine than in healthy controls. Increased aortic stiffness or central systolic blood pressure in the presence of low intracranial artery resistance may predispose patients with migraine to white matter hyperintensities formation.

Device Management and Flow Optimization on Left Ventricular Assist Device Support.

PubMed

Tchoukina, Inna; Smallfield, Melissa C; Shah, Keyur B

2018-07-01

The authors discuss principles of continuous flow left ventricular assist device (LVAD) operation, basic differences between the axial and centrifugal flow designs and hemodynamic performance, normal LVAD physiology, and device interaction with the heart. Systematic interpretation of LVAD parameters and recognition of abnormal patterns of flow and pulsatility on the device interrogation are necessary for clinical assessment of the patient. Optimization of pump flow using LVAD parameters and echocardiographic and hemodynamics guidance are reviewed. Copyright © 2018 Elsevier Inc. All rights reserved.

Numerical study of magnetohydrodynamic pulsatile flow of Sutterby fluid through an inclined overlapping arterial stenosis in the presence of periodic body acceleration

NASA Astrophysics Data System (ADS)

Abbas, Z.; Shabbir, M. S.; Ali, N.

2018-06-01

In the present theoretical investigation, we have numerically simulated the problem of blood flow through an overlapping stenosed arterial blood vessel under the action of externally applied body acceleration and the periodic pressure gradient. The rheology of blood is characterized by the Sutterby fluid model. The blood is considered as an electrically conducting fluid. A steady uniform magnetic field is applied in the radial direction of the blood vessel. The governing nonlinear partial differential equations of the present flow together with prescribed boundary conditions are solved by employing explicit finite difference scheme. Results concerning the temporal distribution of velocity, flow rate, shear stress and resistance to the flow are displayed through graphs. The effects of various emerging parameters on the flow variables are analyzed and discussed in detail. The analysis reveals that the applied magnetic field and periodic body acceleration have considerable effects on the flow field.

Carotid flow pulsatility is higher in women with greater decrement in gait speed during multi-tasking.

PubMed

Gonzales, Joaquin U; James, C Roger; Yang, Hyung Suk; Jensen, Daniel; Atkins, Lee; Al-Khalil, Kareem; O'Boyle, Michael

2017-05-01

Central arterial hemodynamics is associated with cognitive impairment. Reductions in gait speed during walking while performing concurrent tasks known as dual-tasking (DT) or multi-tasking (MT) is thought to reflect the cognitive cost that exceeds neural capacity to share resources. We hypothesized that central vascular function would associate with decrements in gait speed during DT or MT. Gait speed was measured using a motion capture system in 56 women (30-80y) without mild-cognitive impairment. Dual-tasking was considered walking at a fast-pace while balancing a tray. Multi-tasking was the DT condition plus subtracting by serial 7's. Applanation tonometry was used for measurement of aortic stiffness and central pulse pressure. Doppler-ultrasound was used to measure blood flow velocity and β-stiffness index in the common carotid artery. The percent change in gait speed was larger for MT than DT (14.1±11.2 vs. 8.7±9.6%, p <0.01). Tertiles were formed based on the percent change in gait speed for each condition. No vascular parameters differed across tertiles for DT. In contrast, carotid flow pulsatility (1.85±0.43 vs. 1.47±0.42, p=0.02) and resistance (0.75±0.07 vs. 0.68±0.07, p=0.01) indices were higher in women with more decrement (third tertile) as compared to women with less decrement (first tertile) in gait speed during MT after adjusting for age, gait speed, and task error. Carotid pulse pressure and β-stiffness did not contribute to these tertile differences. Elevated carotid flow pulsatility and resistance are characteristics found in healthy women that show lower cognitive capacity to walk and perform multiple concurrent tasks. Copyright © 2017 Elsevier B.V. All rights reserved.

Flow pumping system for physiological waveforms.

PubMed

Tsai, William; Savaş, Omer

2010-02-01

A pulsatile flow pumping system is developed to replicate flow waveforms with reasonable accuracy for experiments simulating physiological blood flows at numerous points in the body. The system divides the task of flow waveform generation between two pumps: a gear pump generates the mean component and a piston pump generates the oscillatory component. The system is driven by two programmable servo controllers. The frequency response of the system is used to characterize its operation. The system has been successfully tested in vascular flow experiments where sinusoidal, carotid, and coronary flow waveforms are replicated.

Pulsatile delivery of a leucine supplement during long-term continuous enteral feeding enhances lean growth in term neonatal pigs

USDA-ARS?s Scientific Manuscript database

Neonatal pigs are used as a model to study and optimize the clinical treatment of infants who are unable to maintain oral feeding. Using this model, we have previously shown that pulsatile administration of leucine during continuous feeding over 24 h via orogastric tube enhanced protein synthesis in...

Flow Visualization of Three-Dimensionality Inside the 12 cc Penn State Pulsatile Pediatric Ventricular Assist Device

PubMed Central

Roszelle, Breigh N.; Deutsch, Steven; Manning, Keefe B.

2010-01-01

In order to aid the ongoing concern of limited organ availability for pediatric heart transplants, Penn State has continued development of a pulsatile Pediatric Ventricular Assist Device (PVAD). Initial studies of the PVAD observed an increase in thrombus formation due to differences in flow field physics when compared to adult sized devices, which included a higher degree of three-dimensionality. This unique flow field brings into question the use of 2D planar particle image velocimetry (PIV) as a flow visualization technique, however the small size and high curvature of the PVAD make other tools such as stereoscopic PIV impractical. In order to test the reliability of the 2D results, we perform a pseudo-3D PIV study using planes both parallel and normal to the diaphragm employing a mock circulatory loop containing a viscoelastic fluid that mimics 40% hematocrit blood. We find that while the third component of velocity is extremely helpful to a physical understanding of the flow, particularly of the diastolic jet and the development of a desired rotational pattern, the flow data taken parallel to the diaphragm is sufficient to describe the wall shear rates, a critical aspect to the study of thrombosis and design of such pumps. PMID:19936926

Pulsatile Flow and Transport of Blood past a Cylinder: Basic Transport for an Artificial Lung.

NASA Astrophysics Data System (ADS)

Zierenberg, Jennifer R.

2005-11-01

The fluid mechanics and transport for flow of blood past a single cylinder is investigated using CFD. This work refers to an artificial lung in which oxygen travels through fibers oriented perpendicularly to the incoming blood flow. A pulsatile blood flow was considered: Ux=U0[ 1+A( φt ) ], where Ux is the velocity far from the cylinder. The Casson equation was used to describe the shear thinning and yield stress properties of blood. The presence of hemoglobin (i.e. facilitated diffusion) was considered. We examined the effect of A, U0 and φ on the flow and transport by varying the dimensionless parameters: A; Reynolds number, Re; and Womersley parameter, α. Two different feed gases were considered: pure O2 and air. The flow and concentration fields were computed for Re = 5, 10, and 40, 0 <=A<= 0.75, α = 0.25, 0.4, and Schmidt number, Sc = 1000. Vortices attached downstream of the cylinder are found to oscillate in size and strength as α and A are varied. Mass transport is found to primarily depend on Re and to increase with increasing Re, α and decreasing A. The presence of hemoglobin increases mass transport. Supported by NIH HL69420, NSF Fellowship

Acetazolamide-induced vasodilation does not inhibit the visually evoked flow response

PubMed Central

Yonai, Yaniv; Boms, Neta; Molnar, Sandor; Rosengarten, Bernhard; Bornstein, Natan M; Csiba, Laszlo; Olah, Laszlo

2010-01-01

Different methods are used to assess the vasodilator ability of cerebral blood vessels; however, the exact mechanism of cerebral vasodilation, induced by different stimuli, is not entirely known. Our aim was to investigate whether the potent vasodilator agent, acetazolamide (AZ), inhibits the neurovascular coupling, which also requires vasodilation. Therefore, visually evoked flow parameters were examined by transcranial Doppler in ten healthy subjects before and after AZ administration. Pulsatility index and peak systolic flow velocity changes, evoked by visual stimulus, were recorded in the posterior cerebral arteries before and after intravenous administration of 15 mg/kg AZ. Repeated-measures ANOVA did not show significant group main effect between the visually evoked relative flow velocity time courses before and after AZ provocation (P=0.43). Visual stimulation induced significant increase of relative flow velocity and decrease of pulsatility index not only before but also at the maximal effect of AZ. These results suggest that maximal cerebral vasodilation cannot be determined by the clinically accepted dose of AZ (15 mg/kg) and prove that neurovascular coupling remains preserved despite AZ-induced vasodilation. Our observation indicates independent regulation of vasodilation during neurovascular coupling, allowing the adaptation of cerebral blood flow according to neuronal activity even if other processes require significant vasodilation. PMID:19809468

On the stability of lung parenchymal lesions with applications to early pneumothorax diagnosis.

PubMed

Bhandarkar, Archis R; Banerjee, Rohan; Seshaiyer, Padmanabhan

2013-01-01

Spontaneous pneumothorax, a prevalent medical challenge in most trauma cases, is a form of sudden lung collapse closely associated with risk factors such as lung cancer and emphysema. Our work seeks to explore and quantify the currently unknown pathological factors underlying lesion rupture in pneumothorax through biomechanical modeling. We hypothesized that lesion instability is closely associated with elastodynamic strain of the pleural membrane from pulsatile air flow and collagen-elastin dynamics. Based on the principles of continuum mechanics and fluid-structure interaction, our proposed model coupled isotropic tissue deformation with pressure from pulsatile air motion and the pleural fluid. Next, we derived mathematical instability criteria for our ordinary differential equation system and then translated these mathematical instabilities to physically relevant structural instabilities via the incorporation of a finite energy limiter. The introduction of novel biomechanical descriptions for collagen-elastin dynamics allowed us to demonstrate that changes in the protein structure can lead to a transition from stable to unstable domains in the material parameter space for a general lesion. This result allowed us to create a novel streamlined algorithm for detecting material instabilities in transient lung CT scan data via analyzing deformations in a local tissue boundary.

Closing in on the Mechanisms of Pulsatile Insulin Secretion.

PubMed

Bertram, Richard; Satin, Leslie S; Sherman, Arthur S

2018-03-01

Insulin secretion from pancreatic islet β-cells occurs in a pulsatile fashion, with a typical period of ∼5 min. The basis of this pulsatility in mouse islets has been investigated for more than four decades, and the various theories have been described as either qualitative or mathematical models. In many cases the models differ in their mechanisms for rhythmogenesis, as well as other less important details. In this Perspective, we describe two main classes of models: those in which oscillations in the intracellular Ca 2+ concentration drive oscillations in metabolism, and those in which intrinsic metabolic oscillations drive oscillations in Ca 2+ concentration and electrical activity. We then discuss nine canonical experimental findings that provide key insights into the mechanism of islet oscillations and list the models that can account for each finding. Finally, we describe a new model that integrates features from multiple earlier models and is thus called the Integrated Oscillator Model. In this model, intracellular Ca 2+ acts on the glycolytic pathway in the generation of oscillations, and it is thus a hybrid of the two main classes of models. It alone among models proposed to date can explain all nine key experimental findings, and it serves as a good starting point for future studies of pulsatile insulin secretion from human islets. © 2018 by the American Diabetes Association.

Correlation between plasma pentosidine concentrations and retinal hemodynamics in patients with type 2 diabetes.

PubMed

Sato, Eiichi; Nagaoka, Taiji; Yokota, Harumasa; Takahashi, Atsushi; Yoshida, Akitoshi

2012-05-01

To investigate whether plasma pentosidine, a well-defined advanced glycation end product, is associated with retinal hemodynamic abnormalities in patients with type 2 diabetes. Prospective cross-sectional study. Forty-two eyes with type 2 diabetes mellitus were evaluated. The type 2 diabetic eyes were divided into 2 groups: 22 eyes (22 patients; mean age, 61 years) with nondiabetic retinopathy (NDR) and 20 eyes (20 patients; mean age, 61 years) with mild nonproliferative diabetic retinopathy (NPDR). We used a retinal laser Doppler system to measure the arterial diameter, velocity, and blood flow in the major temporal retinal arteries. The pulsatility ratio, a resistive index expressed as the peak systolic to the end diastolic velocity ratio, was calculated from the blood velocity traces. Plasma pentosidine was measured in 42 patients with diabetes using a commercially available competitive enzyme-linked immunosorbent assay. The pulsatility ratio significantly increased in patients with NPDR (4.8 ± 1.5) compared with patients with NDR (3.7 ± 0.8) (P = .0061). No differences in velocity, diameter, or blood flow were seen between the 2 groups. Plasma pentosidine levels also increased significantly (P = .0085) in patients with NPDR (0.057 ± 0.015) compared to patients with NDR (0.047 ± 0.012). The pulsatility ratio was correlated positively with the plasma pentosidine levels in patients with NPDR (Pearson correlation, r = 0.45, P = .044). Multiple regression analysis showed that the plasma pentosidine level was significantly associated with the pulsatility ratio (standardized coefficient, 0.62; P = .009). The vascular rigidity of the retinal arteries may increase with increasing plasma pentosidine in patients with type 2 diabetes with retinopathy. Copyright © 2012 Elsevier Inc. All rights reserved.

Mechanical Circulatory Support for Advanced Heart Failure: Are We about to Witness a New "Gold Standard"?

PubMed

Capoccia, Massimo

2016-12-12

The impact of left ventricular assist devices (LVADs) for the treatment of advanced heart failure has played a significant role as a bridge to transplant and more recently as a long-term solution for non-eligible candidates. Continuous flow left ventricular assist devices (CF-LVADs), based on axial and centrifugal design, are currently the most popular devices in view of their smaller size, increased reliability and higher durability compared to pulsatile flow left ventricular assist devices (PF-LVADs). The trend towards their use is increasing. Therefore, it has become mandatory to understand the physics and the mathematics behind their mode of operation for appropriate device selection and simulation set up. For this purpose, this review covers some of these aspects. Although very successful and technologically advanced, they have been associated with complications such as pump thrombosis, haemolysis, aortic regurgitation, gastro-intestinal bleeding and arterio-venous malformations. There is perception that the reduced arterial pulsatility may be responsible for these complications. A flow modulation control approach is currently being investigated in order to generate pulsatility in rotary blood pumps. Thrombus formation remains the most feared complication that can affect clinical outcome. The development of a preoperative strategy aimed at the reduction of complications and patient-device suitability may be appropriate. Patient-specific modelling based on 3D reconstruction from CT-scan combined with computational fluid dynamic studies is an attractive solution in order to identify potential areas of stagnation or challenging anatomy that could be addressed to achieve the desired outcome. The HeartMate II (axial) and the HeartWare HVAD (centrifugal) rotary blood pumps have been now used worldwide with proven outcome. The HeartMate III (centrifugal) is now emerging as the new promising device with encouraging preliminary results. There are now enough pumps on the market: it is time to focus on the complications in order to achieve the full potential and selling-point of this type of technology for the treatment of the increasing heart failure patient population.

Development of a pump flow estimator for rotary blood pumps to enhance monitoring of ventricular function.

PubMed

Granegger, Marcus; Moscato, Francesco; Casas, Fernando; Wieselthaler, Georg; Schima, Heinrich

2012-08-01

Estimation of instantaneous flow in rotary blood pumps (RBPs) is important for monitoring the interaction between heart and pump and eventually the ventricular function. Our group has reported an algorithm to derive ventricular contractility based on the maximum time derivative (dQ/dt(max) as a substitute for ventricular dP/dt(max) ) and pulsatility of measured flow signals. However, in RBPs used clinically, flow is estimated with a bandwidth too low to determine dQ/dt(max) in the case of improving heart function. The aim of this study was to develop a flow estimator for a centrifugal pump with bandwidth sufficient to provide noninvasive cardiac diagnostics. The new estimator is based on both static and dynamic properties of the brushless DC motor. An in vitro setup was employed to identify the performance of pump and motor up to 20 Hz. The algorithm was validated using physiological ventricular and arterial pressure waveforms in a mock loop which simulated different contractilities (dP/dt(max) 600 to 2300 mm Hg/s), pump speeds (2 to 4 krpm), and fluid viscosities (2 to 4 mPa·s). The mathematically estimated pump flow data were then compared to the datasets measured in the mock loop for different variable combinations (flow ranging from 2.5 to 7 L/min, pulsatility from 3.5 to 6 L/min, dQ/dt(max) from 15 to 60 L/min/s). Transfer function analysis showed that the developed algorithm could estimate the flow waveform with a bandwidth up to 15 Hz (±2 dB). The mean difference between the estimated and measured average flows was +0.06 ± 0.31 L/min and for the flow pulsatilities -0.27 ± 0.2 L/min. Detection of dQ/dt(max) was possible up to a dP/dt(max) level of 2300 mm Hg/s. In conclusion, a flow estimator with sufficient frequency bandwidth and accuracy to allow determination of changes in ventricular contractility even in the case of improving heart function was developed. © 2012, Copyright the Authors. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

3D MR flow analysis in realistic rapid-prototyping model systems of the thoracic aorta: comparison with in vivo data and computational fluid dynamics in identical vessel geometries.

PubMed

Canstein, C; Cachot, P; Faust, A; Stalder, A F; Bock, J; Frydrychowicz, A; Küffer, J; Hennig, J; Markl, M

2008-03-01

The knowledge of local vascular anatomy and function in the human body is of high interest for the diagnosis and treatment of cardiovascular disease. A comprehensive analysis of the hemodynamics in the thoracic aorta is presented based on the integration of flow-sensitive 4D MRI with state-of-the-art rapid prototyping technology and computational fluid dynamics (CFD). Rapid prototyping was used to transform aortic geometries as measured by contrast-enhanced MR angiography into realistic vascular models with large anatomical coverage. Integration into a flow circuit with patient-specific pulsatile in-flow conditions and application of flow-sensitive 4D MRI permitted detailed analysis of local and global 3D flow dynamics in a realistic vascular geometry. Visualization of characteristic 3D flow patterns and quantitative comparisons of the in vitro experiments with in vivo data and CFD simulations in identical vascular geometries were performed to evaluate the accuracy of vascular model systems. The results indicate the potential of such patient-specific model systems for detailed experimental simulation of realistic vascular hemodynamics. Further studies are warranted to examine the influence of refined boundary conditions of the human circulatory system such as fluid-wall interaction and their effect on normal and pathological blood flow characteristics associated with vascular geometry. (c) 2008 Wiley-Liss, Inc.

Maintenance of pulmonary vasculature tone by blood derived from the inferior vena cava in a rabbit model of cavopulmonary shunt.

PubMed

Ikai, Akio; Shirai, Mikiyasu; Nishimura, Kazunobu; Ikeda, Tadashi; Kameyama, Takayuki; Ueyama, Koji; Komeda, Masashi

2005-01-01

After cavopulmonary shunt in which the superior vena cava is anastomosed to the right pulmonary artery, the right lung is in a unique condition without flow pulsatility and hepatic venous effluent. In a previous study, we reported that hypoxic pulmonary vasoconstriction disappeared in the pulmonary circulation after cavopulmonary shunt. In this study, however, to investigate the influence of pulsatility and hepatic venous effluent on hypoxic pulmonary vasoconstriction in the pulmonary circulation, we developed an alternative cavopulmonary shunt rabbit model that included hepatic venous effluent in the pulmonary circulation and reduced the pulsatility of the pulmonary arterial blood flow. We then observed the physiologic characteristics of the peripheral pulmonary artery after cavopulmonary shunt, specifically the disappearance of hypoxic pulmonary vasoconstriction. Sixteen Japanese white rabbits (12-16 weeks old) were used in this study. With general anesthesia, a cavopulmonary shunt was established by anastomosing the right superior vena cava to the right pulmonary artery in an end-to-side fashion. Of the 16 rabbits for the study, the proximal right pulmonary artery was completely ligated in 5 (atresia group) and partially ligated in 6 (stenosis group). Sham operation was performed in the remaining 5 rabbits. Two weeks later, we analyzed the response of the pulmonary artery (which was divided into three categories: segmental, lobular, and acinar level artery) to hypoxia (8% oxygen inhalation) with a specially designed video radiographic system. Morphometric analysis of the resistance pulmonary artery was done in each group after angiography. Mean pressure and pulse pressure in the right pulmonary artery were not significantly different between the atresia and stenosis groups. The mean pulmonary artery pressures in the atresia and stenosis groups were 8 and 11 mm Hg, respectively. However, the pulse pressure was less than 2 mm Hg in both groups. The baseline internal diameter of the resistance pulmonary artery of the atresia group was significantly different from those of the stenosis and sham groups. In the atresia group, the resistance pulmonary arteries did not respond to hypoxia. In contrast, significant constriction (as assessed by percentage change of internal diameter of the resistance pulmonary arteries in the acinar and lobular level arteries) was observed in the pulmonary arteries of the sham and stenosis groups (atresia vs stenosis vs sham 0.4% vs - 19.0% vs - 18.8%, P = .01). In our morphometric study, we observed vasodilation of the resistance pulmonary artery with a thinner medial layer in the atresia group, consistent with the result of microangiography. We developed a cavopulmonary shunt rabbit model in which the inferior vena caval blood was derived from the right ventricle. Hypoxic pulmonary vasoconstriction was maintained in the model with the blood flow from the right ventricle. When the blood flow was not maintained, however, hypoxic pulmonary vasoconstriction disappeared. This phenomenon strongly suggests that a substance in hepatic venous effluent partially regulates the physiological pulmonary vascular function in the rabbit lung.

Comparison of valvular resistance, stroke work loss, and Gorlin valve area for quantification of aortic stenosis. An in vitro study in a pulsatile aortic flow model.

PubMed

Voelker, W; Reul, H; Nienhaus, G; Stelzer, T; Schmitz, B; Steegers, A; Karsch, K R

1995-02-15

Valvular resistance and stroke work loss have been proposed as alternative measures of stenotic valvular lesions that may be less flow dependent and, thus, superior over valve area calculations for the quantification of aortic stenosis. The present in vitro study was designed to compare the impacts of valvular resistance, stroke work loss, and Gorlin valve area as hemodynamic indexes of aortic stenosis. In a pulsatile aortic flow model, rigid stenotic orifices in varying sizes (0.5, 1.0, 1.5 and 2.0 cm2) and geometry were studied under different hemodynamic conditions. Ventricular and aortic pressures were measured to determine the mean systolic ventricular pressure (LVSPm) and the transstenotic pressure gradient (delta Pm). Transvalvular flow (Fm) was assessed with an electromagnetic flowmeter. Valvular resistance [VR = 1333.(delta Pm/Fm)] and stroke work loss [SWL = 100.(delta Pm/LVSPm)] were calculated and compared with aortic valve area [AVA = Fm/(50 square root of delta Pm)]. The measurements were performed for a large range of transvalvular flows. At low-flow states, flow augmentation (100-->200 mL/s) increased calculated valvular resistance between 21% (2.0 cm2 orifice) and 66% (0.5-cm2 orifice). Stroke work loss demonstrated an increase from 43% (2.0 cm2) to 100% (1.0 cm2). In contrast, Gorlin valve area revealed only a moderate change from 29% (2.0 cm2) to 5% (0.5 cm2). At physiological flow rates, increase in transvalvular flow (200-->300 mL/s) did not alter calculated Gorlin valve area, whereas valvular resistance and stroke work loss demonstrated a continuing increase. Our experimental results were adopted to interpret the results of three clinical studies in aortic stenosis. The flow-dependent increase of Gorlin valve area, which was found in the cited clinical studies, can be elucidated as true further opening of the stenotic valve but not as a calculation error due to the Gorlin formula. Within the physiological range of flow, calculated aortic valve area was less dependent on hemodynamic conditions than were valvular resistance and stroke work loss, which varied as a function of flow. Thus, for the assessment of the severity of aortic stenosis, the Gorlin valve area is superior over valvular resistance and stroke work loss, which must be indexed for flow to adequately quantify the hemodynamic severity of the obstruction.

Influence of infusion pump operation and flow rate on hemodynamic stability during epinephrine infusion.

PubMed

Klem, S A; Farrington, J M; Leff, R D

1993-08-01

To determine whether variations in the flow rate of epinephrine solutions administered via commonly available infusion pumps lead to significant variations in blood pressure (BP) in vivo. Prospective, randomized, crossover study with factorial design, using infusion pumps with four different operating mechanisms (pulsatile diaphragm, linear piston/syringe, cyclic piston-valve, and linear peristaltic) and three drug delivery rates (1, 5, and 10 mL/hr). Two healthy, mixed-breed dogs (12 to 16 kg). Dogs were made hypotensive with methohexital bolus and continuous infusion. BP was restored to normal with constant-dose epinephrine infusion via two pumps at each rate. Femoral mean arterial pressure (MAP) was recorded every 10 secs. Pump-flow continuity was quantitated in vitro using a digital gravimetric technique. Variations in MAP and flow continuity were expressed by the coefficient of variation; analysis of variance was used for comparisons. The mean coefficients of variations for MAP varied from 3.8 +/- 3.1% (linear piston/syringe) to 6.1 +/- 6.6% (linear peristaltic), and from 3.4 +/- 2.2% (10 mL/hr) to 7.9 +/- 6.6% (1 mL/hr). The coefficients of variation for in vitro flow continuity ranged from 9 +/- 8% (linear piston-syringe) to 250 +/- 162% (pulsatile diaphragm), and from 35 +/- 44% (10 mL/hr) to 138 +/- 196% (1 mL/hr). Both the type of pump and infusion rate significantly (p < .001) influenced variation in drug delivery rate. The 1 mL/hr infusion rate significantly (p < .01) influenced MAP variation. Cyclic fluctuations in MAP of < or = 30 mm Hg were observed using the pulsatile diaphragm pump at 1 mL/hr. Factors inherent in the operating mechanisms of infusion pumps may result in clinically important hemodynamic fluctuations when administering a concentrated short-acting vasoactive medication at slow infusion rates.

Spiral blood flow in aorta-renal bifurcation models.

PubMed

Javadzadegan, Ashkan; Simmons, Anne; Barber, Tracie

2016-01-01

The presence of a spiral arterial blood flow pattern in humans has been widely accepted. It is believed that this spiral component of the blood flow alters arterial haemodynamics in both positive and negative ways. The purpose of this study was to determine the effect of spiral flow on haemodynamic changes in aorta-renal bifurcations. In this regard, a computational fluid dynamics analysis of pulsatile blood flow was performed in two idealised models of aorta-renal bifurcations with and without flow diverter. The results show that the spirality effect causes a substantial variation in blood velocity distribution, while causing only slight changes in fluid shear stress patterns. The dominant observed effect of spiral flow is on turbulent kinetic energy and flow recirculation zones. As spiral flow intensity increases, the rate of turbulent kinetic energy production decreases, reducing the region of potential damage to red blood cells and endothelial cells. Furthermore, the recirculation zones which form on the cranial sides of the aorta and renal artery shrink in size in the presence of spirality effect; this may lower the rate of atherosclerosis development and progression in the aorta-renal bifurcation. These results indicate that the spiral nature of blood flow has atheroprotective effects in renal arteries and should be taken into consideration in analyses of the aorta and renal arteries.

Hemodynamic response to exercise and head-up tilt of patients implanted with a rotary blood pump: a computational modeling study.

PubMed

Lim, Einly; Salamonsen, Robert Francis; Mansouri, Mahdi; Gaddum, Nicholas; Mason, David Glen; Timms, Daniel L; Stevens, Michael Charles; Fraser, John; Akmeliawati, Rini; Lovell, Nigel Hamilton

2015-02-01

The present study investigates the response of implantable rotary blood pump (IRBP)-assisted patients to exercise and head-up tilt (HUT), as well as the effect of alterations in the model parameter values on this response, using validated numerical models. Furthermore, we comparatively evaluate the performance of a number of previously proposed physiologically responsive controllers, including constant speed, constant flow pulsatility index (PI), constant average pressure difference between the aorta and the left atrium, constant average differential pump pressure, constant ratio between mean pump flow and pump flow pulsatility (ratioP I or linear Starling-like control), as well as constant left atrial pressure ( P l a ¯ ) control, with regard to their ability to increase cardiac output during exercise while maintaining circulatory stability upon HUT. Although native cardiac output increases automatically during exercise, increasing pump speed was able to further improve total cardiac output and reduce elevated filling pressures. At the same time, reduced venous return associated with upright posture was not shown to induce left ventricular (LV) suction. Although P l a ¯ control outperformed other control modes in its ability to increase cardiac output during exercise, it caused a fall in the mean arterial pressure upon HUT, which may cause postural hypotension or patient discomfort. To the contrary, maintaining constant average pressure difference between the aorta and the left atrium demonstrated superior performance in both exercise and HUT scenarios. Due to their strong dependence on the pump operating point, PI and ratioPI control performed poorly during exercise and HUT. Our simulation results also highlighted the importance of the baroreflex mechanism in determining the response of the IRBP-assisted patients to exercise and postural changes, where desensitized reflex response attenuated the percentage increase in cardiac output during exercise and substantially reduced the arterial pressure upon HUT. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Study of endothelial cell apoptosis using fluorescence resonance energy transfer (FRET) biosensor cell line with hemodynamic microfluidic chip system.

PubMed

Yu, J Q; Liu, X F; Chin, L K; Liu, A Q; Luo, K Q

2013-07-21

To better understand how hyperglycemia induces endothelial cell dysfunction under the diabetic conditions, a hemodynamic microfluidic chip system was developed. The system combines a caspase-3-based fluorescence resonance energy transfer (FRET) biosensor cell line which can detect endothelial cell apoptosis in real-time, post-treatment effect and with a limited cell sample, by using a microfluidic chip which can mimic the physiological pulsatile flow profile in the blood vessel. The caspase-3-based FRET biosensor endothelial cell line (HUVEC-C3) can produce a FRET-based sensor protein capable of probing caspase-3 activation. When the endothelial cells undergo apoptosis, the color of the sensor cells changes from green to blue, thus sensing apoptosis. A double-labeling fluorescent technique (yo pro-1 and propidium iodide) was used to validate the findings revealed by the FRET-based caspase sensor. The results show high rates of apoptosis and necrosis of endothelial cells when high glucose concentration was applied in our hemodynamic microfluidic chip combined with an exhaustive pulsatile flow profile. The two apoptosis detection techniques (fluorescent method and FRET biosensor) are comparable; but FRET biosensor offers more advantages such as real-time observation and a convenient operating process to generate more accurate and reliable data. Furthermore, the activation of the FRET biosensor also confirms the endothelial cell apoptosis induced by the abnormal pulsatile shear stress and high glucose concentration is through caspase-3 pathway. A 12% apoptotic rate (nearly a 4-fold increase compared to the static condition) was observed when the endothelial cells were exposed to a high glucose concentration of 20 mM under 2 h exhaustive pulsatile shear stress of 30 dyne cm(-2) and followed with another 10 h normal pulsatile shear stress of 15 dyne cm(-2). Therefore, the most important finding of this study is to develop a novel endothelial cell apoptosis detection method, which combines the microfluidic chip system and FRET biosensor. This finding may provide new insight into how glucose causes endothelial cell dysfunction, which is the major cause of diabetes-derived complications.

Videodermoscopy and doppler-ultrasound in spider naevi: towards a new classification?

PubMed

Alegre-Sánchez, A; Bernárdez, C; Fonda-Pascual, P; Moreno-Arrones, O M; López-Gutiérrez, J C; Jaén-Olasolo, P; Boixeda, P

2018-01-01

Spider naevi (SN) are considered a subtype of telangiectasias, currently classified as low-flow vascular malformations. To describe the videodermoscopy and Doppler-ultrasound (US) features of a large group of SN. A retrospective study of cases of SN collected at our Dermatology department during the period between June 2015 and June 2017 was performed. Clinical images, dermoscopic, videodermoscopic and Doppler-US files were reviewed. For each case, the age of the patient, time since onset, size and dermoscopic pattern of the lesions were recorded. The presence of pulsatility was also evaluated visually on the videodermoscopy. Two hundred and thirty-three SN in 189 patients were included. The mean age was 39.5 years (range: 10-76 years). Mean size of the lesions was 4.1 ± 2.0 mm. We described three dermoscopic patterns: network, star and looping. Older age, longer time since onset and larger size were found associated with higher frequency of the looping and star patterns compared to that of network pattern (P < 0.01). Pulsatility during videodermoscopy was found in 88 patients (37%). This pulsatility phenomenon was more commonly associated with the looping pattern (64.7%) than star- (40.3%) or network-like patterns (29.9%) (P < 0.001). In Doppler-US studies, a high-flow with arterial biphasic waveform was found. In the light of the results, we support that SN could be reconsidered in upcoming classifications as lesions closer to the group of high-flow arteriovenous malformations. © 2017 European Academy of Dermatology and Venereology.

Glucose Oscillations Can Activate an Endogenous Oscillator in Pancreatic Islets

PubMed Central

Mukhitov, Nikita; Roper, Michael G.; Bertram, Richard

2016-01-01

Pancreatic islets manage elevations in blood glucose level by secreting insulin into the bloodstream in a pulsatile manner. Pulsatile insulin secretion is governed by islet oscillations such as bursting electrical activity and periodic Ca2+ entry in β-cells. In this report, we demonstrate that although islet oscillations are lost by fixing a glucose stimulus at a high concentration, they may be recovered by subsequently converting the glucose stimulus to a sinusoidal wave. We predict with mathematical modeling that the sinusoidal glucose signal’s ability to recover islet oscillations depends on its amplitude and period, and we confirm our predictions by conducting experiments with islets using a microfluidics platform. Our results suggest a mechanism whereby oscillatory blood glucose levels recruit non-oscillating islets to enhance pulsatile insulin output from the pancreas. Our results also provide support for the main hypothesis of the Dual Oscillator Model, that a glycolytic oscillator endogenous to islet β-cells drives pulsatile insulin secretion. PMID:27788129

Esophageal aerodynamics in an idealized experimental model of tracheoesophageal speech

NASA Astrophysics Data System (ADS)

Erath, Byron D.; Hemsing, Frank S.

2016-03-01

Flow behavior is investigated in the esophageal tract in an idealized experimental model of tracheoesophageal speech. The tracheoesophageal prosthesis is idealized as a first-order approximation using a straight, constant diameter tube. The flow is scaled according to Reynolds, Strouhal, and Euler numbers to ensure dynamic similarity. Flow pulsatility is produced by a driven orifice that approximates the kinematics of the pharyngoesophageal segment during tracheoesophageal speech. Particle image velocimetry data are acquired in three orthogonal planes as the flow exits the model prosthesis and enters the esophageal tract. Contrary to prior investigations performed in steady flow with the prosthesis oriented in-line with the flow direction, the fluid dynamics are shown to be highly unsteady, suggesting that the esophageal pressure field will be similarly complex. A large vortex ring is formed at the inception of each phonatory cycle, followed by the formation of a persistent jet. This vortex ring appears to remain throughout the entire cycle due to the continued production of vorticity resulting from entrainment between the prosthesis jet and the curved esophageal walls. Mean flow in the axial direction of the esophagus produces significant stretching of the vortex throughout the phonatory cycle. The stagnation point created by the jet impinging on the esophageal wall varies throughout the cycle due to fluctuations in the jet trajectory, which most likely arises due to flow separation within the model prosthesis. Applications to tracheoesophageal speech, including shortcomings of the model and proposed future plans, are discussed.

Cerebrospinal Fluid Mechanics and Its Coupling to Cerebrovascular Dynamics

NASA Astrophysics Data System (ADS)

Linninger, Andreas A.; Tangen, Kevin; Hsu, Chih-Yang; Frim, David

2016-01-01

Cerebrospinal fluid (CSF) is not stagnant but displays fascinating oscillatory flow patterns inside the ventricular system and reversing fluid exchange between the cranial vault and spinal compartment. This review provides an overview of the current knowledge of pulsatile CSF motion. Observations contradicting classical views about its bulk production and clearance are highlighted. A clinical account of diseases of abnormal CSF flow dynamics, including hydrocephalus, syringomyelia, Chiari malformation type 1, and pseudotumor cerebri, is also given. We survey medical imaging modalities used to observe intracranial dynamics in vivo. Additionally, we assess the state of the art in predictive models of CSF dynamics. The discussion addresses open questions regarding CSF dynamics as they relate to the understanding and management of diseases.

Computational analysis of the effectiveness of blood flushing with saline injection from an intravascular diagnostic catheter

PubMed Central

Ghata, Narugopal; Aldredge, Ralph C.; Bec, Julien; Marcu, Laura

2015-01-01

SUMMARY Optical techniques including fluorescence lifetime spectroscopy have demonstrated potential as a tool for study and diagnosis of arterial vessel pathologies. However, their application in the intravascular diagnostic procedures has been hampered by the presence of blood hemoglobin that affects the light delivery to and the collection from the vessel wall. We report a computational fluid dynamics model that allows for the optimization of blood flushing parameters in a manner that minimizes the amount of saline needed to clear the optical field of view and reduces any adverse effects caused by the external saline jet. A 3D turbulence (k−ω) model was employed for Eulerian–Eulerian two-phase flow to simulate the flow inside and around a side-viewing fiber-optic catheter. Current analysis demonstrates the effects of various parameters including infusion and blood flow rates, vessel diameters, and pulsatile nature of blood flow on the flow structure around the catheter tip. The results from this study can be utilized in determining the optimal flushing rate for given vessel diameter, blood flow rate, and maximum wall shear stress that the vessel wall can sustain and subsequently in optimizing the design parameters of optical-based intravascular catheters. PMID:24953876

Assessment of subgrid-scale models with a large-eddy simulation-dedicated experimental database: The pulsatile impinging jet in turbulent cross-flow

NASA Astrophysics Data System (ADS)

Baya Toda, Hubert; Cabrit, Olivier; Truffin, Karine; Bruneaux, Gilles; Nicoud, Franck

2014-07-01

Large-Eddy Simulation (LES) in complex geometries and industrial applications like piston engines, gas turbines, or aircraft engines requires the use of advanced subgrid-scale (SGS) models able to take into account the main flow features and the turbulence anisotropy. Keeping this goal in mind, this paper reports a LES-dedicated experiment of a pulsatile hot-jet impinging a flat-plate in the presence of a cold turbulent cross-flow. Unlike commonly used academic test cases, this configuration involves different flow features encountered in complex configurations: shear/rotating regions, stagnation point, wall-turbulence, and the propagation of a vortex ring along the wall. This experiment was also designed with the aim to use quantitative and nonintrusive optical diagnostics such as Particle Image Velocimetry, and to easily perform a LES involving a relatively simple geometry and well-controlled boundary conditions. Hence, two eddy-viscosity-based SGS models are investigated: the dynamic Smagorinsky model [M. Germano, U. Piomelli, P. Moin, and W. Cabot, "A dynamic subgrid-scale eddy viscosity model," Phys. Fluids A 3(7), 1760-1765 (1991)] and the σ-model [F. Nicoud, H. B. Toda, O. Cabrit, S. Bose, and J. Lee, "Using singular values to build a subgrid-scale model for large eddy simulations," Phys. Fluids 23(8), 085106 (2011)]. Both models give similar results during the first phase of the experiment. However, it was found that the dynamic Smagorinsky model could not accurately predict the vortex-ring propagation, while the σ-model provides a better agreement with the experimental measurements. Setting aside the implementation of the dynamic procedure (implemented here in its simplest form, i.e., without averaging over homogeneous directions and with clipping of negative values to ensure numerical stability), it is suggested that the mitigated predictions of the dynamic Smagorinsky model are due to the dynamic constant, which strongly depends on the mesh resolution. Indeed, the shear-stress near the wall increases during the vortex-ring impingement leading to a less refined mesh in terms of wall units, y+. This loss of resolution induces a poor damping of the dynamic constant, which is no longer able to adjust itself to ensure the expected y3-behavior near the wall. It is shown that the dynamic constant is never small enough to properly balance the large values of the squared magnitude of the strain-rate tensor, 2SijSij. The experimental database is made available to the community upon request to the authors.

Transport and flow characteristics of an oscillating cylindrical fiber for total artificial lung application.

PubMed

Qamar, Adnan; Bull, Joseph L

2017-08-01

Mass transport and fluid dynamics characteristics in the vicinity of an oscillating cylindrical fiber with an imposed pulsatile inflow condition are computationally investigated in the present study. The work is motivated by a recently proposed design modification to the Total Artificial Lung (TAL) device, which is expected to provide better gas exchange. Navier-Stokes computations, coupled with convection-diffusion equation are performed to assess flow dynamics and mass transport behavior around the oscillating fiber. The oscillations and the pulsatile free stream velocity are represented by two sinusoidal functions. The resulting non-dimensional parameters are Keulegan-Carpenter number (KC), Schmidt number (Sc), Reynolds number (Re), pulsatile inflow amplitude ([Formula: see text]), and amplitude of cylinder oscillation ([Formula: see text]). Results are computed for [Formula: see text], Sc = 1000, Re = 5 and 10, [Formula: see text] and 0.7 and 0.25 [Formula: see text][Formula: see text][Formula: see text] 5.25. The pulsatile inflow parameters correspond to the flow velocities found in human pulmonary artery while matching the operating TAL Reynolds number. Mass transport from the surface of the cylinder to the bulk fluid is found to be primarily dependent on the size of surface vortices created by the movement of the cylinder. Time-averaged surface Sherwood number (Sh) is dependent on the amplitude and KC of cylinder oscillation. Compared to the fixed cylinder case, a significant gain up to 380% in Sh is achieved by oscillating the cylinder even at the small displacement amplitude (AD = 0.75D). Moreover, with decrease in KC the oscillating cylinder exhibits a lower drag amplitude compared with the fixed cylinder case. Inflow pulsation amplitude has minor effects on the mass transport characteristics. However, an increase in [Formula: see text] results in an increase in the amplitude of the periodic drag force on the cylinder. This rise in the drag amplitude is similar to that measured for the fixed cylinder case. Quantifications of shear stress distribution in the bulk fluid suggest that the physiological concerns of platelet activation and injury to red blood cells due to cylinder oscillation are negligible.

The Effect of Hemodynamics on Cerebral Aneurysm Morphology

NASA Astrophysics Data System (ADS)

Metcalfe, Ralph; Mantha, Aishwarya; Karmonik, Christof; Strother, Charles

2004-11-01

One of the difficulties in applying principles of hemodynamics to the study of blood flow in aneurysms are the drastic variations in possible shape of both the aneurysms and the parent arteries in the region of interest. We have taken data from three para-opthalmic internal carotid artery aneurysms using 3D-digital subtraction angiography (3D-DSA) and performed CFD simulations of steady and unsteady flows through the three different cases using the same pressure gradients and pulsatile flow waveforms (based on the Ku model for flow through the Carotid bifurcation). We have found that the total pressure differential within the aneurysms is consistent with the direction of flow, and that the dynamic pressure gradient within the aneurysm is very small compared with the static pressure variations. Wall shear stresses were highest near regions of sharp arterial curvature, but always remained low inside the aneurysm. These results suggest a more complex role for hemodynamics in aneurysm generation, growth and rupture.

A Three-Pulse Release Tablet for Amoxicillin: Preparation, Pharmacokinetic Study and Physiologically Based Pharmacokinetic Modeling.

PubMed

Li, Jin; Chai, Hongyu; Li, Yang; Chai, Xuyu; Zhao, Yan; Zhao, Yunfan; Tao, Tao; Xiang, Xiaoqiang

2016-01-01

Amoxicillin is a commonly used antibiotic which has a short half-life in human. The frequent administration of amoxicillin is often required to keep the plasma drug level in an effective range. The short dosing interval of amoxicillin could also cause some side effects and drug resistance, and impair its therapeutic efficacy and patients' compliance. Therefore, a three-pulse release tablet of amoxicillin is desired to generate sustained release in vivo, and thus to avoid the above mentioned disadvantages. The pulsatile release tablet consists of three pulsatile components: one immediate-release granule and two delayed release pellets, all containing amoxicillin. The preparation of a pulsatile release tablet of amoxicillin mainly includes wet granulation craft, extrusion/spheronization craft, pellet coating craft, mixing craft, tablet compression craft and film coating craft. Box-Behnken design, Scanning Electron Microscope and in vitro drug release test were used to help the optimization of formulations. A crossover pharmacokinetic study was performed to compare the pharmacokinetic profile of our in-house pulsatile tablet with that of commercial immediate release tablet. The pharmacokinetic profile of this pulse formulation was simulated by physiologically based pharmacokinetic (PBPK) model with the help of Simcyp®. Single factor experiments identify four important factors of the formulation, namely, coating weight of Eudragit L30 D-55 (X1), coating weight of AQOAT AS-HF (X2), the extrusion screen aperture (X3) and compression forces (X4). The interrelations of the four factors were uncovered by a Box-Behnken design to help to determine the optimal formulation. The immediate-release granule, two delayed release pellets, together with other excipients, namely, Avicel PH 102, colloidal silicon dioxide, polyplasdone and magnesium stearate were mixed, and compressed into tablets, which was subsequently coated with Opadry® film to produce pulsatile tablet of amoxicillin. In vitro release study firstly indicated a three-pulse release profile of the tablet. Later the pulse tablet was found to generate the sustained release of amoxicillin in beagle dogs. Furthermore, the Simcyp® software was used to simulate the in vivo concentration time curve model of the three-pulse release tablet for amoxicillin in both human and beagle dog. The prediction by PBPK model nicely fitted the observation in human and beagle dog. This study has demonstrated the interrelation of factors affecting the pulsatile formulation of amoxicillin using a Box-Behnken design. The three-pulse release tablets of amoxicillin were proven to generate pulsatile release in vitro and sustained release in vivo. This formulation was also found to extend the effective plasma concentration in human compared to the tablet of immediate release based on the simulation data by PBPK modeling. This study provides an example of using PBPK to guide the development of pulsatile dosage forms.

A translating stage system for µ-PIV measurements surrounding the tip of a migrating semi-infinite bubble.

PubMed

Smith, B J; Yamaguchi, E; Gaver, D P

2010-01-01

We have designed, fabricated and evaluated a novel translating stage system (TSS) that augments a conventional micro particle image velocimetry (µ-PIV) system. The TSS has been used to enhance the ability to measure flow fields surrounding the tip of a migrating semi-infinite bubble in a glass capillary tube under both steady and pulsatile reopening conditions. With conventional µ-PIV systems, observations near the bubble tip are challenging because the forward progress of the bubble rapidly sweeps the air-liquid interface across the microscopic field of view. The translating stage mechanically cancels the mean bubble tip velocity, keeping the interface within the microscope field of view and providing a tenfold increase in data collection efficiency compared to fixed-stage techniques. This dramatic improvement allows nearly continuous observation of the flow field over long propagation distances. A large (136-frame) ensemble-averaged velocity field recorded with the TSS near the tip of a steadily migrating bubble is shown to compare well with fixed-stage results under identical flow conditions. Use of the TSS allows the ensemble-averaged measurement of pulsatile bubble propagation flow fields, which would be practically impossible using conventional fixed-stage techniques. We demonstrate our ability to analyze these time-dependent two-phase flows using the ensemble-averaged flow field at four points in the oscillatory cycle.

Flow Dynamics of Contrast Dispersion in the Aorta

NASA Astrophysics Data System (ADS)

Eslami, Parastou; Seo, Jung-Hee; Chen, Marcus; Mittal, Rajat

2016-11-01

The time profile of the contrast concentration or arterial input function (AIF) has many fundamental clinical implications and is of importance for many imaging modalities and diagnosis such as MR perfusion, CT perfusion and CT angiography (CTA). Contrast dispersion in CTA has been utilized to develop a novel method- Transluminal Attenuation Flow Encoding (TAFE)- to estimate coronary blood flow (CBF). However, in clinical practice, AIF is only available in the descending aorta and is used as a surrogate of the AIF at the coronary ostium. In this work we use patient specific computational models of the complete aorta to investigate the fluid dynamics of contrast dispersion in the aorta. The simulation employs a realistic kinematic model of the aortic valve and the dispersion patterns are correlated with the complex dynamics of the pulsatile flow in the curved aorta. The simulations allow us to determine the implications of using the descending aorta AIF as a surrogate for the AIF at the coronary ostium. PE is supported by the NIH Individual Partnership Program. -/abstract- Category: 4.7.1: Biological fluid dynamics: Physiological - Cardiovasc This work was done at Johns Hopkins University.

Adding the 'heart' to hanging drop networks for microphysiological multi-tissue experiments.

PubMed

Rismani Yazdi, Saeed; Shadmani, Amir; Bürgel, Sebastian C; Misun, Patrick M; Hierlemann, Andreas; Frey, Olivier

2015-11-07

Microfluidic hanging-drop networks enable culturing and analysis of 3D microtissue spheroids derived from different cell types under controlled perfusion and investigating inter-tissue communication in multi-tissue formats. In this paper we introduce a compact on-chip pumping approach for flow control in hanging-drop networks. The pump includes one pneumatic chamber located directly above one of the hanging drops and uses the surface tension at the liquid-air-interface for flow actuation. Control of the pneumatic protocol provides a wide range of unidirectional pulsatile and continuous flow profiles. With the proposed concept several independent hanging-drop networks can be operated in parallel with only one single pneumatic actuation line at high fidelity. Closed-loop medium circulation between different organ models for multi-tissue formats and multiple simultaneous assays in parallel are possible. Finally, we implemented a real-time feedback control-loop of the pump actuation based on the beating of a human iPS-derived cardiac microtissue cultured in the same system. This configuration allows for simulating physiological effects on the heart and their impact on flow circulation between the organ models on chip.

Numerical simulation of flows in a circular pipe transversely subjected to a localized impulsive body force with applications to blunt traumatic aortic rupture

NASA Astrophysics Data System (ADS)

Di Labbio, G.; Keshavarz-Motamed, Z.; Kadem, L.

2017-06-01

Much debate surrounds the mechanisms responsible for the occurrence of blunt traumatic aortic rupture in car accidents, particularly on the role of the inertial body force experienced by the blood due to the abrupt deceleration. The isolated influence of such body forces acting on even simple fluid flows is a fundamental problem in fluid dynamics that has not been thoroughly investigated. This study numerically investigates the fundamental physical problem, where the pulsatile flow in a straight circular pipe is subjected to a transverse body force on a localized volume of fluid. The body force is applied as a brief rectangular impulse in three distinct cases, namely during the accelerating, peak, and decelerating phases of the pulsatile flow. A dimensionless number, termed the degree of influence of the body force (Ψ), is devised to quantify the relative strength of the body force over the flow inertia. The impact induces counter-rotating cross-stream vortices at the boundaries of the forced section accompanied by complex secondary flow structures. This secondary flow is found to develop slowest for an impact occurring during an accelerating flow and fastest during a decelerating flow. The peak skewness of the velocity field, however, occurred at successively later times for the three respective cases. After the impact, these secondary flows act to restore the unforced state and such dominant spatial structures are revealed by proper orthogonal decomposition of the velocity field. This work presents a new class of problems that requires further theoretical and experimental investigation.

Parametric Characterization of Flow Inside Cererbal Aneurysms Treated with Flow-Diverting Stents

NASA Astrophysics Data System (ADS)

Barbour, Michael; Levitt, Michael; Geindreau, Christian; Johnson, Luke; Chivukula, Keshav; Aliseda, Alberto

2017-11-01

Cerebral aneurysms are often treated with a flow-diverting stent (FDS) to reduce blood flow into the aneurysm sac, promoting the development of a stable thrombus. Successful treatment is highly dependent on the degree of flow reduction and the altered hemodynamics inside the aneurysm sac following treatment. Establishing a causal connection between hemodynamic metrics of FDS-treated CAs and long-term clinical outcomes requires a rigorous parametric characterization of this flow environment. We use 3D particle image velocimetry (PIV) to measure the flow inside idealized aneurysm models treated with FDS. Physiologically realistic Reynolds numbers and increasing levels of parent vessel curvature are analyzed to understand the effect of inertia on flow development. The flow velocity into the aneurysm and the topology of the flow inside the sac is shown to be highly dependent on parent vessel Dean number (De). The role of flow pulsatility is then added to the study via time-dependent waveforms. Velocity measurements at 2 values of parent vessel Womersley number (Wo) allow us to parameterize flow inside of CAs treated with FDS as a function of De, Re and Wo, improving the fundamental understanding of how FDS alter CA hemodynamics and aiding in the development of new treatments.

Virtual Treatment of Basilar Aneurysms Using Shape Memory Polymer Foam

PubMed Central

Ortega, J.M.; Hartman, J.; Rodriguez, J.N.; Maitland, D.J.

2013-01-01

Numerical simulations are performed on patient-specific basilar aneurysms that are treated with shape memory polymer (SMP) foam. In order to assess the post-treatment hemodynamics, two modeling approaches are employed. In the first, the foam geometry is obtained from a micro-CT scan and the pulsatile blood flow within the foam is simulated for both Newtonian and non-Newtonian viscosity models. In the second, the foam is represented as a porous media continuum, which has permeability properties that are determined by computing the pressure gradient through the foam geometry over a range of flow speeds comparable to those of in vivo conditions. Virtual angiography and additional post-processing demonstrate that the SMP foam significantly reduces the blood flow speed within the treated aneurysms, while eliminating the high-frequency velocity fluctuations that are present within the pre-treatment aneurysms. An estimation of the initial locations of thrombus formation throughout the SMP foam is obtained by means of a low fidelity thrombosis model that is based upon the residence time and shear rate of blood. The Newtonian viscosity model and the porous media model capture similar qualitative trends, though both yield a smaller volume of thrombus within the SMP foam. PMID:23329002

MRI studies of the hydrodynamics in a USP 4 dissolution testing cell.

PubMed

Shiko, G; Gladden, L F; Sederman, A J; Connolly, P C; Butler, J M

2011-03-01

We present a detailed study of hydrodynamics inside the flow-through dissolution apparatus when operated according to USP recommendations. The pulsatile flow inside the flow-through cell was measured quantitatively using magnetic resonance imaging (MRI) at a spatial resolution of 234 × 234 μm(2) and slice thickness of 1 mm. We report the experimental protocols developed for in situ MRI studies and the effect that the operating conditions and tablet orientation have on the hydrodynamics inside commercial flow cells. It was found that the flow field inside the dissolution cells was, at most operating conditions, heterogeneous, rather than fully developed laminar flow, and characterised by re-circulation and backward flow. A model tablet was shown to be contacted by a wide distribution of local velocities as a function of position and orientation in the flow cell. The use of 1 mm beads acted as a distributor of the flow but did not suffice to ensure a fully developed laminar flow profile. These results emphasise the necessity to understand the influence of test conditions on dissolution behaviour in defining robust flow-through dissolution methods. Copyright © 2010 Wiley-Liss, Inc.

Pulsatile pressure driven rarefied gas flow in long rectangular ducts

NASA Astrophysics Data System (ADS)

Tsimpoukis, Alexandros; Valougeorgis, Dimitris

2018-04-01

The pulsatile pressure driven fully developed flow of a rarefied gas through an orthogonal duct is investigated, based on the time-dependent linear Bhatnagar, Gross, and Krook equation, by decomposing the flow into its steady and oscillatory parts. The investigation is focused on the oscillatory part, which is characterized by the gas rarefaction and oscillation parameters, the duct aspect ratio, and the accommodation coefficient. As the oscillation frequency is increased, the amplitude of all macroscopic quantities is decreased, while their phase angle lag is increased reaching the limiting value of π/2. As the gas becomes more rarefied, higher frequencies are needed to trigger this behavior. At small and moderate frequencies, there is a critical degree of gas rarefaction, where a maximum flow rate is obtained. As the duct aspect ratio is decreased and tends to zero, the flow rate and mean wall shear stress amplitudes are increased, while their phase angle lags are slightly affected. The accommodation coefficient has a significant effect on the amplitude and a very weak one on the phase angle of the macroscopic quantities. The computation of the inertia and viscous forces clarifies when the flow consists of only one oscillating viscous region or of two regions, namely, the inviscid piston flow in the core and the oscillating Stokes layer at the wall with the velocity overshooting. Finally, the time average oscillatory pumping power is increased as the oscillation frequency is reduced and its maximum value is one half of the corresponding steady one.

Increased central arterial stiffness and altered cerebrovascular haemodynamic properties in South Asian older adults.

PubMed

Brar, I; Robertson, A D; Hughson, R L

2016-05-01

South Asians (SA) suffer from a higher burden of heart disease and stroke compared with White Caucasians (CA). We hypothesized that increased arterial stiffness in older adults of SA origin would be associated with greater cerebrovascular pulsatile pressure and flow characteristics compared with CA older adults. Forty-four SA and CA older adults, free of known cardiovascular and cerebrovascular diseases, were assessed. Vascular ageing was characterized by brachial-ankle pulse wave velocity, carotid pulse pressure, compliance coefficient (CC) and intima-media thickness (IMT). Duplex ultrasonography of the internal carotid arteries estimated anterior cerebral blood flow (aCBF) and cerebrovascular resistance (aCVR), and transcranial Doppler ultrasound quantified middle cerebral artery blood flow velocity, resistive index (RI) and pulsatility index (PI). Fasting blood samples were collected to assess glycaemic status, lipid profile and C-reactive protein. SA had higher carotid pulse pressure and lower CC indicating stiffer arteries compared with CA. Multiple regression analyses revealed that ethnic differences in arterial stiffness were associated with glycated haemoglobin level in SA. Among SA, an inverse association was observed between carotid CC and aCVR. In turn, aCVR was associated with a steeper reduction in aCBF in SA than in CA. IMT was strongly associated with greater PI and RI (r>0.81, P<0.001) in SA, whereas a weaker relationship for PI (r=0.46, P=0.03) and no significant relationship for RI were found in CA. The study found stronger associations between pulsatile cerebrovascular haemodynamics and structural and functional alterations in central arteries in SA that may underlie the elevated risk for cerebrovascular disease.

A novel decision tree approach based on transcranial Doppler sonography to screen for blunt cervical vascular injuries.

PubMed

Purvis, Dianna; Aldaghlas, Tayseer; Trickey, Amber W; Rizzo, Anne; Sikdar, Siddhartha

2013-06-01

Early detection and treatment of blunt cervical vascular injuries prevent adverse neurologic sequelae. Current screening criteria can miss up to 22% of these injuries. The study objective was to investigate bedside transcranial Doppler sonography for detecting blunt cervical vascular injuries in trauma patients using a novel decision tree approach. This prospective pilot study was conducted at a level I trauma center. Patients undergoing computed tomographic angiography for suspected blunt cervical vascular injuries were studied with transcranial Doppler sonography. Extracranial and intracranial vasculatures were examined with a portable power M-mode transcranial Doppler unit. The middle cerebral artery mean flow velocity, pulsatility index, and their asymmetries were used to quantify flow patterns and develop an injury decision tree screening protocol. Student t tests validated associations between injuries and transcranial Doppler predictive measures. We evaluated 27 trauma patients with 13 injuries. Single vertebral artery injuries were most common (38.5%), followed by single internal carotid artery injuries (30%). Compared to patients without injuries, mean flow velocity asymmetry was higher for single internal carotid artery (P = .003) and single vertebral artery (P = .004) injuries. Similarly, pulsatility index asymmetry was higher in single internal carotid artery (P = .015) and single vertebral artery (P = .042) injuries, whereas the lowest pulsatility index was elevated for bilateral vertebral artery injuries (P = .006). The decision tree yielded 92% specificity, 93% sensitivity, and 93% correct classifications. In this pilot feasibility study, transcranial Doppler measures were significantly associated with the blunt cervical vascular injury status, suggesting that transcranial Doppler sonography might be a viable bedside screening tool for trauma. Patient-specific hemodynamic information from transcranial Doppler assessment has the potential to alter patient care pathways to improve outcomes.

Flow field and oscillatory shear stress in a tuning-fork-shaped model of the average human carotid bifurcation.

PubMed

Ding, Z; Wang, K; Li, J; Cong, X

2001-12-01

The oscillatory shear index (OSI) was developed based on the hypothesis that intimal hyperplasia was correlated with oscillatory shear stresses. However, the validity of the OSI was in question since the correlation between intimal thickness and the OSI at the side walls of the sinus in the Y-shaped model of the average human carotid bifurcation (Y-AHCB) was weak. The objectives of this paper are to examine whether the reason for the weak correlation lies in the deviation in geometry of Y-AHCB from real human carotid bifurcation, and whether this correlation is clearly improved in the tuning-fork-shaped model of the average human carotid bifurcation (TF-AHCB). The geometry of the TF-AHCB model was based on observation and statistical analysis of specimens from 74 cadavers. The flow fields in both models were studied and compared by using flow visualization methods under steady flow conditions and by using laser Doppler anemometer (LDA) under pulsatile flow conditions. The TF-shaped geometry leads to a more complex flow field than the Y-shaped geometry. This added complexity includes strengthened helical movements in the sinus, new flow separation zone, and directional changes in the secondary flow patterns. The results show that the OSI-values at the side walls of the sinus in the TF-shaped model were more than two times as large as those in the Y-shaped model. This study confirmed the stronger correlation between the OSI and intimal thickness in the tuning-fork geometry of human carotid bifurcation, and the TF-AHCB model is a significant improvement over the traditional Y-shaped model.

The fluid transport in inkjet-printed liquid rivulets

NASA Astrophysics Data System (ADS)

Singler, Timothy; Liu, Liang; Sun, Xiaoze; Pei, Yunheng; Microfluidic; Interfacial Transport Lab Team

2017-11-01

Inkjet printing holds significant potential for the controlled deposition of solution-processed functional materials spanning applications from microelectronics to biomedical sciences. Although theoretical and experimental investigations addressing the stability criteria of the inkjet-printed liquid rivulets have been discussed in the literature, the associated transport phenomena have received little attention. This study focuses on the experimental investigation of printed rivulets, stable with respect to Rayleigh-Plateau, but exhibiting bulge instability. The morphological evolution and the depth-resolved flow field of the rivulets were assessed via high-speed imaging in conjunction with micro-PIV. We discuss in detail effects of repetitive wave motion induced by periodic drop impact at the leading edge and the associated pulsatile flow, as well as the persistent nonuniform mass distribution in the ridge region of the rivulet. The results provide an experimental foundation for more detailed theoretical modelling of printed rivulet flows.

Pulsatility index variations using two different transit-time flowmeters in coronary artery bypass surgery.

PubMed

Nordgaard, Håvard B; Vitale, Nicola; Astudillo, Rafael; Renzulli, Attilio; Romundstad, Pål; Haaverstad, Rune

2010-05-01

Transit-time flow measurement is widely accepted as an intra-operative assessment in coronary artery bypass grafting (CABG). However, the two most commonly applied flowmeters, manufactured by MediStim ASA and Transonic Inc., have different default filter settings of 20 and 10 Hz, respectively. This may cause different flow measurements, which will influence the reported results. The aim was to compare pulsatility index (PI) values recorded by the MediStim and Transonic flowmeters in two different clinical settings: (1) analysis of the flow patterns recorded simultaneously by both flowmeters in the same CABGs; and (2) evaluation of flow patterns under different levels of filter settings in the same grafts. Graft flow and PI were measured using the two different flowmeters simultaneously in 19 bypass grafts. Finally, eight grafts were assessed under different digital filter settings at 5, 10, 20, 30, 50 and 100 Hz. The Transonic flowmeter provided substantially lower PI as compared with the MediStim flowmeter. By increasing the filter setting in the flowmeter, PI increased considerably. The Transonic flowmeter displayed a lower PI than the MediStim, due to a lower filter setting. In the Transonic,flow signals are filtered at a lower level, rendering a 'smoother' pattern of flow curves. Because different filter settings determine different PIs, caution must be taken when flow values and flowmeters are compared. The type of flowmeter should be indicated whenever graft flow measurements and derived indexes are provided [corrected]. Copyright 2009 European Association for Cardio-Thoracic Surgery. All rights reserved.

Dynamic modeling for flow-activated chloride-selective membrane current in vascular endothelial cells.

PubMed

Qin, Kai-Rong; Xiang, Cheng; Cao, Ling-Ling

2011-10-01

In this paper, a dynamic model is proposed to quantify the relationship between fluid flow and Cl(-)-selective membrane current in vascular endothelial cells (VECs). It is assumed that the external shear stress would first induce channel deformation in VECs. This deformation could activate the Cl(-) channels on the membrane, thus allowing Cl(-) transport across the membrane. A modified Hodgkin-Huxley model is embedded into our dynamic system to describe the electrophysiological properties of the membrane, such as the Cl(-)-selective membrane current (I), voltage (V) and conductance. Three flow patterns, i. e., steady flow, oscillatory flow, and pulsatile flow, are applied in our simulation studies. When the extracellular Cl(-) concentration is constant, the I-V characteristics predicted by our dynamic model shows strong consistency with the experimental observations. It is also interesting to note that the Cl(-) currents under different flow patterns show some differences, indicating that VECs distinguish among and respond differently to different types of flows. When the extracellular Cl(-) concentration keeps constant or varies slowly with time (i.e. oscillates at 0.02 Hz), the convection and diffusion of Cl(-) in extracellular space can be ignored and the Cl(-) current is well captured by the modified Hodgkin-Huxley model alone. However, when the extracellular Cl(-) varies fast (i.e., oscillates at 0.2 Hz), the convection and diffusion effect should be considered because the Cl(-) current dynamics is different from the case where the convection-diffusion effect is simply ignored. The proposed dynamic model along with the simulation results could not only provide more insights into the flow-regulated electrophysiological behavior of the cell membrane but also help to reveal new findings in the electrophysiological experimental investigations of VECs in response to dynamic flow and biochemical stimuli.

Setup of a Biomedical Facility to Study Physiologically Relevant Flow-Structure Interactions

NASA Astrophysics Data System (ADS)

Mehdi, Faraz; Sheng, Jian

2013-11-01

The design and implementation of a closed loop biomedical facility to study arterial flows is presented. The facility has a test section of 25 inches, and is capable of generating both steady and pulsatile flows via a centrifugal and a dual piston pump respectively. The Reynolds and Womersley numbers occurring in major blood vessels can be matched. The working fluid is a solution of NaI that allows refractive index matching with both rigid glass and compliant polymer models to facilitate tomographic PIV and holographic PIV. The combination of these two techniques allows us to study both large scale flow features as well as flows very close to the wall. The polymer models can be made with different modulus of elasticity and can be pre-stressed using a 5-axis stage. Radially asymmetric patches can also be pre-fabricated and incorporated in the tube during the manufacturing process to simulate plaque formation in arteries. These tubes are doped with tracer particles allowing for the measurement of wall deformation. Preliminary flow data over rigid and compliant walls is presented. One of the aims of this study is to characterize the changes in flow as the compliancy of blood vessels change due to age or disease, and explore the fluid interactions with an evolving surface boundary.

Effect of echo artifacts on characterization of pulsatile tissues in neonatal cranial ultrasonic movies

NASA Astrophysics Data System (ADS)

Fukuzawa, Masayuki; Takahashi, Kazuki; Tabata, Yuki; Kitsunezuka, Yoshiki

2016-04-01

Effect of echo artifacts on characterization of pulsatile tissues has been examined in neonatal cranial ultrasonic movies by characterizing pulsatile intensities with different regions of interest (ROIs). The pulsatile tissue, which is a key point in pediatric diagnosis of brain tissue, was detected from a heartbeat-frequency component in Fourier transform of a time-variation of 64 samples of echo intensity at each pixel in a movie fragment. The averages of pulsatile intensity and power were evaluated in two ROIs: common fan-shape and individual cranial-shape. The area of pulsatile region was also evaluated as the number of pixels where the pulsatile intensity exceeds a proper threshold. The extracranial pulsatile region was found mainly in the sections where mirror image was dominant echo artifact. There was significant difference of pulsatile area between two ROIs especially in the specific sections where mirror image was included, suggesting the suitability of cranial-shape ROI for statistical study on pulsatile tissues in brain. The normalized average of pulsatile power in the cranial-shape ROI exhibited most similar tendency to the normalized pulsatile area which was treated as a conventional measure in spite of its requirement of thresholding. It suggests the potential of pulsatile power as an alternative measure for pulsatile area in further statistical study of pulsatile tissues because it was neither affected by echo artifacts nor threshold.

Long-Term Durability Test for the Left Ventricular Assist System EVAHEART under the Physiologic Pulsatile Load.

PubMed

Kitano, Tomoya; Iwasaki, Kiyotaka

The EVAHEART Left Ventricular Assist System (LVAS) was designed for the long-term support of a patient with severe heart failure. It has an original water lubrication system for seal and bearing and wear on these parts was considered one of its critical failure modes. A durability test focusing on wear was designed herein. We developed a mock loop, which generates a physiologic pulsatile flow and is sufficiently durable for a long-term test. The pulsatile load and the low fluid viscosity enable the creation of a severe condition for the mechanical seal. A total of 18 EVAHEART blood pumps completed 2 years of operation under the pulsatile condition without any failure. It indicated the EVAHEART blood pump had a greater than 90% reliability with a 88% confidence level. The test was continued with six blood pumps and achieved an average of 8.6 years, which was longer than the longest clinical use in Japan. The test result showed that no catastrophic, critical, marginal, or minor failures of the blood pump or their symptoms were observed. The seal performance was maintained after the test. Moreover, the surface roughness did not change, which showed any burn or abnormal wear occurred. The original water lubrication system equipped in EVAHEART LVAS prevent severe wear on the seal and the bearing, and it can be used in the bridge to transplant and destination therapy.

Prediction and control of neural responses to pulsatile electrical stimulation

NASA Astrophysics Data System (ADS)

Campbell, Luke J.; Sly, David James; O'Leary, Stephen John

2012-04-01

This paper aims to predict and control the probability of firing of a neuron in response to pulsatile electrical stimulation of the type delivered by neural prostheses such as the cochlear implant, bionic eye or in deep brain stimulation. Using the cochlear implant as a model, we developed an efficient computational model that predicts the responses of auditory nerve fibers to electrical stimulation and evaluated the model's accuracy by comparing the model output with pooled responses from a group of guinea pig auditory nerve fibers. It was found that the model accurately predicted the changes in neural firing probability over time to constant and variable amplitude electrical pulse trains, including speech-derived signals, delivered at rates up to 889 pulses s-1. A simplified version of the model that did not incorporate adaptation was used to adaptively predict, within its limitations, the pulsatile electrical stimulus required to cause a desired response from neurons up to 250 pulses s-1. Future stimulation strategies for cochlear implants and other neural prostheses may be enhanced using similar models that account for the way that neural responses are altered by previous stimulation.

Rectification of pulsatile stress on soft tissues: a mechanism for normal-pressure hydrocephalus

NASA Astrophysics Data System (ADS)

Jalikop, Shreyas; Hilgenfeldt, Sascha

2011-11-01

Hydrocephalus is a pathological condition of the brain that occurs when cerebrospinal fluid (CSF) accumulates excessively in the brain cavities, resulting in compression of the brain parenchyma. Counter-intuitively, normal-pressure hydrocephalus (NPH) does not show elevated pressure differences across the compressed parenchyma. We investigate the effects of nonlinear tissue mechanics and periodic driving in this system. The latter is due to the cardiac cycle, which provides significant intracranial pressure and volume flow rate fluctuations. Nonlinear rectification of the periodic driving within a model of fluid flow in poroelastic material can lead to compression or expansion of the parenchyma, and this effect does not rely on changes in the mean intracranial pressure. The rectification effects can occur gradually over several days, in agreement with clinical studies of NPH.

Fluid dynamics of aortic valve stenosis

NASA Astrophysics Data System (ADS)

Keshavarz-Motamed, Zahra; Maftoon, Nima

2009-11-01

Aortic valve stenosis, which causes considerable constriction of the flow passage, is one of the most frequent cardiovascular diseases and is the most common cause of the valvular replacements which take place for around 100,000 per year in North America. Furthermore, it is considered as the most frequent cardiac disease after arterial hypertension and coronary artery disease. The objective of this study is to develop an analytical model considering the coupling effect between fluid flow and elastic deformation with reasonable boundary conditions to describe the effect of AS on the left ventricle and the aorta. The pulsatile and Newtonian blood flow through aortic stenosis with vascular wall deformability is analyzed and its effects are discussed in terms of flow parameters such as velocity, resistance to flow, shear stress distribution and pressure loss. Meanwhile we developed analytical expressions to improve the comprehension of the transvalvular hemodynamics and the aortic stenosis hemodynamics which is of great interest because of one main reason. To medical scientists, an accurate knowledge of the mechanical properties of whole blood flow in the aorta can suggest a new diagnostic tool.

In vitro evaluation of flow patterns and turbulent kinetic energy in trans-catheter aortic valve prostheses.

PubMed

Giese, Daniel; Weiss, Kilian; Baeßler, Bettina; Madershahian, Navid; Choi, Yeong-Hoon; Maintz, David; Bunck, Alexander C

2018-02-01

The objective of the current work was to evaluate flow and turbulent kinetic energy in different transcatheter aortic valve implants using highly undersampled time-resolved multi-point 3-directional phase-contrast measurements (4D Flow MRI) in an in vitro setup. A pulsatile flow setup was used with a compliant tubing mimicking a stiff left ventricular outflow tract and ascending aorta. Five different implants were measured using a highly undersampled multi-point 4D Flow MRI sequence. Velocities and turbulent kinetic energy values were analysed and compared. Strong variations of turbulent kinetic energy distributions between the valves were observed. Maximum turbulent kinetic energy values ranged from 100 to over 500 J/m 3 while through-plane velocities were similar between all valves. Highly accelerated 4D Flow MRI for the measurement of velocities and turbulent kinetic energy values allowed for the assessment of hemodynamic parameters in five different implant models. The presented setup, measurement protocol and analysis methods provides an efficient approach to compare different valve implants and could aid future novel valve designs.

Virtual Treatment of Basilar Aneurysms Using Shape Memory Polymer Foam

NASA Astrophysics Data System (ADS)

Ortega, J. M.; Hartman, J.; Rodriguez, J. N.; Maitland, D. J.

2012-11-01

Numerical simulations are performed on patient-specific basilar aneurysms that are treated with shape memory polymer (SMP) foam. In order to assess the post-treatment hemodynamics, two modeling approaches are employed. In the first, the foam geometry is obtained from a micro-CT scan and the pulsatile blood flow within the foam is simulated for both Newtonian and non-Newtonian viscosity models. In the second, the foam is represented as a porous media continuum, which has permeability properties that are determined by computing the pressure gradient through the foam geometry over a range of flow speeds comparable to those of in vivo conditions. Virtual angiography and additional post-processing demonstrate that the SMP foam significantly reduces the blood flow speed within the treated aneurysms, while eliminating the high-frequency velocity fluctuations that are present prior to treatment. A prediction of the initial locations of thrombus formation throughout the SMP foam is obtained by means of a low fidelity thrombosis model that is based upon the residence time and shear rate of blood. The two modeling approaches capture similar qualitative trends for the initial locations of thrombus within the SMP foam.

SDOCT Doppler velocimetry for investigating the morphological influences on blood flow in the developing chick embryo heart

NASA Astrophysics Data System (ADS)

Davis, Anjul M.; Rothenberg, Florence G.; Law, Tzuo H.; Taber, Larry A.; Izatt, Joseph A.

2007-02-01

The onset of congenital heart disease (CHD) is believed to occur at very early stages of development. Investigations in the initiation and development of CHD has been hampered by the inability to image early stage heart structure and function, in vivo. Imaging small animals using optical coherence tomography (OCT) has filled a niche between the limited penetration depth of confocal microscopy and insufficient resolution from ultrasound. Previous demonstrations of chick heart imaging using OCT have entailed excision of, or arresting the heart to prevent motion artifacts. In this summary, we introduce SDOCT Doppler velocimetry as an enhancement of Doppler OCT for in vivo measurement of localized temporal blood flow dynamics. With this technique, dynamic velocity waveforms were measured in the outflow tract of the heart tube. These flow dynamics correlate to a finite element model of pulsatile flow and may lead to a further understanding of morphological influences on early heart development.

A Three-Pulse Release Tablet for Amoxicillin: Preparation, Pharmacokinetic Study and Physiologically Based Pharmacokinetic Modeling

PubMed Central

Li, Jin; Chai, Hongyu; Li, Yang; Chai, Xuyu; Zhao, Yan; Zhao, Yunfan; Tao, Tao; Xiang, Xiaoqiang

2016-01-01

Background Amoxicillin is a commonly used antibiotic which has a short half-life in human. The frequent administration of amoxicillin is often required to keep the plasma drug level in an effective range. The short dosing interval of amoxicillin could also cause some side effects and drug resistance, and impair its therapeutic efficacy and patients’ compliance. Therefore, a three-pulse release tablet of amoxicillin is desired to generate sustained release in vivo, and thus to avoid the above mentioned disadvantages. Methods The pulsatile release tablet consists of three pulsatile components: one immediate-release granule and two delayed release pellets, all containing amoxicillin. The preparation of a pulsatile release tablet of amoxicillin mainly includes wet granulation craft, extrusion/spheronization craft, pellet coating craft, mixing craft, tablet compression craft and film coating craft. Box–Behnken design, Scanning Electron Microscope and in vitro drug release test were used to help the optimization of formulations. A crossover pharmacokinetic study was performed to compare the pharmacokinetic profile of our in-house pulsatile tablet with that of commercial immediate release tablet. The pharmacokinetic profile of this pulse formulation was simulated by physiologically based pharmacokinetic (PBPK) model with the help of Simcyp®. Results and Discussion Single factor experiments identify four important factors of the formulation, namely, coating weight of Eudragit L30 D-55 (X1), coating weight of AQOAT AS-HF (X2), the extrusion screen aperture (X3) and compression forces (X4). The interrelations of the four factors were uncovered by a Box–Behnken design to help to determine the optimal formulation. The immediate-release granule, two delayed release pellets, together with other excipients, namely, Avicel PH 102, colloidal silicon dioxide, polyplasdone and magnesium stearate were mixed, and compressed into tablets, which was subsequently coated with Opadry® film to produce pulsatile tablet of amoxicillin. In vitro release study firstly indicated a three-pulse release profile of the tablet. Later the pulse tablet was found to generate the sustained release of amoxicillin in beagle dogs. Furthermore, the Simcyp® software was used to simulate the in vivo concentration time curve model of the three-pulse release tablet for amoxicillin in both human and beagle dog. The prediction by PBPK model nicely fitted the observation in human and beagle dog. Conclusions This study has demonstrated the interrelation of factors affecting the pulsatile formulation of amoxicillin using a Box–Behnken design. The three-pulse release tablets of amoxicillin were proven to generate pulsatile release in vitro and sustained release in vivo. This formulation was also found to extend the effective plasma concentration in human compared to the tablet of immediate release based on the simulation data by PBPK modeling. This study provides an example of using PBPK to guide the development of pulsatile dosage forms. PMID:27479702

Reference Curve for the Mean Uterine Artery Pulsatility Index in Singleton Pregnancies.

PubMed

Weichert, Alexander; Hagen, Andreas; Tchirikov, Michael; Fuchs, Ilka B; Henrich, Wolfgang; Entezami, Michael

2017-05-01

Doppler sonography of the uterine artery (UA) is done to monitor pregnancies, because the detected flow patterns are useful to draw inferences about possible disorders of trophoblast invasion. Increased resistance in the UA is associated with an increased risk of preeclampsia and/or intrauterine growth restriction (IUGR) and perinatal mortality. In the absence of standardized figures, the normal ranges of the various available reference curves sometimes differ quite substantially from one another. The causes for this are differences in the flow patterns of the UA depending on the position of the pulsed Doppler gates as well as branching of the UA. Because of the discrepancies between the different reference curves and the practical problems this poses for guideline recommendations, we thought it would be useful to create our own reference curves for Doppler measurements of the UA obtained from a singleton cohort under standardized conditions. This retrospective cohort study was carried out in the Department of Obstetrics of the Charité - Universitätsmedizin Berlin, the Department for Obstetrics and Prenatal Medicine of the University Hospital Halle (Saale) and the Center for Prenatal Diagnostics and Human Genetics Kurfürstendamm 199. Available datasets from the three study locations were identified and reference curves were generated using the LMS method. Measured values were correlated with age of gestation, and a cubic model and Box-Cox power transformation (L), the median (M) and the coefficient of variation (S) were used to smooth the curves. 103 720 Doppler examinations of the UA carried out in singleton pregnancies from the 11th week of gestation (10 + 1 GW) were analyzed. The mean pulsatility index (Mean PI) showed a continuous decline over the course of pregnancy, dropping to a plateau of around 0.84 between the 23rd and 27th GW, after which it decreased again. Age of gestation, placental position, position of pulsed Doppler gates and branching of the UA can all change the flow pattern. The mean pulsatility index (Mean PI) showed a continuous decrease over time. There were significant differences between our data and alternative reference curves. A system of classifying Doppler studies and a reference curve adapted to the current technology are urgently required to differentiate better between physiological and pathological findings.

Lifelong Cyclic Mechanical Strain Promotes Large Elastic Artery Stiffening: Increased Pulse Pressure and Old Age-Related Organ Failure.

PubMed

Thorin-Trescases, Nathalie; Thorin, Eric

2016-05-01

The arterial wall is under a huge mechanical constraint imposed by the cardiac cycle that is bound to generate damage with time. Each heartbeat indeed imposes a pulsatile pressure that generates a vascular stretch. Lifetime accumulation of pulsatile stretches will eventually induce fatigue of the elastic large arterial walls, such as aortic and carotid artery walls, promoting their stiffening that will gradually perturb the normal blood flow and local pressure within the organs, and lead to organ failure. The augmented pulse pressure induced by arterial stiffening favours left ventricular hypertrophy because of the repeated extra work against stiff high-pressure arteries, and tissue damage as a result of excessive pulsatile pressure transmitted into the microcirculation, especially in low resistance/high-flow organs such as the brain and kidneys. Vascular aging is therefore characterized by the stiffening of large elastic arteries leading to a gradual increase in pulse pressure with age. In this review we focus on the effect of age-related stiffening of large elastic arteries. We report the clinical evidence linking arterial stiffness and organ failure and discuss the molecular pathways that are activated by the increase of mechanical stress in the wall. We also discuss the possible interventions that could limit arterial stiffening with age, such as regular aerobic exercise training, and some pharmacological approaches. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Comparison of 2-dimensional, 3-dimensional, and vascular ultrasonographic parameters for endometrial receptivity between 2 consecutive stimulated in vitro fertilization cycles.

PubMed

Ng, Ernest Hung Yu; Chan, Carina Chi Wai; Tang, Oi Shan; Ho, Pak Chung

2007-07-01

We compared the ultrasonographic parameters for endometrial receptivity between 2 consecutive in vitro fertilization (IVF) cycles in the same patients. Patients who had undergone 2 in vitro fertilization cycles between November 2002 and December 2004 were recruited. A 3-dimensional ultrasonographic examination with power Doppler imaging was performed on the day of oocyte retrieval to determine the endometrial thickness, endometrial pattern, pulsatility and resistive indices of uterine vessels, endometrial volume, vascularization index, flow index, and vascularization flow index of endometrial and subendometrial regions. Of 662 patients, 95 (14.4%) underwent 2 consecutive cycles using the same stimulation regimen during the study period. There were no significant differences in these ultrasonographic parameters between the first and second cycles. The intraclass correlation coefficient (ICC) for endometrial volume was significantly higher than that of other ultrasonographic parameters. The ICC for the endometrial thickness, uterine pulsatility index, and endometrial 3-dimensional power Doppler flow indices were similar. Ultrasonographic parameters for endometrial receptivity were comparable in the 2 consecutive stimulated cycles. The endometrial volume had the highest ICC among these ultrasonographic parameters and was most reproducible between 2 cycles.

Another way of pumping blood with a rotary but noncentrifugal pump for an artificial heart.

PubMed

Monties, J R; Mesana, T; Havlik, P; Trinkl, J; Demunck, J L; Candelon, B

1990-01-01

This article describes an alternative mode of pumping blood inside the body. The device is a non centrifugal, valveless, low speed rotary pump, electrically powered, based on Wankel engine principle. The authors developed an implantable electrical actuator resulting in a compact, sealed motor-pump unit with electrical and magnetic components insulated from fluids. The results in the flow curve and in the pumping action show some common points but also some basic differences compared to classical pulsatile pumps or centrifugal pumps. The blood coming from the atrium follows a continuous movement without any stop flow but with variations creating pulsatility. Ejection and filling of the pump are simultaneous. It is always an active filling. Hydraulic efficiency depends on clearance in the pumping chamber and outlet port pressure. A 60 cc device allows flows up to 8-9 liters. The implantable motor is cyclindrical in shape, has a moderate weight (490 grams) and presents a good efficiency (32% for a rotary speed of 90 rpm against a mean aortic pressure of 150 mm of Hg). The authors conclude that their device could be proposed after further experimental studies, as an LVAD for shortterm assistance with a good promise for permanent application.

The Relationship Between Pulsatile Flow Impingement and Intraluminal Thrombus Deposition in Abdominal Aortic Aneurysms.

PubMed

Lozowy, Richard J; Kuhn, David C S; Ducas, Annie A; Boyd, April J

2017-03-01

Direct numerical simulations were performed on four patient-specific abdominal aortic aneurysm (AAA) geometries and the resulting pulsatile blood flow dynamics were compared to aneurysm shape and correlated with intraluminal thrombus (ILT) deposition. For three of the cases, turbulent vortex structures impinged/sheared along the anterior wall and along the posterior wall a zone of recirculating blood formed. Within the impingement region the AAA wall was devoid of ILT and remote to this region there was an accumulation of ILT. The high wall shear stress (WSS) caused by the impact of vortexes is thought to prevent the attachment of ILT. WSS from impingement is comparable to peak-systolic WSS in a normal-sized aorta and therefore may not damage the wall. Expansion occurred to a greater extent in the direction of jet impingement and the wall-normal force from the continuous impact of vortexes may contribute to expansion. It was shown that the impingement region has low oscillatory shear index (OSI) and recirculation zones can have either low or high OSI. No correlation could be identified between OSI and ILT deposition since different flow dynamics can have similar OSI values.

Control system for an artificial heart

NASA Technical Reports Server (NTRS)

Gebben, V. D.; Webb, J. A., Jr.

1970-01-01

Inexpensive industrial pneumatic components are combined to produce control system to drive sac-type heart-assistance blood pump with controlled pulsatile pressure that makes pump rate of flow sensitive to venous /atrial/ pressure, while stroke is centered about set operating point and pump is synchronized with natural heart.

Enhanced elastin synthesis and maturation in human vascular smooth muscle tissue derived from induced-pluripotent stem cells.

PubMed

Eoh, Joon H; Shen, Nian; Burke, Jacqueline A; Hinderer, Svenja; Xia, Zhiyong; Schenke-Layland, Katja; Gerecht, Sharon

2017-04-01

Obtaining vascular smooth muscle tissue with mature, functional elastic fibers is a key obstacle in tissue-engineered blood vessels. Poor elastin secretion and organization leads to a loss of specialization in contractile smooth muscle cells, resulting in over proliferation and graft failure. In this study, human induced-pluripotent stem cells (hiPSCs) were differentiated into early smooth muscle cells, seeded onto a hybrid poly(ethylene glycol) dimethacrylate/poly (l-lactide) (PEGdma-PLA) scaffold and cultured in a bioreactor while exposed to pulsatile flow, towards maturation into contractile smooth muscle tissue. We evaluated the effects of pulsatile flow on cellular organization as well as elastin expression and assembly in the engineered tissue compared to a static control through immunohistochemistry, gene expression and functionality assays. We show that culturing under pulsatile flow resulted in organized and functional hiPSC derived smooth muscle tissue. Immunohistochemistry analysis revealed hiPSC-smooth muscle tissue with robust, well-organized cells and elastic fibers and the supporting microfibril proteins necessary for elastic fiber assembly. Through qRT-PCR analysis, we found significantly increased expression of elastin, fibronectin, and collagen I, indicating the synthesis of necessary extracellular matrix components. Functionality assays revealed that hiPSC-smooth muscle tissue cultured in the bioreactor had an increased calcium signaling and contraction in response to a cholinergic agonist, significantly higher mature elastin content and improved mechanical properties in comparison to the static control. The findings presented here detail an effective approach to engineering elastic human vascular smooth muscle tissue with the functionality necessary for tissue engineering and regenerative medicine applications. Obtaining robust, mature elastic fibers is a key obstacle in tissue-engineered blood vessels. Human induced-pluripotent stem cells have become of interest due to their ability to supplement tissue engineered scaffolds. Their ability to differentiate into cells of vascular lineages with defined phenotypes serves as a potential solution to a major cause of graft failure in which phenotypic shifts in smooth muscle cells lead to over proliferation and occlusion of the graft. Herein, we have differentiated human induced-pluripotent stem cells in a pulsatile flow bioreactor, resulting in vascular smooth muscle tissue with robust elastic fibers and enhanced functionality. This study highlights an effective approach to engineering elastic functional vascular smooth muscle tissue for tissue engineering and regenerative medicine applications. Copyright © 2017 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Magnetic resonance imaging 4-D flow-based analysis of aortic hemodynamics in Turner syndrome.

PubMed

Arnold, Raoul; Neu, Marie; Hirtler, Daniel; Gimpel, Charlotte; Markl, Michael; Geiger, Julia

2017-04-01

Cardiovascular surveillance is important in Turner syndrome because of the increased risk of aortic dilation and dissection with consecutively increased mortality. To compare 4-D flow MRI for the characterization of aortic 3-D flow patterns, dimensions and vessel wall parameters in pediatric patients with Turner syndrome and age-matched controls. We performed 4-D flow MRI measuring in vivo 3-D blood flow with coverage of the thoracic aorta in 25 patients with Turner syndrome and in 16 female healthy controls (age mean ± standard deviation were 16 ± 5 years and 17 ± 4 years, respectively). Blood flow was visualized by time-resolved 3-D path lines. Visual grading of aortic flow in terms of helices and vortices was performed by two independent observers. Quantitative analysis included measurement of aortic diameters, quantification of peak systolic wall shear stress, pulsatility index and oscillatory shear index at eight defined sites. Patients with Turner syndrome had significantly larger aortic diameters normalized to BSA, increased vortices in the ascending aorta and elevated helix flow in the ascending and descending aorta compared to controls (all P<0.03). Patients with abnormal helical or vortical flow in the ascending aorta had significantly larger diameters of the ascending aorta (P<0.03). Peak systolic wall shear stress, pulsatility index and oscillatory shear index were significantly lower in Turner patients compared to controls (p=0.02, p=0.002 and p=0.01 respectively). Four-dimensional flow MRI provides new insights into the altered aortic hemodynamics and wall shear stress that could have an impact on the development of aortic dissections.

An improved methodology for investigating the parameters influencing migration resistance of abdominal aortic stent-grafts.

PubMed

Corbett, Timothy J; Callanan, Anthony; O'Donnell, Michael R; McGloughlin, Tim M

2010-02-01

To develop an improved methodology for investigating the parameters influencing stent-graft migration, with particular focus on the limitations of existing methods. A physiological silicone rubber abdominal aortic aneurysm (AAA) model for fixation studies was manufactured based on an idealized AAA geometry: the model had a 24-mm neck, a 50-mm aneurysm, 12-mm-diameter legs, a 60 degrees bifurcation angle, and 2-mm-thick walls. The models were authenticated in neck fixation experiments. The displacement force required to migrate stent-grafts in physiological pulsatile flow was tested dynamically in water at 37 degrees C. A commercially available longitudinally rigid stent-graft (AneuRx) and a homemade device with little longitudinal rigidity were studied in a number of different configurations to investigate the effect of neck fixation length and systolic pressure on displacement force. The AneuRx (6.95+/-0.49 to 8.52+/-0.5 N) performed significantly better than the homemade device (2.57+/-0.11 to 4.62+/-0.25 N) in pulsatile flow. The opposite was true in the neck fixation tests because the longitudinal stiffness of the AneuRx was not accounted for. Increasing pressure or decreasing fixation length compromised the fixation of the homemade device. This relationship was not as clear for the AneuRx because decreasing proximal fixation resulted in an increase in iliac fixation, which could assist fixation in this device. Assessing the migration resistance of stent-grafts based solely on proximal fixation discriminates against devices that are longitudinally stiff. Current in vivo models may give inaccurate displacement forces due to the high degree of oversizing in these studies. A novel in vitro approach, accounting for longitudinal rigidity and realistic graft oversizing, was developed to determine the resistance of aortic stent-grafts to migration in the period immediately after device implantation.

Estimating right ventricular stroke work and the pulsatile work fraction in pulmonary hypertension.

PubMed

Chemla, Denis; Castelain, Vincent; Zhu, Kaixian; Papelier, Yves; Creuzé, Nicolas; Hoette, Susana; Parent, Florence; Simonneau, Gérald; Humbert, Marc; Herve, Philippe

2013-05-01

The mean pulmonary artery pressure (mPAP) replaces mean systolic ejection pressure (msePAP) in the classic formula of right ventricular stroke work (RVSW) = (mPAP - RAP) × stroke volume, where RAP is mean right atrial pressure. Only the steady work is thus taken into account, not the pulsatile work, whereas pulmonary circulation is highly pulsatile. Our retrospective, high-fidelity pressure study tested the hypothesis that msePAP was proportional to mPAP, and looked at the implications for RVSW. Eleven patients with severe, precapillary pulmonary hypertension (PH) (six patients with idiopathic pulmonary arterial hypertension and five with chronic thromboembolic PH; mPAP = 57 ± 10 mm Hg) were studied at rest and during mild to moderate exercise. Eight non-PH control subjects were also studied at rest (mPAP = 16 ± 2 mm Hg). The msePAP was averaged from end diastole to dicrotic notch. In the full data set (53 pressure-flow points), mPAP ranged from 14 to 99.5 mm Hg, cardiac output from 2.38 to 11.1 L/min, and heart rate from 53 to 163 beats/min. There was a linear relationship between msePAP and mPAP (r² = 0.99). The msePAP matched 1.25 mPAP (bias, -0.5 ± 2.6 mm Hg). Results were similar in the resting non-PH group and in resting and the exercising PH group. This implies that the classic formula markedly underestimates RVSW and that the pulsatile work may be a variable 20% to 55% fraction of RVSW, depending on RAP and mPAP. At rest, RVSW in patients with PH was twice as high as that of the non-PH group (P < .05), but pulsatile work fraction was similar between the two groups (26 ± 4% vs 24 ± 1%) because of the counterbalancing effects of high RAP (11 ± 5 mm Hg vs 4 ± 2 mm Hg), which increases the fraction, and high mPAP, which decreases the fraction. Our study favored the use of an improved formula that takes into account the variable pulsatile work fraction: RVSW = (1.25 mPAP - RAP) × stroke volume. Increased RAP and increased mPAP have opposite effects on the pulsatile work fraction.

Pulsatile Lavage of Musculoskeletal Wounds Causes Muscle Necrosis and Dystrophic Calcification in a Rat Model.

PubMed

Chiaramonti, Alexander M; Robertson, Astor D; Nguyen, Thao P; Jaffe, David E; Hanna, E Lex; Holmes, Robert; Barfield, William R; Fourney, William L; Stains, Joseph P; Pellegrini, Vincent D

2017-11-01

Adequate irrigation of open musculoskeletal injuries is considered the standard of care to decrease bacterial load and other contaminants. While the benefit of debris removal compared with the risk of further seeding by high-pressure lavage has been studied, the effects of irrigation on muscle have been infrequently reported. Our aim in the present study was to assess relative damage to muscle by pulsatile lavage compared with bulb-syringe irrigation. In an animal model of heterotopic ossification, 24 Sprague-Dawley rats underwent hindlimb blast amputation via detonation of a submerged explosive, with subsequent through-the-knee surgical amputation proximal to the zone of injury. All wounds were irrigated and underwent primary closure. In 12 of the animals, pulsatile lavage (20 psi [138 kPa]) was used as the irrigation method, and in the other 12 animals, bulb-syringe irrigation was performed. A third group of 6 rats did not undergo the blast procedure but instead underwent surgical incision into the left thigh muscle followed by pulsatile lavage. Serial radiographs of the animals were made to monitor the formation of soft-tissue radiopaque lesions until euthanasia at 6 months. Image-guided muscle biopsies were performed at 8 weeks and 6 months (at euthanasia) on representative animals from each group. Histological analysis was performed with hematoxylin and eosin, alizarin red, and von Kossa staining on interval biopsy and postmortem specimens. All animals managed with pulsatile lavage, with or without blast injury, developed soft-tissue radiopaque lesions, whereas no animal that had bulb-syringe irrigation developed these lesions (p = 0.001). Five of the 12 animals that underwent blast amputation with pulsatile lavage experienced wound complications, whereas no animal in the other 2 groups experienced wound complications (p = 0.014). Radiopaque lesions appeared approximately 10 days postoperatively, increased in density until approximately 16 weeks, then demonstrated signs of variable regression. Histological analysis of interval biopsy and postmortem specimens demonstrated tissue damage with inflammatory cells, cell death, and dystrophic calcification. Pulsatile lavage of musculoskeletal wounds can cause irreversible insult to tissue, resulting in myonecrosis and dystrophic calcification. The benefits and offsetting harm of pulsatile lavage (20 psi) should be considered before its routine use in the management of musculoskeletal wounds.

Flow modification in canine intracranial aneurysm model by an asymmetric stent: studies using digital subtraction angiography (DSA) and image-based computational fluid dynamics (CFD) analyses

NASA Astrophysics Data System (ADS)

Hoi, Yiemeng; Ionita, Ciprian N.; Tranquebar, Rekha V.; Hoffmann, Kenneth R.; Woodward, Scott H.; Taulbee, Dale B.; Meng, Hui; Rudin, Stephen

2006-03-01

An asymmetric stent with low porosity patch across the intracranial aneurysm neck and high porosity elsewhere is designed to modify the flow to result in thrombogenesis and occlusion of the aneurysm and yet to reduce the possibility of also occluding adjacent perforator vessels. The purposes of this study are to evaluate the flow field induced by an asymmetric stent using both numerical and digital subtraction angiography (DSA) methods and to quantify the flow dynamics of an asymmetric stent in an in vivo aneurysm model. We created a vein-pouch aneurysm model on the canine carotid artery. An asymmetric stent was implanted at the aneurysm, with 25% porosity across the aneurysm neck and 80% porosity elsewhere. The aneurysm geometry, before and after stent implantation, was acquired using cone beam CT and reconstructed for computational fluid dynamics (CFD) analysis. Both steady-state and pulsatile flow conditions using the measured waveforms from the aneurysm model were studied. To reduce computational costs, we modeled the asymmetric stent effect by specifying a pressure drop over the layer across the aneurysm orifice where the low porosity patch was located. From the CFD results, we found the asymmetric stent reduced the inflow into the aneurysm by 51%, and appeared to create a stasis-like environment which favors thrombus formation. The DSA sequences also showed substantial flow reduction into the aneurysm. Asymmetric stents may be a viable image guided intervention for treating intracranial aneurysms with desired flow modification features.

Regulated recovery of pulsatile growth hormone secretion from negative feedback: a preclinical investigation

PubMed Central

Bowers, Cyril Y.

2011-01-01

Although stimulatory (feedforward) and inhibitory (feedback) dynamics jointly control neurohormone secretion, the factors that supervise feedback restraint are poorly understood. To parse the regulation of growth hormone (GH) escape from negative feedback, 25 healthy men and women were studied eight times each during an experimental GH feedback clamp. The clamp comprised combined bolus infusion of GH or saline and continuous stimulation by saline GH-releasing hormone (GHRH), GHRP-2, or both peptides after randomly ordered supplementation with placebo (both sexes) vs. E2 (estrogen; women) and T (testosterone; men). Endpoints were GH pulsatility and entropy (a model-free measure of feedback quenching). Gender determined recovery of pulsatile GH secretion from negative feedback in all four secretagog regimens (0.003 ≤ P ≤ 0.017 for women>men). Peptidyl secretagog controlled the mass, number, and duration of feedback-inhibited GH secretory bursts (each, P < 0.001). E2/T administration potentiated both pulsatile (P = 0.006) and entropic (P < 0.001) modes of GH recovery. IGF-I positively predicted the escape of GH secretory burst number and mode (P = 0.022), whereas body mass index negatively forecast GH secretory burst number and mass (P = 0.005). The composite of gender, body mass index, E2, IGF-I, and peptidyl secretagog strongly regulates the escape of pulsatile and entropic GH secretion from autonegative feedback. The ensemble factors identified in this preclinical investigation enlarge the dynamic model of GH control in humans. PMID:21795635

Optical aggregometry of red blood cells associated with the blood-clotting reaction in extracorporeal circulation support.

PubMed

Sakota, Daisuke; Kosaka, Ryo; Nishida, Masahiro; Maruyama, Osamu

2016-09-01

The aggregability of red blood cell (RBCs) is associated with the contribution of plasma proteins, such as fibrinogen and lipoproteids, to blood-clotting. Hence, we hypothesized that RBC aggregability reflects the blood-clotting reaction. A noninvasive optical monitoring method to measure RBC aggregability for the assessment of blood-clotting stage during mechanical circulatory support was developed. An in vitro thrombogenic test was conducted with a rotary blood pump using heparinized fresh porcine blood. Near-infrared laser light at a wavelength of 785 nm was guided by an optical fiber. The fibers for detecting incident, forward-, and backward-scattered light were fixed on the circuit tubing with an inner diameter of 1/4 inch. Because there is substantial RBC aggregation at low shear flow rates, a pulsatile flow was generated by controlling the pump rotational speed. The flow rate was changed from 0 to 8.5 L/min at a period of 40 s. The intensities of forward- and backward-scattered light changed dramatically when the flow stopped. The aggregability was evaluated by the increase ratio of the transmitted light intensity from the flow stopping in the low-flow condition. The experiment started when the anticoagulation was stopped by the addition of protamine into the circulating blood. Reduction in RBC aggregability was associated with a decrease in the amount of fibrinogen and the number of platelets. Continuous, noninvasive monitoring of thrombosis risk is possible using optical measurements combining pulsatile flow control of a rotary blood pump. RBC aggregometry is a potential label-free method for evaluating blood-clotting risk.

Development of a new extracorporeal whole-liver perfusion system.

PubMed

Naruse, Katsutoshi; Sakai, Yasuyuki; Guo, Lei; Natori, Takeshi; Shindoh, Junichi; Karasawa, Yasuaki; Iida, Yuhki; Kojima, Kentaro; Michishita, Kazuya; Makuuchi, Masatoshi

2003-01-01

We have developed a new extracorporeal whole-liver accommodation device in which a whole swine liver is placed in a physiological state by modeling the intraabdominal arrangement in the pig body, with the liver supported by a special inferior vena cava tube. Furthermore, we employed a diaphragm-type artificial heart in our system to produce pulsatile blood flow through the hepatic artery, which is considered to be indispensable to dilate peripheral vessels and supply oxygenated whole blood to the peripheral liver tissue. Beneficial effects were demonstrated in visual findings and bile juice secretion. The color of the liver surface in our system remained bright red, indicating that the liver vessels were well drained and free from congestion, and bile juice secretion was maintained at more than 10 ml/h throughout the perfusion period. Our system exhibited excellent ammonia removal and urea nitrogen synthesis, and serum aspartate aminotransferase levels showed no increase, indicating the absence of hepatocyte destruction. Histological findings showed that the liver could expand appropriately and was free from compression caused by its own weight. In conclusion, our original liver accommodation device enabled appropriate expansion of the whole liver and supplied adequate oxygenated blood to peripheral areas by means of a pulsatile pump.

Motion Tolerant Unfocused Imaging of Physiological Waveforms for Blood Pressure Waveform Estimation Using Ultrasound.

PubMed

Seo, Joohyun; Pietrangelo, Sabino J; Sodini, Charles G; Lee, Hae-Seung

2018-05-01

This paper details unfocused imaging using single-element ultrasound transducers for motion tolerant arterial blood pressure (ABP) waveform estimation. The ABP waveform is estimated based on pulse wave velocity and arterial pulsation through Doppler and M-mode ultrasound. This paper discusses approaches to mitigate the effect of increased clutter due to unfocused imaging on blood flow and diameter waveform estimation. An intensity reduction model (IRM) estimator is described to track the change of diameter, which outperforms a complex cross-correlation model (C3M) estimator in low contrast environments. An adaptive clutter filtering approach is also presented, which reduces the increased Doppler angle estimation error due to unfocused imaging. Experimental results in a flow phantom demonstrate that flow velocity and diameter waveforms can be reliably measured with wide lateral offsets of the transducer position. The distension waveform estimated from human carotid M-mode imaging using the IRM estimator shows physiological baseline fluctuations and 0.6-mm pulsatile diameter change on average, which is within the expected physiological range. These results show the feasibility of this low cost and portable ABP waveform estimation device.

Optimization of an idealized Y-Shaped Extracardiac Fontan Baffle

NASA Astrophysics Data System (ADS)

Yang, Weiguang; Feinstein, Jeffrey; Mohan Reddy, V.; Marsden, Alison

2008-11-01

Research has showed that vascular geometries can significantly impact hemodynamic performance, particularly in pediatric cardiology, where anatomy varies from one patient to another. In this study we optimize a newly proposed design for the Fontan procedure, a surgery used to treat single ventricle heart patients. The current Fontan procedure connects the inferior vena cava (IVC) to the pulmonary arteries (PA's) via a straight Gore-Tex tube, forming a T-shaped junction. In the Y-graft design, the IVC is connected to the left and right PAs by two branches. Initial studies on the Y-graft design showed an increase in efficiency and improvement in flow distribution compared to traditional designs in a single patient-specific model. We now optimize an idealized Y-graft model to refine the design prior to patient testing. A derivate-free optimization algorithm using Kriging surrogate functions and mesh adaptive direct search is coupled to a 3-D finite element Navier-Stokes solver. We will present optimization results for rest and exercise conditions and examine the influence of energy efficiency, wall shear stress, pulsatile flow, and flow distribution on the optimal design.

Fluid Dynamics in Rotary Piston Blood Pumps.

PubMed

Wappenschmidt, Johannes; Sonntag, Simon J; Buesen, Martin; Gross-Hardt, Sascha; Kaufmann, Tim; Schmitz-Rode, Thomas; Autschbach, Ruediger; Goetzenich, Andreas

2017-03-01

Mechanical circulatory support can maintain a sufficient blood circulation if the native heart is failing. The first implantable devices were displacement pumps with membranes. They were able to provide a sufficient blood flow, yet, were limited because of size and low durability. Rotary pumps have resolved these technical drawbacks, enabled a growing number of mechanical circulatory support therapy and a safer application. However, clinical complications like gastrointestinal bleeding, aortic insufficiency, thromboembolic complications, and impaired renal function are observed with their application. This is traced back to their working principle with attenuated or non-pulsatile flow and high shear stress. Rotary piston pumps potentially merge the benefits of available pump types and seem to avoid their complications. However, a profound assessment and their development requires the knowledge of the flow characteristics. This study aimed at their investigation. A functional model was manufactured and investigated with particle image velocimetry. Furthermore, a fluid-structure interaction computational simulation was established to extend the laboratory capabilities. The numerical results precisely converged with the laboratory measurements. Thus, the in silico model enabled the investigation of relevant areas like gap flows that were hardly feasible with laboratory means. Moreover, an economic method for the investigation of design variations was established.

Adding the ‘heart’ to hanging drop networks for microphysiological multi-tissue experiments†

PubMed Central

Yazdi, Saeed Rismani; Shadmani, Amir; Bürgel, Sebastian C.; Misun, Patrick M.; Hierlemann, Andreas; Frey, Olivier

2017-01-01

Microfluidic hanging-drop networks enable culturing and analysis of 3D microtissue spheroids derived from different cell types under controlled perfusion and investigating inter-tissue communication in multi-tissue formats. In this paper we introduce a compact on-chip pumping approach for flow control in hanging-drop networks. The pump includes one pneumatic chamber located directly above one of the hanging drops and uses the surface tension at the liquid–air-interface for flow actuation. Control of the pneumatic protocol provides a wide range of unidirectional pulsatile and continuous flow profiles. With the proposed concept several independent hanging-drop networks can be operated in parallel with only one single pneumatic actuation line at high fidelity. Closed-loop medium circulation between different organ models for multi-tissue formats and multiple simultaneous assays in parallel are possible. Finally, we implemented a real-time feedback control-loop of the pump actuation based on the beating of a human iPS-derived cardiac microtissue cultured in the same system. This configuration allows for simulating physiological effects on the heart and their impact on flow circulation between the organ models on chip. PMID:26401602

Growth patterns and cerebro-placental hemodynamics in fetuses with congenital heart disease.

PubMed

Mebius, M J; Clur, S A B; Vink, A S; Pajkrt, E; Kalteren, W S; Kooi, E M W; Bos, A F; du Marchie Sarvaas, G J; Bilardo, C M

2018-05-28

Congenital heart disease (CHD) has been associated with a reduced fetal head circumference (HC). The underlying pathophysiological background remains undetermined. We aimed to define trends in fetal growth and cerebro-placental Doppler flow, and to investigate the association between head growth and cerebro-placental flow in fetuses with CHD. Fetuses with CHD and serial measurements of HC, abdominal circumference (AC), middle cerebral artery pulsatility index (MCA-PI), umbilical artery pulsatility index (UA-PI), and cerebro-placental ratio (CPR) were included. CHD was categorized into 3 groups based on expected cerebral arterial oxygen saturation: normal, mild to moderately reduced, and severely reduced. Trends over time in Z-scores were analyzed using a linear mixed-effects model. 181 fetuses fulfilled the inclusion criteria. Expected cerebral arterial oxygen saturation in CHD was classified as normal in 44, mild to moderately reduced in 84 and severely reduced in 53 cases. HC z-scores showed a tendency to decrease until 23 weeks, then to increase until 33 weeks, followed by a decrease again in the late third trimester. AC increased progressively with advancing gestation. MCA-PI and UA-PI showed significant trends throughout pregnancy, but CPR did not. There were no associations between expected cerebral arterial oxygen saturation and fetal growth. Average trends in MCA-PI were significantly different in the three subgroups (P=0.010), whereas average trends in UA-PI and CPR were similar (P=0.530 and P=0.285). Furthermore, there was no significant association between MCA-PI and HC (P=0.284). Fetal biometry and Doppler flow patterns are within normal ranges in fetuses with CHD, but show trends over time. Fetal head growth is not associated with the cerebral blood flow pattern or placental function and HC is not influenced by the cerebral arterial oxygen saturation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Development and evaluation of endurance test system for ventricular assist devices.

PubMed

Sumikura, Hirohito; Homma, Akihiko; Ohnuma, Kentaro; Taenaka, Yoshiyuki; Takewa, Yoshiaki; Mukaibayashi, Hiroshi; Katano, Kazuo; Tatsumi, Eisuke

2013-06-01

We developed a novel endurance test system that can arbitrarily set various circulatory conditions and has durability and stability for long-term continuous evaluation of ventricular assist devices (VADs), and we evaluated its fundamental performance and prolonged durability and stability. The circulation circuit of the present endurance test system consisted of a pulsatile pump with a small closed chamber (SCC), a closed chamber, a reservoir and an electromagnetic proportional valve. Two duckbill valves were mounted in the inlet and outlet of the pulsatile pump. The features of the circulation circuit are as follows: (1) the components of the circulation circuit consist of optimized industrial devices, giving durability; (2) the pulsatile pump can change the heart rate and stroke length (SL), as well as its compliance using the SCC. Therefore, the endurance test system can quantitatively reproduce various circulatory conditions. The range of reproducible circulatory conditions in the endurance test circuit was examined in terms of fundamental performance. Additionally, continuous operation for 6 months was performed in order to evaluate the durability and stability. The circulation circuit was able to set up a wide range of pressure and total flow conditions using the SCC and adjusting the pulsatile pump SL. The long-term continuous operation test demonstrated that stable, continuous operation for 6 months was possible without leakage or industrial device failure. The newly developed endurance test system demonstrated a wide range of reproducible circulatory conditions, durability and stability, and is a promising approach for evaluating the basic characteristics of VADs.

Biological factors in plasma from diabetes mellitus patients enhance hyperglycaemia and pulsatile shear stress-induced endothelial cell apoptosis.

PubMed

Liu, X F; Yu, J Q; Dalan, R; Liu, A Q; Luo, K Q

2014-05-01

People suffering from Diabetes Mellitus (DM) are prone to an array of vascular complications leading to end organ damage. The hallmark of these vascular complications is endothelium dysfunction, which is caused by endothelial cell (EC) apoptosis. Although the endothelial cell (EC) dysfunction induced by hyperglycaemia and fluid shear stress has been studied, the effects of biological factors in the blood of DM patients on EC integrity have not been reported in the in vitro models that mimic the physiological pulsatile nature of the vascular system. This study reports the development of a hemodynamic lab-on-a-chip system to investigate this issue. The pulsatile flow was applied to a monolayer of endothelial cells expressing a fluorescence resonance energy transfer (FRET)-based biosensor that changes colour from green to blue in response to caspase-3 activation during apoptosis. Plasma samples from healthy volunteers and DM patients were compared to identify biological factors that are critical to endothelial disruption. Three types of microchannels were designed to simulate the blood vessels under healthy and partially blocked pathological conditions. The results showed that EC apoptosis rates increased with increasing glucose concentration and levels of shear stress. The rates of apoptosis further increased by a factor of 1.4-2.3 for hyperglycaemic plasma under all dynamic conditions. Under static conditions, little difference was detected in the rate of EC apoptosis between experiments using plasma from DM patients and glucose medium, suggesting that the effects of hyperglycaemia and biological factors on the induction of EC apoptosis are all shear flow-dependent. A proteomics study was then conducted to identify biological factors, demonstrating that the levels of eight proteins, including haptoglobin and clusterin, were significantly down-regulated, while six proteins, including apolipoprotein C-III, were significantly up-regulated in the plasma of DM patients compared to healthy volunteers. This hemodynamic lab-on-a-chip system can serve as a high throughput platform to assess the risk of vascular complications of DM patients and to determine the effects of therapeutics or other interventions on EC apoptosis.

Urethral anatomy and semen flow during ejaculation

NASA Astrophysics Data System (ADS)

Kelly, Diane

2016-11-01

Ejaculation is critical for reproductive success in many animals, but little is known about its hydrodynamics. In mammals, ejaculation pushes semen along the length of the penis through the urethra. Although the urethra also carries urine during micturition, the flow dynamics of micturition and ejaculation differ: semen is more viscous than urine, and the pressure that drives its flow is derived primarily from the rhythmic contractions of muscles at the base of the penis, which produce pulsatile rather than steady flow. In contrast, Johnston et al. (2014) describe a steady flow of semen through the crocodilian urethral groove during ejaculation. Anatomical differences of tissues associated with mammalian and crocodilian urethral structures may underlie these differences in flow behavior.

Wall shear stress estimates in coronary artery constrictions

NASA Technical Reports Server (NTRS)

Back, L. H.; Crawford, D. W.

1992-01-01

Wall shear stress estimates from laminar boundary layer theory were found to agree fairly well with the magnitude of shear stress levels along coronary artery constrictions obtained from solutions of the Navier Stokes equations for both steady and pulsatile flow. The relatively simple method can be used for in vivo estimates of wall shear stress in constrictions by using a vessel shape function determined from a coronary angiogram, along with a knowledge of the flow rate.

Hemodynamic effects of long-term morphological changes in the human carotid sinus.

PubMed

Seong, Jaehoon; Jeong, Woowon; Smith, Nataliya; Towner, Rheal A

2015-04-13

Previous investigations of morphology for human carotid artery bifurcation from infancy to young adulthood found substantial growth of the internal carotid artery with advancing age, and the development of the carotid sinus at the root of the internal carotid artery during teenage years. Although the reasons for the appearance of the carotid sinus are not clearly understood yet, it has been hypothesized that the dilation of the carotid sinus serves to support pressure sensing, and slows the blood flow to reduce pulsatility to protect the brain. In order to understand this interesting evolvement at the carotid bifurcation in the aspects of fluid mechanics, we performed in vitro phase-contrast MR flow experiments using compliant silicone replicas of age-dependent carotid artery bifurcations. The silicone models in childhood, adolescence, and adulthood were fabricated using a rapid prototyping technique, and incorporated with a bench-top flow mock circulation loop using a computer-controlled piston pump. The results of the in vitro flow study showed highly complex flow characteristics at the bifurcation in all age-dependent models. However, the highest magnitude of kinetic energy was found at the internal carotid artery in the child model. The high kinetic energy in the internal carotid artery during childhood might be one of the local hemodynamic forces that initiate morphological long-term development of the carotid sinus in the human carotid bifurcation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Acute microcirculatory response to nicotine in frog web.

PubMed

Horimoto, M; Koyama, T

1982-01-01

Acute effects of nicotine (NC) on the microcirculation of frog webs were studied by measuring the blood flow velocity in arterioles, and by determining the diameter of both arterioles and venules. Simultaneous recordings of the ventricular pressure and heart rate were obtained in order to compute the vascular resistance and to interpret the changes in microcirculation. The web of right hindlimb was immersed in a solution of NC (2.6 to 3.4 mg/ml) for 4 min. Blood flow velocity in web arterioles of left hindlimb was measured by means of a laser Doppler microscope. Internal diameters of web microvessels were determined using a micrometer on the ocular lens of the microscope. Mean flow velocity (MV) and pulsatile amplitude (PA) were calculated from the pulsatile flow-velocity contour for each vessel. Both MV and PA were increased after the immersion of the web in NC solution. Although the magnitude of the increment in MV was proportional to that in ventricular pressure, the vasodilation of both arterioles and venules and the flow rate in arterioles higher than the initial state continued even after the ventricular pressure had returned to the initial control value. Calculation of the relative change in vascular resistance in web arterioles following NC administration suggested a vasodilator response to NC. Furthermore, our results indicate that sufficient NC can be absorbed across the web epithelium to produce a systemic vascular response when the concentration of NC in the bathing solution is 2.6 mg/ml.

Dispersive aortic cannulas reduce aortic wall shear stress affecting atherosclerotic plaque embolization.

PubMed

Assmann, Alexander; Gül, Fethi; Benim, Ali Cemal; Joos, Franz; Akhyari, Payam; Lichtenberg, Artur

2015-03-01

Neurologic complications during on-pump cardiovascular surgery are often induced by mobilization of atherosclerotic plaques, which is directly related to enhanced wall shear stress. In the present study, we numerically evaluated the impact of dispersive aortic cannulas on aortic blood flow characteristics, with special regard to the resulting wall shear stress profiles. An idealized numerical model of the human aorta and its branches was created and used to model straight as well as bent dispersive aortic cannulas with meshlike tips inserted in the distal ascending aorta. Standard cannulas with straight beveled or bent tips served as controls. Using a recently optimized computing method, simulations of pulsatile and nonpulsatile extracorporeal circulation were performed. Dispersive aortic cannulas reduced the maximum and average aortic wall shear stress values to approximately 50% of those with control cannulas, while the difference in local values was even larger. Moreover, under pulsatile circulation, dispersive cannulas shortened the time period during which wall shear stress values were increased. The turbulent kinetic energy was also diminished by utilizing dispersive cannulas, reducing the risk of hemolysis. In summary, dispersive aortic cannulas decrease aortic wall shear stress and turbulence during extracorporeal circulation and may therefore reduce the risk of endothelial and blood cell damage as well as that of neurologic complications caused by atherosclerotic plaque mobilization. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Optoelectronic system for the determination of blood volume in pneumatic heart assist devices.

PubMed

Konieczny, Grzegorz; Pustelny, Tadeusz; Setkiewicz, Maciej; Gawlikowski, Maciej

2015-12-10

The following article describes the concept of optical measurement of blood volume in ventricular assist devices (VAD's) of the pulsatile type. The paper presents the current state of art in blood volume measurements of such devices and introduces a newly developed solution in the optic domain. The objective of the research is to overcome the disadvantages of the previously developed acoustic method-the requirement of additional sensor chamber. The idea of a compact measurement system has been introduced, followed by laboratory measurements. Static tests of the system have been presented, followed by dynamic measurements on a physical model of the human ventricular system. The results involving the measurements of blood chamber volume acquired by means of an optical system have been compared with the results acquired by means of the Transonic T410 ultrasound flow rate sensor (11PLX transducer, uncertainty ±5 %). Preliminary dynamic measurements conducted on the physical model of the human cardiovascular system show that the proposed optical measurement system may be used to measure the transient blood chamber volumes of pulsatile VAD's with the uncertainties (standard mean deviation) lower than 10 %. The results show that the noninvasive measurements of the temporary blood chamber volume in the POLVAD prosthesis with the use of the developed optical system allows us to carry out accurate static and dynamic measurements.

Fluid Dynamic Characterization of a Polymeric Heart Valve Prototype (Poli-Valve) tested under Continuous and Pulsatile Flow Conditions

PubMed Central

De Gaetano, Francesco; Serrani, Marta; Bagnoli, Paola; Brubert, Jacob; Stasiak, Joanna; Moggridge, Geoff D.; Costantino, Maria Laura

2016-01-01

Introduction Only mechanical and biological heart valve prostheses are currently commercially available. The former show longer durability but require anticoagulant therapy, the latter display better fluid dynamic behaviour but do not have adequate durability. New Polymeric Heart Valves (PHVs) could potentially combine the haemodynamic properties of biological valves with the durability of mechanical valves. This work presents a hydrodynamic evaluation of two groups of newly developed supra-annular tri-leaflet prosthetic heart valves made from styrenic block copolymers (SBC): Poli-Valves. Methods Two types of Poli-Valves made of SBC differing in polystyrene fraction content were tested under continuous and pulsatile flow conditions as prescribed by ISO 5840 Standard. An ad - hoc designed pulse duplicator allowed the valve prototypes to be tested at different flow rates and frequencies. Pressure and flow were recorded; pressure drops, effective orifice area (EOA), and regurgitant volume were computed to assess the valve’s behaviour. Results Both types Poli-Valves met the minimum requirements in terms of regurgitation and EOA as specified by ISO 5840 Standard. Results were compared with five mechanical heart valves (MHVs) and five tissue heart valves (THVs), currently available on the market. Conclusion Based on these results, polymeric heart valves based on styrenic block copolymers, as Poli-Valves are, can be considered as promising alternative for heart valve replacement in near future. PMID:26689146

Fluid dynamic characterization of a polymeric heart valve prototype (Poli-Valve) tested under continuous and pulsatile flow conditions.

PubMed

De Gaetano, Francesco; Serrani, Marta; Bagnoli, Paola; Brubert, Jacob; Stasiak, Joanna; Moggridge, Geoff D; Costantino, Maria Laura

2015-11-01

Only mechanical and biological heart valve prostheses are currently commercially available. The former show longer durability but require anticoagulant therapy; the latter display better fluid dynamic behavior but do not have adequate durability. New Polymeric Heart Valves (PHVs) could potentially combine the hemodynamic properties of biological valves with the durability of mechanical valves. This work presents a hydrodynamic evaluation of 2 groups of newly developed supra-annular, trileaflet prosthetic heart valves made from styrenic block copolymers (SBC): Poli-Valves. 2 types of Poli-Valves made of SBC and differing in polystyrene fraction content were tested under continuous and pulsatile flow conditions as prescribed by ISO 5840 Standard. A pulse duplicator designed ad hoc allowed the valve prototypes to be tested at different flow rates and frequencies. Pressure and flow were recorded; pressure drops, effective orifice area (EOA), and regurgitant volume were computed to assess the behavior of the valve. Both types of Poli-Valves met the minimum requirements in terms of regurgitation and EOA as specified by the ISO 5840 Standard. Results were compared with 5 mechanical heart valves (MHVs) and 5 tissue heart valves (THVs), currently available on the market. Based on these results, PHVs based on styrenic block copolymers, as are Poli-Valves, can be considered a promising alternative for heart valve replacement in the near future.

Hydrodynamic Forces on Microbubbles under Ultrasound Excitation

NASA Astrophysics Data System (ADS)

Clark, Alicia; Aliseda, Alberto

2014-11-01

Ultrasound (US) pressure waves exert a force on microbubbles that can be used to steer them in a flow. To control the motion of microbubbles under ultrasonic excitation, the coupling between the volume oscillations induced by the ultrasound pressure and the hydrodynamic forces needs to be well understood. We present experimental results for the motion of small, coated microbubbles, with similar sizes and physico-chemical properties as clinically-available ultrasound contrast agents (UCAs). The size distribution for the bubbles, resulting from the in-house manufacturing process, was characterized by analysis of high magnification microscopic images and determined to be bimodal. More than 99% of the volume is contained in microbubbles less than 10 microns in diameter, the size of a red blood cell. The motion of the microbubbles in a pulsatile flow, at different Reynolds and Womersley numbers, is studied from tracking of high-speed shadowgraphy. The influence of ultrasound forcing, at or near the resonant frequency of the bubbles, on the hydrodynamic forces due to the pulsatile flow is determined from the experimental measurements of the trajectories. Previous evidence of a sign reversal in Saffman lift is the focus of particular attention, as this is frequently the only hydrodynamic force acting in the direction perpendicular to the flow pathlines. Application of the understanding of this physical phenomenon to targeted drug delivery is analyzed in terms of the transport of the microbubbles. NSF GRFP.

A Bayesian Model for Highly Accelerated Phase-Contrast MRI

PubMed Central

Rich, Adam; Potter, Lee C.; Jin, Ning; Ash, Joshua; Simonetti, Orlando P.; Ahmad, Rizwan

2015-01-01

Purpose Phase-contrast magnetic resonance imaging (PC-MRI) is a noninvasive tool to assess cardiovascular disease by quantifying blood flow; however, low data acquisition efficiency limits the spatial and temporal resolutions, real-time application, and extensions to 4D flow imaging in clinical settings. We propose a new data processing approach called Reconstructing Velocity Encoded MRI with Approximate message passing aLgorithms (ReVEAL) that accelerates the acquisition by exploiting data structure unique to PC-MRI. Theory and Methods ReVEAL models physical correlations across space, time, and velocity encodings. The proposed Bayesian approach exploits the relationships in both magnitude and phase among velocity encodings. A fast iterative recovery algorithm is introduced based on message passing. For validation, prospectively undersampled data are processed from a pulsatile flow phantom and five healthy volunteers. Results ReVEAL is in good agreement, quantified by peak velocity and stroke volume (SV), with reference data for acceleration rates R ≤ 10. For SV, Pearson r ≥ 0.996 for phantom imaging (n = 24) and r ≥ 0.956 for prospectively accelerated in vivo imaging (n = 10) for R ≤ 10. Conclusion ReVEAL enables accurate quantification of blood flow from highly undersampled data. The technique is extensible to 4D flow imaging, where higher acceleration may be possible due to additional redundancy. PMID:26444911

Experimental validation of numerical simulations on a cerebral aneurysm phantom model

PubMed Central

Seshadhri, Santhosh; Janiga, Gábor; Skalej, Martin; Thévenin, Dominique

2012-01-01

The treatment of cerebral aneurysms, found in roughly 5% of the population and associated in case of rupture to a high mortality rate, is a major challenge for neurosurgery and neuroradiology due to the complexity of the intervention and to the resulting, high hazard ratio. Improvements are possible but require a better understanding of the associated, unsteady blood flow patterns in complex 3D geometries. It would be very useful to carry out such studies using suitable numerical models, if it is proven that they reproduce accurately enough the real conditions. This validation step is classically based on comparisons with measured data. Since in vivo measurements are extremely difficult and therefore of limited accuracy, complementary model-based investigations considering realistic configurations are essential. In the present study, simulations based on computational fluid dynamics (CFD) have been compared with in situ, laser-Doppler velocimetry (LDV) measurements in the phantom model of a cerebral aneurysm. The employed 1:1 model is made from transparent silicone. A liquid mixture composed of water, glycerin, xanthan gum and sodium chloride has been specifically adapted for the present investigation. It shows physical flow properties similar to real blood and leads to a refraction index perfectly matched to that of the silicone model, allowing accurate optical measurements of the flow velocity. For both experiments and simulations, complex pulsatile flow waveforms and flow rates were accounted for. This finally allows a direct, quantitative comparison between measurements and simulations. In this manner, the accuracy of the employed computational model can be checked. PMID:24265876

In vitro performance testing of a pediatric oxygenator with an integrated pulsatile pump.

PubMed

Borchardt, Ralf; Schlanstein, Peter; Mager, Ilona; Arens, Jutta; Schmitz-Rode, Thomas; Steinseifer, Ulrich

2012-01-01

For different lung and heart diseases (e.g., acute respiratory distress syndrome, congenital heart failure, and cardiomyopathy) extracorporeal membrane oxygenation is a well-established therapy, particularly in the field of neonatal and pediatric medicine. To reduce the priming volume of the extracorporeal circuit, different components can be combined. In this study, an oval-shaped oxygenator (called ExMeTrA) with integrated pulsatile pump was tested in vitro using porcine blood. A feasibility study regarding the performance of collapsing and expanding silicone tubes within an oxygenator fiber bundle as a pulsatile pump was previously completed with successful results. The findings of this study improve upon the previous feasibility results, particularly in terms of gas exchange and filling volume. Five modules were manufactured in sizes of 20 ± 2.2 ml (priming volume) with fiber surface areas of 0.24 ± 0.027 m(2) and an analytically calculated volume pumping capacity of 692 ± 75 ml/min. The modules were made of polymethylpentene fibers with dense outer layer to permit long-term applications. The gas exchange rates at a gas/blood flow ratio of 2:1 were between 64 and 72.7 ml(O)(2)/l(blood) and between 62.5 and 81.5 ml/l(blood), depending on the blood flow. The individual module's pumping capacity ranged from 200-500 ml/min thus providing room for further improvements. In order to enhance the pumping capacity while maintaining sufficient gas exchange rates future optimization, adjustments will be made to the inlet and outlet geometries.

Color Doppler Sonographic Evaluation of Peak Systolic Velocity and Pulsatility Index in Artery after Pulsed HIFU Exposure

NASA Astrophysics Data System (ADS)

Yang, Feng-Yi; Chiu, Wei-Hsiu; Yeh, Chi-Fang

2011-09-01

The objective of current study was to investigate the functional changes in arteries induced by pulsed-HIFU with or without microbubbles. Sonication was applied at an ultrasound frequency of 1 MHz with a burst length of 50 ms and a repetition frequency of 1 Hz. The duration of the whole sonication was 6s. The abdominal aortas of Sprague-Dawley rats were surgically exposed and sonicated with pulsed HIFU; the pulsed HIFU beam was aimed using color images of the blood flow. There was no obvious normalized peak systolic velocity (PSV) change at various acoustic powers of pulsed-HIFU exposure in the absence of ultrasound contrast agent (UCA). However, the normalized PSV change induced by pulsed-HIFU decreased with the injected dose of UCA at acoustic powers. At this time, the normalized pulsatility index (PI) change in the vessel subjected to pulsed-HIFU increased in proportion to UCA dose. Additional research is needed to investigate the detailed mechanical effects of pulsed-HIFU exposure on blood flow and the structure of vessel walls.

Design of a pulsatile DC electromagnetic blood pump for ECMO.

PubMed

Liu, Jingjing; Ge, Bin; Lu, Tong

2017-08-09

Extracorporeal membrane oxygenation (ECMO) has developed rapidly and becomes a significant treatment for emergency. Current blood pumps for ECMO have different disadvantages. To design a pulsatile DC electromagnetic blood pump for ECMO. The design is presented with a driving principle which the rectilinear reciprocation of a magnet inside energized solenoids is implemented, and with a structure of solenoids with compensation coils. Furthermore, a prototype was constructed and the performance indexes of it were measured with the experimental evaluations, where the acceleration experiment was performed without any loads, and the flows were measured in the ranges of preload and afterload are 5 to 30 mmHg and 50 to 80 mmHg respectively when the frequency of the motion is 80 beats per minute. The electromagnetic force is greater than 1.4 N when the DC reaches 2.7 A and the flow of the prototype is greater than 3.0 L/min except the differences between the preload and the afterload are greater than or equal to 70 mmHg. The design of the blood pump for ECMO meets the theoretical and clinical requirements.

Uteroplacental circulation in early pregnancy complicated by threatened abortion supplemented with vaginal micronized progesterone or oral dydrogesterone.

PubMed

Czajkowski, Krzysztof; Sienko, Jacek; Mogilinski, Mariusz; Bros, Magdalena; Szczecina, Roman; Czajkowska, Anna

2007-03-01

To compare the influence of vaginal micronized progesterone and oral dydrogesterone supplementation on uteroplacental circulation in early pregnancy that is complicated by threatened abortion. Randomized, parallel group, double-blind, double dummy-controlled study. Tertiary care university hospital. Fifty-three patients with threatened abortion and a living embryo. Three hundred milligrams of micronized vaginal progesterone or 30 mg of oral dydrogesterone daily supplementation for 6 weeks, serial transvaginal Doppler ultrasound measurement of pulsatility index, resistance index, and systolic/diastolic ratio of the spiral arteries, the uterine arteries, and the intrachorionic area. Uteroplacental blood flow. The study demonstrated that vaginal progesterone administration, but not oral dydrogesterone treatment, results in the decrease in the spiral artery pulsatility and resistance index and systolic/diastolic ratio. Insignificant decrease in pulsatility index and resistance index of the uterine artery was observed at >9 weeks and was not associated with treatment regimen. Dydrogesterone treatment was only accompanied by the decrease in the uterine artery systolic/diastolic ratio. Vaginal progesterone and oral dydrogesterone supplementation have a different influence on the uteroplacental circulation in early pregnancy that is complicated by threatened abortion.

Effects of single low-temperature sauna bathing in patients with severe motor and intellectual disabilities

NASA Astrophysics Data System (ADS)

Iiyama, Junichi; Matsushita, Kensuke; Tanaka, Nobuyuki; Kawahira, Kazumi

2008-07-01

We have previously reported that thermal vasodilation following warm-water bathing and low-temperature sauna bathing (LTSB) at 60 °C for 15 min improves the cardiac function in patients with congestive heart failure. Through a comparative before-and-after study, we studied the hemodynamic and clinical effects of single exposure to LTSB in cerebral palsy (CP) patients who usually suffer from chilled extremities and low cardiac output. The study population comprised 16 patients ranging between 19 and 53 years with severe motor and intellectual disabilities. Noninvasive methods were used to estimate the systemic and peripheral circulatory changes before and after LTSB. Using blood flow velocity analysis, the pulsatile and resistive indexes of the peripheral arteries of the patients’ lower limbs were calculated. Following LTSB, the patients’ deep body temperature increased significantly by 1°C. Their heart rates increased and blood pressure decreased slightly. The total peripheral resistance decreased by 11%, and the cardiac output increased by 14%. There was significant improvement in the parameters that are indicative of the peripheral circulatory status, including the skin blood flow, blood flow velocity, pulsatile index, and resistive index. Numbness and chronic myalgia of the extremities decreased. There were no adverse side effects. Thus, it can be concluded that LTSB improves the peripheral circulation in CP patients.

Effects of single low-temperature sauna bathing in patients with severe motor and intellectual disabilities.

PubMed

Iiyama, Junichi; Matsushita, Kensuke; Tanaka, Nobuyuki; Kawahira, Kazumi

2008-07-01

We have previously reported that thermal vasodilation following warm-water bathing and low-temperature sauna bathing (LTSB) at 60 degrees C for 15 min improves the cardiac function in patients with congestive heart failure. Through a comparative before-and-after study, we studied the hemodynamic and clinical effects of single exposure to LTSB in cerebral palsy (CP) patients who usually suffer from chilled extremities and low cardiac output. The study population comprised 16 patients ranging between 19 and 53 years with severe motor and intellectual disabilities. Noninvasive methods were used to estimate the systemic and peripheral circulatory changes before and after LTSB. Using blood flow velocity analysis, the pulsatile and resistive indexes of the peripheral arteries of the patients' lower limbs were calculated. Following LTSB, the patients' deep body temperature increased significantly by 1 degrees C. Their heart rates increased and blood pressure decreased slightly. The total peripheral resistance decreased by 11%, and the cardiac output increased by 14%. There was significant improvement in the parameters that are indicative of the peripheral circulatory status, including the skin blood flow, blood flow velocity, pulsatile index, and resistive index. Numbness and chronic myalgia of the extremities decreased. There were no adverse side effects. Thus, it can be concluded that LTSB improves the peripheral circulation in CP patients.

[The specific features of Doppler ultrasound study of ophthalmic vessels in young persons with peripheral vitreochorioretinal dystrophies].

PubMed

Pozdeeva, O G

2005-01-01

Hemodynamic parameters were studied in the ophthalmic artery, short posterior ciliary arteries (SPCA), long posterior ciliary arteries (LPCA), and central artery of the retina (CAR). Doppler ultrasound study (DUSS) was performed on an Acuson Aspen multipurpose diagnostic system using a linear transducer at a frequency of 7.5 MHz in the pulse mode. Chelyabinsk students aged 17-25 years were examined. A number of specific features of retinal blood supply were detected in young persons with dystrophic diseases of the periphery of the fundus oculi. These included decreased blood flow velocities and less systolic flow acceleration time in SPCA, LPCA, and CAR in peripheral vitreochorioretinal dystrophies (PVCRD). The higher pulsatile index (PI) in the LPCA system characterized a possible mechanism responsible for compensation of impaired blood supply in the retinal periphery in the development of PVCRD. The high values of the pulsatile index and the vascular wall resistivity index in CAR reflected the changes determining the absence of complications as retinal ruptures and detachment. There were neither changes in ophthalmic arterial blood flow depending on the type of PVCRD and the nature of its course nor significant differences in blood supply to the eye in different types of refraction.

In vitro reconstruction of hybrid vascular tissue. Hierarchic and oriented cell layers.

PubMed

Kanda, K; Matsuda, T; Oka, T

1993-01-01

Hybrid vascular tissue was hierarchically reconstructed in vitro. A hybrid medial layer composed of type I collagen gel, in which SMCs derived from a mongrel dog were embedded, was formed on the inner surface of a compliant porous polyurethane graft (internal diameter = 3 mm). Endothelial cells (ECs) from the same animal were seeded and cultured on the hybrid media to build an intimal layer. Subsequently, hierarchically structured grafts constructed in this manner were subjected to pulsatile flow (flow rate: 8.5 ml/min; frequency: 60 rpm; amplitude: 5% of graft outer diameter) of culture medium (Medium 199 supplemented with 20% fetal calf serum). After stress loading for as long as 10 days, tissues were morphologically investigated with a light microscope and a scanning electron microscope. Inner surfaces of the hybrid tissues were covered with EC monolayers that aligned along the direction of the flow (i.e., longitudinally). However, SMCs beneath the intima aligned in the circumferential direction. These cellular orientations resembled those in native muscular arteries. The pulsatile stress loaded hybrid tissue mimicked native muscular arteries with respect to hierarchic structure and cellular orientation. In vitro mechanical stress loading on a hybrid graft might provide a high degree of integrity in terms of tissue structure that promises high tolerance toward hydrodynamic stress and regulation of vasomotor tone upon implantation.

Effects of Pump Pulsation on Hydrodynamic Properties and Dissolution Profiles in Flow-Through Dissolution Systems (USP 4).

PubMed

Yoshida, Hiroyuki; Kuwana, Akemi; Shibata, Hiroko; Izutsu, Ken-Ichi; Goda, Yukihiro

2016-06-01

To clarify the effects of pump pulsation and flow-through cell (FTC) dissolution system settings on the hydrodynamic properties and dissolution profiles of model formulations. Two FTC systems with different cell temperature control mechanisms were used. Particle image velocimetry (PIV) was used to analyze the hydrodynamic properties of test solutions in the flow-through dissolution test cell. Two pulsation pumps (semi-sine, full-sine) and a non-pulsatile pump were used to study the effects of varied flows on the dissolution profiles of United States Pharmacopeia standard tablets. PIV analysis showed periodic changes in the aligned upward fluid flow throughout the dissolution cell that was designed to reduce the temperature gradient during pump pulsation (0.5 s/pulse). The maximum instantaneous flow from the semi-sine pump was higher than that of the full-sine pump under all conditions. The flow from the semi-sine wave pump showed faster dissolution of salicylic acid and prednisone tablets than those from other pumps. The semi-sine wave pump flow showed similar dissolution profiles in the two FTC systems. Variations in instantaneous fluid flow caused by pump pulsation that meets the requirements of pharmacopoeias are a factor that affects the dissolution profiles of tablets in FTC systems.

In Vitro Evaluation of a Rheolytic Thrombectomy System for Clot Removal from Five Different Temporary Vena Cava Filters

DOE Office of Scientific and Technical Information (OSTI.GOV)

Buecker, Arno; Neuerburg, Joerg; Schmitz-Rode, Thomas

1997-11-15

Purpose: To evaluate the feasibility of thrombus removal from temporary vena cava filters using a rheolytic thrombectomy device and to assess the embolization rate of this procedure. Methods: Five temporary vena cava filters together with porcine thrombi were placed in a vena cava flow model (semitranslucent silicone tube of 23 mm diameter, pulsatile flow at a mean flow rate of 4 L/min). A rheolytic thrombectomy system (Hydrolyser) was used with a 9 Fr guiding catheter to remove the clots. The effluent was passed through filters of different size and the amount of embolized particles as well as the remaining thrombusmore » were measured. Results: Thrombus removal rates ranged from 85% to 100%. Embolization rates between 47% and 60% were calculated for the different filters. Conclusion: The Hydrolyser is able to remove sufficiently high amounts of thrombus from temporary vena cava filters. However, the amount of embolized particles makes it impossible to utilize this method without special precautions against embolization.« less

Applications of magnetohydrodynamics in biological systems-a review on the numerical studies

NASA Astrophysics Data System (ADS)

Rashidi, Saman; Esfahani, Javad Abolfazli; Maskaniyan, Mahla

2017-10-01

Magnetohydrodynamic (MHD) fluid flow in different geometries relevant to human body parts is an interesting and important scientific area due to its applications in medical sciences. This article performs a comprehensive review on the applications of MHD and their numerical modelling in biological systems. Applications of MHD in medical sciences are classified into four categories in this paper. Applications of MHD in simple flow, peristaltic flow, pulsatile flow, and drag delivery are these categories. The numerical researches performed for these categories are reviewed and summarized separately. Finally, some conclusions and suggestions for future works based on the literature review are presented. The results indicated that during a surgery when it is necessary to drop blood flow or reduce tissue temperature, it may be achieved by using a magnetic field. Moreover, the review showed that the trapping is an important phenomenon in peristaltic flows that causes the formation of thrombus in blood and the movement of food bolus in gastrointestinal tract. This phenomenon may be disappeared by using a proper magnetic field. Finally, the concentration of particles that are delivered to the target region increases with an increase in the magnetic field intensity.

A Fictitious Domain Method for Resolving the Interaction of Blood Flow with Clot Growth

NASA Astrophysics Data System (ADS)

Mukherjee, Debanjan; Shadden, Shawn

2016-11-01

Thrombosis and thrombo-embolism cause a range of diseases including heart attack and stroke. Closer understanding of clot and blood flow mechanics provides valuable insights on the etiology, diagnosis, and treatment of thrombotic diseases. Such mechanics are complicated, however, by the discrete and multi-scale phenomena underlying thrombosis, and the complex interactions of unsteady, pulsatile hemodynamics with a clot of arbitrary shape and microstructure. We have developed a computational technique, based on a fictitious domain based finite element method, to study these interactions. The method can resolve arbitrary clot geometries, and dynamically couple fluid flow with static or growing clot boundaries. Macroscopic thrombus-hemodynamics interactions were investigated within idealized vessel geometries representative of the common carotid artery, with realistic unsteady flow profiles as inputs. The method was also employed successfully to resolve micro-scale interactions using a model driven by in-vivo morphology data. The results provide insights into the flow structures and hemodynamic loading around an arbitrarily grown clot at arterial length-scales, as well as flow and transport within the interstices of platelet aggregates composing the clot. The work was supported by AHA Award No: 16POST27500023.

Transesophageal Doppler measurement of renal arterial blood flow velocities and indices in children.

PubMed

Zabala, Luis; Ullah, Sana; Pierce, Carol D'Ann; Gautam, Nischal K; Schmitz, Michael L; Sachdeva, Ritu; Craychee, Judith A; Harrison, Dale; Killebrew, Pamela; Bornemeier, Renee A; Prodhan, Parthak

2012-06-01

Doppler-derived renal blood flow indices have been used to assess renal pathologies. However, transesophageal ultrasonography (TEE) has not been previously used to assess these renal variables in pediatric patients. In this study, we (a) assessed whether TEE allows adequate visualization of the renal parenchyma and renal artery, and (b) evaluated the concordance of TEE Doppler-derived renal blood flow measurements/indices compared with a standard transabdominal renal ultrasound (TAU) in children. This prospective cohort study enrolled 28 healthy children between the ages of 1 and 17 years without known renal dysfunction who were undergoing atrial septal defect device closure in the cardiac catheterization laboratory. TEE was used to obtain Doppler renal artery blood velocities (peak systolic velocity, end-diastolic velocity, mean diastolic velocity, resistive index, and pulsatility index), and these values were compared with measurements obtained by TAU. Concordance correlation coefficient (CCC) was used to determine clinically significant agreement between the 2 methods. The Bland-Altman plots were used to determine whether these 2 methods agree sufficiently to be used interchangeably. Statistical significance was accepted at P ≤ 0.05. Obtaining 2-dimensional images of kidney parenchyma and Doppler-derived measurements using TEE in children is feasible. There was statistically significant agreement between the 2 methods for all measurements. The CCC between the 2 imaging techniques was 0.91 for the pulsatility index and 0.66 for the resistive index. These coefficients were sensitive to outliers. When the highest and lowest data points were removed from the analysis, the CCC between the 2 imaging techniques was 0.62 for the pulsatility index and 0.50 for the resistive index. The 95% confidence interval (CI) for pulsatility index was 0.35 to 0.98 and for resistive index was 0.21 to 0.89. The Bland-Altman plots indicate good agreement between the 2 methods; for the pulsatility index, the limits of agreement were -0.80 to 0.53. The correlation of the size of the measurement and the mean difference in methods (-0.14; 95% CI = -0.28, 0.01) was not statistically significant (r = 0.31, P = 0.17). For the resistive index, the limits of agreement were -0.22 to 0.12. The correlation of the size of the measurement and the mean difference in methods (-0.05; 95% CI = -0.09, -0.01) was not statistically significant (r = 0.10, P = 0.65). This study confirms the feasibility of obtaining 2-dimensional images of kidney parenchyma and Doppler-derived measurements using TEE in children. Angle-independent TEE Doppler-derived indices show significant concordance with those derived by TAU. Further studies are required to assess whether this correlation holds true in the presence of renal pathology. This technique has the potential to help modulate intraoperative interventions based on their impact on renal variables and may prove helpful in the perioperative period for children at risk of acute kidney injury.

Age-specific changes in the regulation of LH-dependent testosterone secretion: assessing responsiveness to varying endogenous gonadotropin output in normal men.

PubMed

Liu, Peter Y; Takahashi, Paul Y; Roebuck, Pamela D; Iranmanesh, Ali; Veldhuis, Johannes D

2005-09-01

Pulsatile and thus total testosterone (Te) secretion declines in older men, albeit for unknown reasons. Analytical models forecast that aging may reduce the capability of endogenous luteinizing hormone (LH) pulses to stimulate Leydig cell steroidogenesis. This notion has been difficult to test experimentally. The present study used graded doses of a selective gonadotropin releasing hormone (GnRH)-receptor antagonist to yield four distinct strata of pulsatile LH release in each of 18 healthy men ages 23-72 yr. Deconvolution analysis was applied to frequently sampled LH and Te concentration time series to quantitate pulsatile Te secretion over a 16-h interval. Log-linear regression was used to relate pulsatile LH secretion to attendant pulsatile Te secretion (LH-Te drive) across the four stepwise interventions in each subject. Linear regression of the 18 individual estimates of LH-Te feedforward dose-response slopes on age disclosed a strongly negative relationship (r = -0.721, P < 0.001). Accordingly, the present data support the thesis that aging in healthy men attenuates amplitude-dependent LH drive of burst-like Te secretion. The experimental strategy of graded suppression of neuroglandular outflow may have utility in estimating dose-response adaptations in other endocrine systems.

Elimination of motion and pulsation artifacts using BLADE sequences in knee MR imaging.

PubMed

Lavdas, Eleftherios; Mavroidis, Panayiotis; Hatzigeorgiou, Vasiliki; Roka, Violeta; Arikidis, Nikos; Oikonomou, Georgia; Andrianopoulos, Konstantinos; Notaras, Ioannis

2012-10-01

The purpose of this study is to evaluate the ability of proton density (PD)-BLADE sequences in reducing or even eliminating motion and pulsatile flow artifacts in knee magnetic resonance imaging examinations. Eighty consecutive patients, who had been routinely scanned for knee examination, participated in the study. The following pairs of sequences with and without BLADE were compared: (a) PD turbo spin echo (TSE) sagittal (SAG) fat saturation (FS) in 35 patients, (b) PD TSE coronal (COR) FS in 19 patients, (c) T2 TSE axial in 13 patients and (d) PD TSE SAG in 13 patients. Both qualitative and quantitative analyses were performed based on the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and relative contrast (ReCon) measures of normal anatomic structures. The qualitative analysis was performed by experienced radiologists. Also, the presence of image motion and pulsation artifacts was evaluated. Based on the results of the SNR, CRN and ReCon for the different sequences and anatomical structures, the BLADE sequences were significantly superior in 19 cases, whereas the corresponding conventional sequences were significantly superior in only 6 cases. BLADE sequences eliminated motion artifacts in all the cases. However, motion artifacts were shown in (a) six PD TSE SAG FS, (b) three PD TSE COR FS, (c) three PD TSE SAG and (d) two T2 TSE axial conventional sequences. In our results, it was found that, in PD FS sequences (sagittal and coronal), the differences between the BLADE and conventional sequences regarding the elimination of motion and pulsatile flow artifacts were statistically significant. In all the comparisons, the PD FS BLADE sequences (coronal and sagittal) were significantly superior to the corresponding conventional sequences regarding the classification of their image quality. In conclusion, this technique appears to be capable to potentially eliminate motion and pulsatile flow artifacts in MR images. Copyright © 2012 Elsevier Inc. All rights reserved.

Flow Residence Time and Regions of Intraluminal Thrombus Deposition in Intracranial Aneurysms

PubMed Central

Boussel, L.; Ge, L.; Leach, J. R.; Martin, A. J.; Lawton, M. T.; McCulloch, C.; Saloner, D.

2010-01-01

Thrombus formation in intracranial aneurysms, while sometimes stabilizing lesion growth, can present additional risk of thrombo-embolism. The role of hemodynamics in the progression of aneurysmal disease can be elucidated by patient-specific computational modeling. In our previous work, patient-specific computational fluid dynamics (CFD) models were constructed from MRI data for three patients who had fusiform basilar aneurysms that were thrombus-free and then proceeded to develop intraluminal thrombus. In this study, we investigated the effect of increased flow residence time (RT) by modeling passive scalar advection in the same aneurysmal geometries. Non-Newtonian pulsatile flow simulations were carried out in base-line geometries and a new postprocessing technique, referred to as “virtual ink” and based on the passive scalar distribution maps, was used to visualize the flow and estimate the flow RT. The virtual ink technique clearly depicted regions of flow separation. The flow RT at different locations adjacent to aneurysmal walls was calculated as the time the virtual ink scalar remained above a threshold value. The RT values obtained in different areas were then correlated with the location of intra-aneurysmal thrombus observed at a follow-up MR study. For each patient, the wall shear stress (WSS) distribution was also obtained from CFD simulations and correlated with thrombus location. The correlation analysis determined a significant relationship between regions where CFD predicted either an increased RT or low WSS and the regions where thrombus deposition was observed to occur in vivo. A model including both low WSS and increased RT predicted thrombus-prone regions significantly better than the models with RT or WSS alone. PMID:20499185

Dynamical modes of two almost identical chemical oscillators connected via both pulsatile and diffusive coupling.

PubMed

Safonov, Dmitry A; Vanag, Vladimir K

2018-05-03

The dynamical regimes of two almost identical Belousov-Zhabotinsky oscillators with both pulsatile (with time delay) and diffusive coupling have been studied theoretically with the aid of ordinary differential equations for four combinations of these types of coupling: inhibitory diffusive and inhibitory pulsatile (IDIP); excitatory diffusive and inhibitory pulsatile; inhibitory diffusive and excitatory pulsatile; and finally, excitatory diffusive and excitatory pulsatile (EDEP). The combination of two types of coupling creates a condition for new feedback, which promotes new dynamical modes for the IDIP and EDEP coupling.

Experimental study of the intraventricular filling vortex in diastolic dysfunction

NASA Astrophysics Data System (ADS)

Santhanakrishnan, Arvind; Samaee, Milad; Nelsen, Nicholas

2016-11-01

Heart failure with normal ejection fraction (HFNEF) is a clinical syndrome that is prevalent in over half of heart failure patients. HFNEF patients typically show diastolic dysfunction, caused by a decrease in relaxation capability of the left ventricular (LV) muscle tissue and/or an increase in LV chamber stiffness. Numerous studies using non-invasive medical imaging have shown that an intraventricular filling vortex is formed in the LV during diastole. We conducted 2D particle image velocimetry and hemodynamics measurements on a left heart simulator to investigate diastolic flow under increasing LV wall stiffness, LV wall thickness and heart rate (HR) conditions. Flexible-walled, optically clear LV physical models cast from silicone were fitted within a fluid-filled acrylic chamber. Pulsatile flow within the LV model was generated using a piston pump and 2-component Windkessel elements were used to tune the least stiff (baseline) LV model to physiological conditions. The results show that peak circulation of the intraventricular filling vortex is diminished in conditions of diastolic dysfunction as compared to the baseline case. Increasing HR exacerbated the circulation of the filling vortex across all cases.

Hemodynamic simulations in coronary aneurysms of children with Kawasaki disease

NASA Astrophysics Data System (ADS)

Sengupta, Dibyendu; Burns, Jane; Marsden, Alison

2009-11-01

Kawasaki disease (KD) is a serious pediatric illness affecting the cardiovascular system. One of the most serious complications of KD, occurring in about 25% of untreated cases, is the formation of large aneurysms in the coronary arteries, which put patients at risk for myocardial infarction. In this project we performed patient specific computational simulations of blood flow in aneurysmal left and right coronary arteries of a KD patient to gain an understanding about their hemodynamics. Models were constructed from CT data using custom software. Typical pulsatile flow waveforms were applied at the model inlets, while resistance and RCR lumped models were applied and compared at the outlets. Simulated pressure waveforms compared well with typical physiologic data. High wall shear stress values are found in the narrow region at the base of the aneurysm and low shear values occur in regions of recirculation. A Lagrangian approach has been adopted to perform particle tracking and compute particle residence time in the recirculation. Our long-term goal will be to develop links between hemodynamics and the risk for thrombus formation in order to assist in clinical decision-making.

Computational fluid dynamics modeling of intracranial aneurysms: effects of parent artery segmentation on intra-aneurysmal hemodynamics.

PubMed

Castro, M A; Putman, C M; Cebral, J R

2006-09-01

The purpose of this study is to show the influence of the upstream parent artery geometry on intraaneurysmal hemodynamics of cerebral aneurysms. Patient-specific models of 4 cerebral aneurysms (1 posterior communicating artery [PcomA], 2 middle cerebral artery [MCA], and 1 anterior communicating artery [AcomA]) were constructed from 3D rotational angiography images. Two geometric models were constructed for each aneurysm. One model had the native parent vessel geometry; the second model was truncated approximately 1 cm upstream from the aneurysm, and the parent artery replaced with a straight cylinder. Corresponding finite element grids were generated and computational fluid dynamics simulations were carried out under pulsatile flow conditions. The intra-aneurysmal flow patterns and wall shear stress (WSS) distributions were visualized and compared. Models using the truncated parent vessel underestimated the WSS in the aneurysms in all cases and shifted the impaction zone to the neck compared with the native geometry. These effects were more pronounced in the PcomA and AcomA aneurysms where upstream curvature was substantial. The MCA aneurysm with a long M1 segment was the least effected. The more laminar flow pattern within the parent vessel in truncated models resulted in a less complex intra-aneurysmal flow patterns with fewer vortices and less velocity at the dome. Failure to properly model the inflow stream contributed by the upstream parent artery can significantly influence the results of intra-aneurysmal hemodynamic models. The upstream portion of the parent vessel of cerebral aneurysms should be included to accurately represent the intra-aneurysmal hemodynamics.

Acute impact of drinking coffee on the cerebral and systemic vasculature.

PubMed

Washio, Takuro; Sasaki, Hiroyuki; Ogoh, Shigehiko

2017-05-01

Previous studies have suggested that the risk of ischemic stroke increases immediately after drinking coffee. Indeed, drinking coffee, that is, caffeine, acutely increases arterial stiffness as well as blood pressure and peripheral vascular resistance. On the other hand, it has been reported that arterial stiffening is associated with elevation in the pulsatility index (PI) of cerebral blood flow (CBF), which increases the risk of brain disease. However, the effect of drinking coffee on the PI of the CBF and its interaction with arterial stiffness remain unknown. Against this background, we hypothesized that an acute increase in arterial stiffness induced by drinking coffee augments cerebral pulsatile stress. To test this hypothesis, in 10 healthy young men we examined the effects of drinking coffee on the PI of middle cerebral artery blood velocity (MCAv) and brachial-ankle pulse wave velocity (baPWV) as indices of cerebral pulsatile stress and arterial stiffness, respectively. Mean arterial blood pressure and baPWV were higher ( P  < 0.01 and P  = 0.02), whereas mean MCA V and mean cerebrovascular conductance index were lower upon drinking coffee ( P  = 0.02 and P  < 0.01) compared with a placebo (decaffeinated coffee). However, there was no difference in the PI of MCAv between drinking coffee and the placebo condition. These findings suggest that drinking coffee does not increase cerebral pulsatile stress acutely despite an elevation in arterial stiffness in the systemic circulation. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

Rapid Speed Modulation of a Rotary Total Artificial Heart Impeller.

PubMed

Kleinheyer, Matthias; Timms, Daniel L; Tansley, Geoffrey D; Nestler, Frank; Greatrex, Nicholas A; Frazier, O Howard; Cohn, William E

2016-09-01

Unlike the earlier reciprocating volume displacement-type pumps, rotary blood pumps (RBPs) typically operate at a constant rotational speed and produce continuous outflow. When RBP technology is used in constructing a total artificial heart (TAH), the pressure waveform that the TAH produces is flat, without the rise and fall associated with a normal arterial pulse. Several studies have suggested that pulseless circulation may impair microcirculatory perfusion and the autoregulatory response and may contribute to adverse events such as gastrointestinal bleeding, arteriovenous malformations, and pump thrombosis. It may therefore be beneficial to attempt to reproduce pulsatile output, similar to that generated by the native heart, by rapidly modulating the speed of an RBP impeller. The choice of an appropriate speed profile and control strategy to generate physiologic waveforms while minimizing power consumption and blood trauma becomes a challenge. In this study, pump operation modes with six different speed profiles using the BiVACOR TAH were evaluated in vitro. These modes were compared with respect to: hemodynamic pulsatility, which was quantified as surplus hemodynamic energy (SHE); maximum rate of change of pressure (dP/dt); pulse power index; and motor power consumption as a function of pulse pressure. The results showed that the evaluated variables underwent different trends in response to changes in the speed profile shape. The findings indicated a possible trade-off between SHE levels and flow rate pulsatility related to the relative systolic duration in the speed profile. Furthermore, none of the evaluated measures was sufficient to fully characterize hemodynamic pulsatility. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Effects of varying duty cycle and pulse width on high-intensity focused ultrasound (HIFU)-induced transcranial thrombolysis.

PubMed

Hölscher, Thilo; Raman, Rema; Fisher, David J; Ahadi, Golnaz; Zadicario, Eyal; Voie, Arne

2013-01-01

The goal was to test the effects of various combinations of pulse widths (PW) and duty cycles (DC) on high-intensity focused ultrasound (HIFU)-induced sonothrombolysis efficacy using an in vitro flow model. An ExAblate™ 4000 HIFU headsystem (InSightec, Inc., Israel) was used. Artificial blood clots were placed into test tubes inside a human calvarium and exposed to pulsatile flow. Four different duty cycles were tested against four different pulse widths. For all study groups, an increase in thrombolysis efficacy could be seen in association with increasing DC and/or PW (p < 0.0001). Using transcranial HIFU, significant thrombolysis can be achieved within seconds and without the use of lytic drugs in vitro. Longer duty cycles in combination with longer pulse widths seem to have the highest potential to optimize clot lysis efficacy.

Effects of varying duty cycle and pulse width on high-intensity focused ultrasound (HIFU)-induced transcranial thrombolysis

PubMed Central

2013-01-01

The goal was to test the effects of various combinations of pulse widths (PW) and duty cycles (DC) on high-intensity focused ultrasound (HIFU)-induced sonothrombolysis efficacy using an in vitro flow model. An ExAblate™ 4000 HIFU headsystem (InSightec, Inc., Israel) was used. Artificial blood clots were placed into test tubes inside a human calvarium and exposed to pulsatile flow. Four different duty cycles were tested against four different pulse widths. For all study groups, an increase in thrombolysis efficacy could be seen in association with increasing DC and/or PW (p < 0.0001). Using transcranial HIFU, significant thrombolysis can be achieved within seconds and without the use of lytic drugs in vitro. Longer duty cycles in combination with longer pulse widths seem to have the highest potential to optimize clot lysis efficacy. PMID:25512862

Initial Simulated FFR Investigation Using Flow Measurements in Patient-specific 3D Printed Coronary Phantoms.

PubMed

Shepard, Lauren; Sommer, Kelsey; Izzo, Richard; Podgorsak, Alexander; Wilson, Michael; Said, Zaid; Rybicki, Frank J; Mitsouras, Dimitrios; Rudin, Stephen; Angel, Erin; Ionita, Ciprian N

2017-02-11

Accurate patient-specific phantoms for device testing or endovascular treatment planning can be 3D printed. We expand the applicability of this approach for cardiovascular disease, in particular, for CT-geometry derived benchtop measurements of Fractional Flow Reserve, the reference standard for determination of significant individual coronary artery atherosclerotic lesions. Coronary CT Angiography (CTA) images during a single heartbeat were acquired with a 320×0.5mm detector row scanner (Toshiba Aquilion ONE). These coronary CTA images were used to create 4 patient-specific cardiovascular models with various grades of stenosis: severe, <75% (n=1); moderate, 50-70% (n=1); and mild, <50% (n=2). DICOM volumetric images were segmented using a 3D workstation (Vitrea, Vital Images); the output was used to generate STL files (using AutoDesk Meshmixer), and further processed to create 3D printable geometries for flow experiments. Multi-material printed models (Stratasys Connex3) were connected to a programmable pulsatile pump, and the pressure was measured proximal and distal to the stenosis using pressure transducers. Compliance chambers were used before and after the model to modulate the pressure wave. A flow sensor was used to ensure flow rates within physiological reported values. 3D model based FFR measurements correlated well with stenosis severity. FFR measurements for each stenosis grade were: 0.8 severe, 0.7 moderate and 0.88 mild. 3D printed models of patient-specific coronary arteries allows for accurate benchtop diagnosis of FFR. This approach can be used as a future diagnostic tool or for testing CT image-based FFR methods.

Mechanisms of Mechano-Transduction within Osteoblasts

DTIC Science & Technology

1999-09-01

inositol trisphosphate levels (Reich and Frangos , 1993) with increasing shear stress. In a study concerning the effect of fluid shear...stress on cultured rat calvaria 34 osteoblasts, Hillsley and Frangos (1997) reported no change in collagen or osteopontin expression...Hillsley MV and Frangos JA (1997). Alkaline phosphatase in osteoblasts is down-regulated by pulsatile fluid flow. Calcif Tissue Int 60

Colon-specific pulsatile drug release provided by electrospun shellac nanocoating on hydrophilic amorphous composites

PubMed Central

Yu, Deng-Guang; Wang, Ke; Liu, Ping; Chen, Xiaohong

2018-01-01

Background Colon-specific pulsatile drug release, as a combined drug controlled-release model, is a useful drug delivery manner for a series of diseases. New nanomedicines and related preparation methods are highly desired. Methods With diclofenac sodium (DS) as a model drug, a new type of structural nanocomposite (SC), in which composite polyvinylpyrrolidone (PVP)–DS core was coated by shellac, was fabricated via modified coaxial electrospinning. For comparison, traditional PVP–DS monolithic hydrophilic nanocomposites (HCs) were generated using a traditional blending process. Scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction (XRD), attenuated total reflectance-Fourier transform infrared (ATR-FTIR), water contact angle (WCA), and in vitro dissolution and ex vivo permeation tests were conducted to characterize the composites. Results SEM images demonstrated that both composites were linear nanofibers with smooth surface morphology and cross sections. TEM disclosed that the SCs had a thin shellac sheath layer of approximately 12 nm. XRD and ATR-FTIR results demonstrated that the crystalline DS was converted into amorphous composites with PVP because of favorable secondary interactions. WCA and in vitro dissolution tests demonstrated that the sheath shellac layers in SC could resist acid conditions and provide typical colon-specific pulsatile release, rather than a pulsatile release of HC under acid conditions. Ex vivo permeation results demonstrated that the SCs were able to furnish a tenfold drug permeation rate than the DS particles on the colon membrane. Conclusion A new SC with a shellac coating on hydrophilic amorphous nanocomposites could furnish a colon-specific pulsatile drug release profile. The modified coaxial process can be exploited as a useful tool to create nanocoatings. PMID:29713169

Colon-specific pulsatile drug release provided by electrospun shellac nanocoating on hydrophilic amorphous composites.

PubMed

Yang, Yao-Yao; Liu, Zhe-Peng; Yu, Deng-Guang; Wang, Ke; Liu, Ping; Chen, Xiaohong

2018-01-01

Colon-specific pulsatile drug release, as a combined drug controlled-release model, is a useful drug delivery manner for a series of diseases. New nanomedicines and related preparation methods are highly desired. With diclofenac sodium (DS) as a model drug, a new type of structural nanocomposite (SC), in which composite polyvinylpyrrolidone (PVP)-DS core was coated by shellac, was fabricated via modified coaxial electrospinning. For comparison, traditional PVP-DS monolithic hydrophilic nanocomposites (HCs) were generated using a traditional blending process. Scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction (XRD), attenuated total reflectance-Fourier transform infrared (ATR-FTIR), water contact angle (WCA), and in vitro dissolution and ex vivo permeation tests were conducted to characterize the composites. SEM images demonstrated that both composites were linear nanofibers with smooth surface morphology and cross sections. TEM disclosed that the SCs had a thin shellac sheath layer of approximately 12 nm. XRD and ATR-FTIR results demonstrated that the crystalline DS was converted into amorphous composites with PVP because of favorable secondary interactions. WCA and in vitro dissolution tests demonstrated that the sheath shellac layers in SC could resist acid conditions and provide typical colon-specific pulsatile release, rather than a pulsatile release of HC under acid conditions. Ex vivo permeation results demonstrated that the SCs were able to furnish a tenfold drug permeation rate than the DS particles on the colon membrane. A new SC with a shellac coating on hydrophilic amorphous nanocomposites could furnish a colon-specific pulsatile drug release profile. The modified coaxial process can be exploited as a useful tool to create nanocoatings.

Effects of pacing magnitudes and forms on bistability width in a modeled ventricular tissue

NASA Astrophysics Data System (ADS)

Huang, Xiaodong; Liu, Xuemei; Zheng, Lixian; Mi, Yuanyuan; Qian, Yu

2013-07-01

Bistability in periodically paced cardiac tissue is relevant to cardiac arrhythmias and its control. In the present paper, one-dimensional tissue of the phase I Luo-Rudy model is numerically investigated. The effects of various parameters of pacing signals on bistability width are studied. The following conclusions are obtained: (i) Pacing can be classified into two types: pulsatile and sinusoidal types. Pulsatile pacing reduces bistability width as its magnitude is increased. Sinusoidal pacing increases the width as its amplitude is increased. (ii) In a pacing period the hyperpolarizing part plays a more important role than the depolarizing part. Variations of the hyperpolarizing ratio in a period evidently change the width of bistability and its variation tendency. (iii) A dynamical mechanism is proposed to qualitatively explain the phenomena, which reveals the reason for the different effects of pulsatile and sinusoidal pacing on bistability. The methods for changing bistability width by external pacing may help control arrhythmias in cardiology.

The Connected Steady State Model and the Interdependence of the CSF Proteome and CSF Flow Characteristics.

PubMed

Metzger, Fabian; Mischek, Daniel; Stoffers, Frédéric

2017-01-01

Here we show that the hydrodynamic radii-dependent entry of blood proteins into cerebrospinal fluid (CSF) can best be modeled with a diffusional system of consecutive interdependent steady states between barrier-restricted molecular flux and bulk flow of CSF. The connected steady state model fits precisely to experimental results and provides the theoretical backbone to calculate the in-vivo hydrodynamic radii of blood-derived proteins as well as individual barrier characteristics. As the experimental reference set we used a previously published large-scale patient cohort of CSF to serum quotient ratios of immunoglobulins in relation to the respective albumin quotients. We related the inter-individual variances of these quotient relationships to the individual CSF flow time and barrier characteristics. We claim that this new concept allows the diagnosis of inflammatory processes with Reibergrams derived from population-based thresholds to be shifted to individualized judgment, thereby improving diagnostic sensitivity. We further use the source-dependent gradient patterns of proteins in CSF as intrinsic tracers for CSF flow characteristics. We assume that the rostrocaudal gradient of blood-derived proteins is a consequence of CSF bulk flow, whereas the slope of the gradient is a consequence of the unidirectional bulk flow and bidirectional pulsatile flow of CSF. Unlike blood-derived proteins, the influence of CSF flow characteristics on brain-derived proteins in CSF has been insufficiently discussed to date. By critically reviewing existing experimental data and by reassessing their conformity to CSF flow assumptions we conclude that the biomarker potential of brain-derived proteins in CSF can be improved by considering individual subproteomic dynamics of the CSF system.

Highly Efficient Gating of Electrically Actuated Nanochannels for Pulsatile Drug Delivery Stemming from a Reversible Wettability Switch.

PubMed

Zhang, Qianqian; Kang, Jianxin; Xie, Zhiqiang; Diao, Xungang; Liu, Zhaoyue; Zhai, Jin

2018-01-01

Many ion channels in the cell membrane are believed to function as gates that control the water and ion flow through the transitions between an inherent hydrophobic state and a stimuli-induced hydration state. The construction of nanofluidic gating systems with high gating efficiency and reversibility is inspired by this hydrophobic gating behavior. A kind of electrically actuated nanochannel is developed by integrating a polypyrrole (PPy) micro/nanoporous film doped with perfluorooctanesulfonate ions onto an anodic aluminum oxide nanoporous membrane. Stemming from the reversible wettability switch of the doped PPy film in response to the applied redox potentials, the nanochannels exhibit highly efficient and reversible gating behaviors. The optimized gating ratio is over 10 5 , which is an ultrahigh value when compared with that of the existing reversibly gated nanochannels with comparable pore diameters. Furthermore, the gating behavior of the electrically actuated nanochannels shows excellent repeatability and stability. Based on this highly efficient and reversible gating function, the electrically actuated nanochannels are further applied for drug delivery, which achieves the pulsatile release of two water-soluble drug models. The electrically actuated nanochannels may find potential applications in accurate and on-demand drug therapy. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The hydrodynamic and ultrasound-induced forces on microbubbles under high Reynolds number flow representative of the human systemic circulation

NASA Astrophysics Data System (ADS)

Clark, Alicia; Aliseda, Alberto

2016-11-01

Ultrasound contrast agents (UCAs) are micron-sized bubbles that are used in conjunction with ultrasound (US) in medical applications such as thrombolysis and targeted intravenous drug delivery. Previous work has shown that the Bjerknes force, due to the phase difference between the incoming US pressure wave and the bubble volume oscillations, can be used to manipulate the trajectories of microbubbles. Our work explores the behavior of microbubbles in medium sized blood vessels under both uniform and pulsatile flows at a range of physiologically relevant Reynolds and Womersley numbers. High speed images were taken of the microbubbles in an in-vitro flow loop that replicates physiological flow conditions. During the imaging, the microbubbles were insonified at different diagnostic ultrasound settings (varying center frequency, PRF, etc.). An in-house Lagrangian particle tracking code was then used to determine the trajectories of the microbubbles and, thus, a dynamic model for the microbubbles including the Bjerknes forces acting on them, as well as drag, lift, and added mass. Preliminary work has also explored the behavior of the microbubbles in a patient-specific model of a carotid artery bifurcation to demonstrate the feasibility of preferential steering of microbubbles towards the intracranial circulation with US.

A fluid-structure interaction model of the internal carotid and ophthalmic arteries for the noninvasive intracranial pressure measurement method.

PubMed

Misiulis, Edgaras; Džiugys, Algis; Navakas, Robertas; Striūgas, Nerijus

2017-05-01

Accurate and clinically safe measurements of intracranial pressure (ICP) are crucial for secondary brain damage prevention. There are two methods of ICP measurement: invasive and noninvasive. Invasive methods are clinically unsafe; therefore, safer noninvasive methods are being developed. One of the noninvasive ICP measurement methods implements the balance principle, which assumes that if the velocity of blood flow in both ophthalmic artery segments - the intracranial (IOA) and extracranial (EOA) - is equal, then the acting ICP on the IOA and the external pressure (Pe) on the EOA are also equal. To investigate the assumption of the balance principle, a generalized computational model incorporating a fluid-structure interaction (FSI) module was created and used to simulate noninvasive ICP measurement by accounting for the time-dependent behavior of the elastic internal carotid (ICA) and ophthalmic (OA) arteries and their interaction with pulsatile blood flow. It was found that the extra balance pressure term, which incorporates the hydrodynamic pressure drop between measurement points, must be added into the balance equation, and the corrections on a difference between the velocity of blood flow in the IOA and EOA must be made, due to a difference in the blood flow rate. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Generation and Propagation of Arterial Murmurs from a Stenosed Artery: A Computational Study

NASA Astrophysics Data System (ADS)

Zhu, Chi; Seo, Jung-Hee; Bakhshaee, Hani; Mittal, Rajat

2015-11-01

Cardiac auscultation - the procedure of diagnosing cardiovascular conditions using the stethoscope - has been used effectively for over a hundred years but still, the flow mechanism(s) responsible for the generation of these murmurs, as well as the effect of intervening tissue on the propagation of these murmurs, is not well understood. In this study, a one-way coupled, hybrid approach is used to investigate the propagation of murmurs generated from the flow in a stenosed artery. Specifically, the flow in the modeled artery is solved by an incompressible Navier-Stokes solver with the immersed-boundary method. The structural wave propagation in the tissue is resolved by a high-order, linear viscoelastic wave solver, and a mathematical decomposition is applied to separate the compressional and shear component of the acoustic wave propagating through the tissue. The simulations suggest, somewhat counterintuitively, that the shear wave contributes a significant component to the signal picked up by a stethoscope, and that this component carries much of the information that characterizes the source of the murmur. The implications of this for cardiac auscultation and further modeling of hemoacoustics are discussed. The effect of the stenosis severity and the flow pulsatility will also be investigated. The authors would like to acknowledge the SCH for funding this project.

Effect of ovarian endometrioma on uterine and ovarian blood flow in infertile women.

PubMed

El-Mazny, Akmal; Kamel, Ahmed; Ramadan, Wafaa; Gad-Allah, Sherine; Abdelaziz, Suzy; Hussein, Ahmed M

2016-01-01

Angiogenesis has been found to be among the most important factors in the pathogenesis of endometriosis. The formation of new blood vessels is critical for the survival of newly implanted endometriotic foci. The use of 3-D power Doppler allows for the demonstration of the dynamic vascular changes that occur during the process of in vitro fertilization (IVF). We aimed to evaluate the effect of ovarian endometrioma on uterine and ovarian blood flow in infertile women. In a case-control study at a university teaching hospital, 138 women with unilateral ovarian endometrioma scheduled for IVF were compared to 138 women with male-factor or unexplained infertility. In the mid-luteal (peri-implantation) phase of the cycle, endometrial thickness, uterine and ovarian artery pulsatility index and resistance index, endometrial and ovarian volume, 3-D power Doppler vascularization index (VI), flow index (FI), and vascularization FI (VFI) values were measured in both groups. There were no significant differences ( P >0.05) in endometrial thickness, uterine ovarian artery pulsatility index and resistance index, endometrial and ovarian volume, or VI, FI, and VFI between the two groups. Furthermore, the endometrial and ovarian Doppler indices were not influenced by endometrioma size. No significant differences were observed in the ovarian Doppler indices between endometrioma-containing ovaries and contralateral ovaries. Ovarian endometrioma is not associated with impaired endometrial and ovarian blood flows in infertile women scheduled for IVF, and it is not likely to affect endometrial receptivity or ovarian function through a vascular mechanism.

Evaluation of hemodynamics changes during interventional stent placement using Doppler optical coherence tomography

NASA Astrophysics Data System (ADS)

Vuong, Barry; Genis, Helen; Wong, Ronnie; Ramjist, Joel; Jivraj, Jamil; Farooq, Hamza; Sun, Cuiru; Yang, Victor X. D.

2015-03-01

Carotid atherosclerosis is a critical medical concern that can lead to ischemic stroke. Local hemodynamic patterns have also been associated with the development of atherosclerosis, particularly in regions with disturbed flow patterns such as bifurcations. Traditionally, this disease was treated using carotid endarterectomy, however recently there is an increasing trend of carotid artery stenting due to its minimally invasive nature. It is well known that this interventional technique creates changes in vasculature geometry and hemodynamic patterns due to the interaction of stent struts with arterial lumen, and is associated with complications such as distal emboli and restenosis. Currently, there is no standard imaging technique to evaluate regional hemodynamic patterns found in stented vessels. Doppler optical coherence tomography (DOCT) provides an opportunity to identify in vivo hemodynamic changes in vasculature using high-resolution imaging. In this study, blood flow profiles were examined at the bifurcation junction in the internal carotid artery (ICA) in a porcine model following stent deployment. Doppler imaging was further conducted using pulsatile flow in a phantom model, and then compared to computational fluid dynamics (CFD) simulation of a virtual bifurcation to assist with the interpretation of emphin vivo results.

Inertial particle dynamics in large artery flows - Implications for modeling arterial embolisms.

PubMed

Mukherjee, Debanjan; Shadden, Shawn C

2017-02-08

The complexity of inertial particle dynamics through swirling chaotic flow structures characteristic of pulsatile large-artery hemodynamics renders significant challenges in predictive understanding of transport of such particles. This is specifically crucial for arterial embolisms, where knowledge of embolus transport to major vascular beds helps in disease diagnosis and surgical planning. Using a computational framework built upon image-based CFD and discrete particle dynamics modeling, a multi-parameter sampling-based study was conducted on embolic particle dynamics and transport. The results highlighted the strong influence of material properties, embolus size, release instance, and embolus source on embolus distribution to the cerebral, renal and mesenteric, and ilio-femoral vasculature beds. The study also isolated the importance of shear-gradient lift, and elastohydrodynamic contact, in affecting embolic particle transport. Near-wall particle re-suspension due to lift alters aortogenic embolic particle dynamics significantly as compared to cardiogenic. The observations collectively indicated the complex interplay of particle inertia, fluid-particle density ratio, and wall collisions, with chaotic flow structures, which render the overall motion of the particles to be non-trivially dispersive in nature. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Evaluation and Optimization of Microvascular Arterial Anastomoses by Transit Time Flow Measurement].

PubMed

Herberhold, S; Röttker, J; Bartmann, D; Solbach, A; Keiner, S; Welz, A; Bootz, F; Laffers, W

2016-03-01

INDRODUCTION: The regular application of transit time flow measurement in microvascular anastomoses during heart surgery has lead to improvements of the outcome of coronary artery bypass grafts. Our study was meant to discover whether this measurement method was also applicable for evaluation and optimization of microvascular arterial anastomoses of radial forearm flaps. In this prospective examination a combining ultrasound imaging and transit time flow measurement device (VeriQ, MediStim) was used during surgery to assess anastomotic quality of 15 radial forearm flaps. Pulsatility index (PI) and mean blood flow were measured immediately after opening the arterial anastomosis as well as 15 min afterwards. Furthermore, application time and description of handling were recorded seperately for every assessment. Mean blood flow immediately after opening the anastomosis and 15 min later were 3.9 and 3.4 ml/min resepectively showing no statistically significant difference (p=0.96). There was no significance in the increase of pulsatility index from 22.1 to 27.2 (p=0.09) during the same time range, either. Due to measurement results showing atypical pulse curves in 2 cases decision for surgical revision of the anastomoses was made. All forearm flaps showed good vascularisation during follow-up. Time for device set up, probe placement and measurements was about 20 min. Handling was described to be uncomplicated without exception. There were no noteworthy problems. Transit time flow measurement contributes to the improvement of anastomotic quality and therefore to the overall outcome of radial forearm flaps. The examined measurement method provides objective results and is useful for documentation purposes. © Georg Thieme Verlag KG Stuttgart · New York.

Effect of maternal activity during gestation on maternal behavior, fetal growth, umbilical blood flow, and farrowing characteristics in pigs.

PubMed

Harris, E K; Berg, E P; Berg, E L; Vonnahme, K A

2013-02-01

Yorkshire gilts either remained in their individual stall from d 40 to term (CON; n = 7) or were subjected to exercise for 30 min 3 times per week from mid to late gestation (EX; n = 7) to determine the impact of increased maternal activity during gestation on maternal behavior, fetal growth, umbilical blood flow, and parturition. In parity 1, maternal body composition (10th rib back fat and LM area), maternal behavior, and farrowing characteristics were recorded. In parities 1 and 2, fetal growth, fetal heart rate, pulsatility index and resistance index, and umbilical blood flow were monitored beginning at d 39 of gestation continuing to d 81 of gestation. Exercise continued until d 104. Gilts allowed to exercise sat less (P < 0.01), stood more (P < 0.01), tended (P = 0.06) to lie down less, and had fewer postural changes (P < 0.01) compared with CON gilts. Umbilical blood flow increased (P < 0.01) in EX compared with CON gilts. Moreover, gilts had greater (P < 0.01) umbilical blood flow in their first parity compared with their second. Indices of vascular resistance were not affected (P ≥ 0.15) by maternal treatment; however, EX gilts reached peak pulsatility index earlier than CON gilts (56.2 vs. 64.3 ± 3.6 d). Fetal weights, piglet birth weights, placental weight, interval between piglet births, and blood lactate of newborn piglets were unaffected (P ≥ 0.15) by maternal treatment. Although maternal exercise during gestation in the pig increased umbilical blood flow and appeared to reduce maternal restlessness, impacts on offspring development in postnatal life are not known.

In vitro fabrication of a tissue engineered human cardiovascular patch for future use in cardiovascular surgery.

PubMed

Yang, Chao; Sodian, Ralf; Fu, Ping; Lüders, Cora; Lemke, Thees; Du, Jing; Hübler, Michael; Weng, Yuguo; Meyer, Rudolf; Hetzer, Roland

2006-01-01

One approach to tissue engineering has been the development of in vitro conditions for the fabrication of functional cardiovascular structures intended for implantation. In this experiment, we developed a pulsatile flow system that provides biochemical and biomechanical signals in order to regulate autologous, human patch-tissue development in vitro. We constructed a biodegradable patch scaffold from porous poly-4-hydroxy-butyrate (P4HB; pore size 80 to 150 microm). The scaffold was seeded with pediatric aortic cells. The cell-seeded patch constructs were placed in a self-developed bioreactor for 7 days to observe potential tissue formation under dynamic cell culture conditions. As a control, cell-seeded scaffolds were not conditioned in the bioreactor system. After maturation in vitro, the analysis of the tissue engineered constructs included biochemical, biomechanical, morphologic, and immunohistochemical examination. Macroscopically, all tissue engineered constructs were covered by cells. After conditioning in the bioreactor, the cells were mostly viable, had grown into the pores, and had formed tissue on the patch construct. Electron microscopy showed confluent smooth surfaces. Additionally, we demonstrated the capacity to generate collagen and elastin under in vitro pulsatile flow conditions in biochemical examination. Biomechanical testing showed mechanical properties of the tissue engineered human patch tissue without any statistical differences in strength or resistance to stretch between the static controls and the conditioned patches. Immunohistochemical examination stained positive for alpha smooth muscle actin, collagen type I, and fibronectin. There was minor tissue formation in the nonconditioned control samples. Porous P4HB may be used to fabricate a biodegradable patch scaffold. Human vascular cells attached themselves to the polymeric scaffold, and extracellular matrix formation was induced under controlled biomechanical and biodynamic stimuli in a self-developed pulsatile bioreactor system.

Wavelet analysis of hemispheroid flow separation toward understanding human vocal fold pathologies

NASA Astrophysics Data System (ADS)

Plesniak, Daniel H.; Carr, Ian A.; Bulusu, Kartik V.; Plesniak, Michael W.

2014-11-01

Physiological flows observed in human vocal fold pathologies, such as polyps and nodules, can be modeled by flow over a wall-mounted protuberance. The experimental investigation of flow separation over a surface-mounted hemispheroid was performed using particle image velocimetry (PIV) and measurements of surface pressure in a low-speed wind tunnel. This study builds on the hypothesis that the signatures of vortical structures associated with flow separation are imprinted on the surface pressure distributions. Wavelet decomposition methods in one- and two-dimensions were utilized to elucidate the flow behavior. First, a complex Gaussian wavelet was used for the reconstruction of surface pressure time series from static pressure measurements acquired from ports upstream, downstream, and on the surface of the hemispheroid. This was followed by the application of a novel continuous wavelet transform algorithm (PIVlet 1.2) using a 2D-Ricker wavelet for coherent structure detection on instantaneous PIV-data. The goal of this study is to correlate phase shifts in surface pressure with Strouhal numbers associated with the vortex shedding. Ultimately, the wavelet-based analytical framework will be aimed at addressing pulsatile flows. This material is based in part upon work supported by the National Science Foundation under Grant Number CBET-1236351, and GW Center for Biomimetics and Bioinspired Engineering (COBRE).

Validation of color Doppler ultrasonography for evaluating the uterine blood flow and perfusion during late normal pregnancy and uterine torsion in buffaloes.

PubMed

Hussein, Hassan A

2013-04-15

The aim of this study was to verify the efficacy of color Doppler ultrasonography for diagnosis of degree and duration of uterine torsion in buffaloes. In Assiut province/Upper Egypt, 65 buffaloes (37 with uterine torsion, 28 with normal late pregnancy) were examined clinically and using Doppler ultrasonography. The Doppler indices including resistance index (RI), pulsatility index (PI), time-averaged maximum velocity (TAMV), and blood flow volume (BFV) in the arteries ipsilateral to the uterine torsion (IPUT) and in arteries contralateral to the uterine torsion (COUT) were recorded. Methods of correction were documented along with dam and calf survival. Torsion was recorded postcervically with vaginal involvement in 35/37 (94.6%) of the cases. The degrees of uterine torsion were light and high in 9/37 (24.3%) and 28/37 (75.7%) of the cases, respectively (P = 0.001). Right uterine torsion was present in 36/37 (97.3%) of the cases (P = 0.0001). Pulsatility index, RI, TAMV, and BFV in IPUT and COUT did not differ significantly (P > 0.05) in normal late pregnancy. The PI and RI in IPUT were significantly higher (P < 0.01) than in COUT, and the TAMV and BFV in IPUT were less (P < 0.001) than that in COUT in uterine torsion. The PI and RI of torsion cases in IPUT were higher (P < 0.001) than that in normal pregnancy. Time-averaged maximum velocity and BFV in torsion cases were lower (P < 0.01) than that of normal pregnancy in IPUT. There was approximately 50% of RI and PI higher than in light degree uterine torsion in IPUT (P < 0.001). Consequently, TAMV and BFV were greatly lower (P < 0.0001) than that in light degree in IPUT. Pulsatility index and RI were positively correlated (r = 0.856; P < 0.001) with the duration and degree of the uterine torsion, and TAMV and BFV were negatively correlated (r = -0.763; P < 0.001). In all cases of uterine torsion the uterine flow velocity waveform showed high systolic flow and absence of early diastolic flow and poor uterine and placentomal blood perfusion. In conclusion, depicting blood flow within the middle uterine artery using color Doppler sonography could be helpful in correct diagnosis of duration and degree of uterine torsion and concurrently predicting the viability of the fetus and dam. Copyright © 2013 Elsevier Inc. All rights reserved.

Numerical and experimental analysis of the transitional flow across a real stenosis.

PubMed

Agujetas, R; Ferrera, C; Marcos, A C; Alejo, J P; Montanero, J M

2017-08-01

In this paper, we present a numerical study of the pulsatile transitional flow crossing a severe real stenosis located right in front of the bifurcation between the right subclavian and right common carotid arteries. The simulation allows one to determine relevant features of this subject-specific flow, such as the pressure waves in the right subclavian and right common carotid arteries. We explain the subclavian steal syndrome suffered by the patient in terms of the drastic pressure drop in the right subclavian artery. This pressure drop is caused by both the diverging part of the analyzed stenosis and the reverse flow in the bifurcation induced by another stenosis in the right internal carotid artery.

Continuous-Flow Left Ventricular Assist Device Support Improves Myocardial Supply:Demand in Chronic Heart Failure.

PubMed

Soucy, Kevin G; Bartoli, Carlo R; Phillips, Dustin; Giridharan, Guruprasad A; Sobieski, Michael A; Wead, William B; Dowling, Robert D; Wu, Zhongjun J; Prabhu, Sumanth D; Slaughter, Mark S; Koenig, Steven C

2017-06-01

Continuous-flow left ventricular assist devices (CF LVADs) are rotary blood pumps that improve mean blood flow, but with potential limitations of non-physiological ventricular volume unloading and diminished vascular pulsatility. In this study, we tested the hypothesis that left ventricular unloading with increasing CF LVAD flow increases myocardial flow normalized to left ventricular work. Healthy (n = 8) and chronic ischemic heart failure (IHF, n = 7) calves were implanted with CF LVADs. Acute hemodynamics and regional myocardial blood flow were measured during baseline (LVAD off, clamped), partial (2-4 L/min) and full (>4 L/min) LVAD support. IHF calves demonstrated greater reduction of cardiac energy demand with increasing LVAD support compared to healthy calves, as calculated by rate-pressure product. Coronary artery flows (p < 0.05) and myocardial blood flow (left ventricle (LV) epicardium and myocardium, p < 0.05) decreased with increasing LVAD support in normal calves. In the IHF model, blood flow to the septum, LV, LV epicardium, and LV myocardium increased significantly with increasing LVAD support when normalized to cardiac energy demand (p < 0.05). In conclusion, myocardial blood flow relative to cardiac demand significantly increased in IHF calves, thereby demonstrating that CF LVAD unloading effectively improves cardiac supply and demand ratio in the setting of ischemic heart failure.

Shape optimization of pulsatile ventricular assist devices using FSI to minimize thrombotic risk

NASA Astrophysics Data System (ADS)

Long, C. C.; Marsden, A. L.; Bazilevs, Y.

2014-10-01

In this paper we perform shape optimization of a pediatric pulsatile ventricular assist device (PVAD). The device simulation is carried out using fluid-structure interaction (FSI) modeling techniques within a computational framework that combines FEM for fluid mechanics and isogeometric analysis for structural mechanics modeling. The PVAD FSI simulations are performed under realistic conditions (i.e., flow speeds, pressure levels, boundary conditions, etc.), and account for the interaction of air, blood, and a thin structural membrane separating the two fluid subdomains. The shape optimization study is designed to reduce thrombotic risk, a major clinical problem in PVADs. Thrombotic risk is quantified in terms of particle residence time in the device blood chamber. Methods to compute particle residence time in the context of moving spatial domains are presented in a companion paper published in the same issue (Comput Mech, doi: 10.1007/s00466-013-0931-y, 2013). The surrogate management framework, a derivative-free pattern search optimization method that relies on surrogates for increased efficiency, is employed in this work. For the optimization study shown here, particle residence time is used to define a suitable cost or objective function, while four adjustable design optimization parameters are used to define the device geometry. The FSI-based optimization framework is implemented in a parallel computing environment, and deployed with minimal user intervention. Using five SEARCH/ POLL steps the optimization scheme identifies a PVAD design with significantly better throughput efficiency than the original device.

In vitro evaluation of the effect of aortic compliance on pediatric intra-aortic balloon pumping.

PubMed

Minich, L L; Tani, L Y; Hawkins, J A; Bartkowiak, R R; Royall, M L; Pantalos, G M

2001-04-01

OBJECTIVES: To evaluate the effect of aortic compliance on pediatric intra-aortic balloon pumping (IABP). DESIGN: In vitro study using a mechanical model of the pediatric left heart circulation. SETTING: Cardiovascular fluid dynamics research laboratory. SUBJECT: Pulsatile flow system simulating the pediatric left heart circulation and two different aortas with compliances comparable to those of the pediatric aorta (0.12 and 0.07 mL/mm Hg). INTERVENTIONS: Measurements were made at a baseline peak aortic flow of 4 L/min, at simulated shock (1.7 L/min), and with 1:1 IABP (rates, 130 and 150 bpm; balloon volumes, 2.5 and 5.0 mL). MEASUREMENTS AND MAIN RESULTS: Peak flow rates were measured in the ascending aorta, coronary arterial system, and brachiocephalic arterial systems. Aortic pressure was measured in the ascending aorta. For both aortas (0.12 and 0.07 mL/mm Hg), IABP resulted in diastolic augmentation (38 +/- 8 and 43 +/- 16 mm Hg) and afterload reduction (4 +/- 2 and 6 +/- 3 mm Hg). For both aortas, compared to shock, IABP resulted in significant increases in coronary arterial and brachiocephalic arterial flow and aortic pressure for both aortas. Aortic flow significantly increased only in the less-compliant aorta. CONCLUSIONS: In a laboratory model of pediatric left heart circulation, IABP results in diastolic augmentation, afterload reduction, and improved hemodynamics, even in aortas of greater compliance.

A Bayesian model for highly accelerated phase-contrast MRI.

PubMed

Rich, Adam; Potter, Lee C; Jin, Ning; Ash, Joshua; Simonetti, Orlando P; Ahmad, Rizwan

2016-08-01

Phase-contrast magnetic resonance imaging is a noninvasive tool to assess cardiovascular disease by quantifying blood flow; however, low data acquisition efficiency limits the spatial and temporal resolutions, real-time application, and extensions to four-dimensional flow imaging in clinical settings. We propose a new data processing approach called Reconstructing Velocity Encoded MRI with Approximate message passing aLgorithms (ReVEAL) that accelerates the acquisition by exploiting data structure unique to phase-contrast magnetic resonance imaging. The proposed approach models physical correlations across space, time, and velocity encodings. The proposed Bayesian approach exploits the relationships in both magnitude and phase among velocity encodings. A fast iterative recovery algorithm is introduced based on message passing. For validation, prospectively undersampled data are processed from a pulsatile flow phantom and five healthy volunteers. The proposed approach is in good agreement, quantified by peak velocity and stroke volume (SV), with reference data for acceleration rates R≤10. For SV, Pearson r≥0.99 for phantom imaging (n = 24) and r≥0.96 for prospectively accelerated in vivo imaging (n = 10) for R≤10. The proposed approach enables accurate quantification of blood flow from highly undersampled data. The technique is extensible to four-dimensional flow imaging, where higher acceleration may be possible due to additional redundancy. Magn Reson Med 76:689-701, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Biomathematical modeling of pulsatile hormone secretion: a historical perspective.

PubMed

Evans, William S; Farhy, Leon S; Johnson, Michael L

2009-01-01

Shortly after the recognition of the profound physiological significance of the pulsatile nature of hormone secretion, computer-based modeling techniques were introduced for the identification and characterization of such pulses. Whereas these earlier approaches defined perturbations in hormone concentration-time series, deconvolution procedures were subsequently employed to separate such pulses into their secretion event and clearance components. Stochastic differential equation modeling was also used to define basal and pulsatile hormone secretion. To assess the regulation of individual components within a hormone network, a method that quantitated approximate entropy within hormone concentration-times series was described. To define relationships within coupled hormone systems, methods including cross-correlation and cross-approximate entropy were utilized. To address some of the inherent limitations of these methods, modeling techniques with which to appraise the strength of feedback signaling between and among hormone-secreting components of a network have been developed. Techniques such as dynamic modeling have been utilized to reconstruct dose-response interactions between hormones within coupled systems. A logical extension of these advances will require the development of mathematical methods with which to approximate endocrine networks exhibiting multiple feedback interactions and subsequently reconstruct their parameters based on experimental data for the purpose of testing regulatory hypotheses and estimating alterations in hormone release control mechanisms.

Flow-gated radial phase-contrast imaging in the presence of weak flow.

PubMed

Peng, Hsu-Hsia; Huang, Teng-Yi; Wang, Fu-Nien; Chung, Hsiao-Wen

2013-01-01

To implement a flow-gating method to acquire phase-contrast (PC) images of carotid arteries without use of an electrocardiography (ECG) signal to synchronize the acquisition of imaging data with pulsatile arterial flow. The flow-gating method was realized through radial scanning and sophisticated post-processing methods including downsampling, complex difference, and correlation analysis to improve the evaluation of flow-gating times in radial phase-contrast scans. Quantitatively comparable results (R = 0.92-0.96, n = 9) of flow-related parameters, including mean velocity, mean flow rate, and flow volume, with conventional ECG-gated imaging demonstrated that the proposed method is highly feasible. The radial flow-gating PC imaging method is applicable in carotid arteries. The proposed flow-gating method can potentially avoid the setting up of ECG-related equipment for brain imaging. This technique has potential use in patients with arrhythmia or weak ECG signals.

Blood Pressure and Arterial Load After Transcatheter Aortic Valve Replacement for Aortic Stenosis.

PubMed

Lindman, Brian R; Otto, Catherine M; Douglas, Pamela S; Hahn, Rebecca T; Elmariah, Sammy; Weissman, Neil J; Stewart, William J; Ayele, Girma M; Zhang, Feifan; Zajarias, Alan; Maniar, Hersh S; Jilaihawi, Hasan; Blackstone, Eugene; Chinnakondepalli, Khaja M; Tuzcu, E Murat; Leon, Martin B; Pibarot, Philippe

2017-07-01

After aortic valve replacement, left ventricular afterload is often characterized by the residual valve obstruction. Our objective was to determine whether higher systemic arterial afterload-as reflected in blood pressure, pulsatile and resistive load-is associated with adverse clinical outcomes after transcatheter aortic valve replacement (TAVR). Total, pulsatile, and resistive arterial load were measured in 2141 patients with severe aortic stenosis treated with TAVR in the PARTNER I trial (Placement of Aortic Transcatheter Valve) who had systolic blood pressure (SBP) and an echocardiogram obtained 30 days after TAVR. The primary end point was 30-day to 1-year all-cause mortality. Lower SBP at 30 days after TAVR was associated with higher mortality (20.0% for SBP 100-129 mm Hg versus 12.0% for SBP 130-170 mm Hg; P <0.001). This association remained significant after adjustment, was consistent across subgroups, and confirmed in sensitivity analyses. In adjusted models that included SBP, higher total and pulsatile arterial load were associated with increased mortality ( P <0.001 for all), but resistive load was not. Patients with low 30-day SBP and high pulsatile load had a 3-fold higher mortality than those with high 30-day SBP and low pulsatile load (26.1% versus 8.1%; hazard ratio, 3.62; 95% confidence interval, 2.36-5.55). Even after relief of valve obstruction in patients with aortic stenosis, there is an independent association between post-TAVR blood pressure, systemic arterial load, and mortality. Blood pressure goals in patients with a history of aortic stenosis may need to be redefined. Increased pulsatile arterial load, rather than blood pressure, may be a target for adjunctive medical therapy to improve outcomes after TAVR. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00530894. © 2017 American Heart Association, Inc.

Pulsatile flow in a compliant stenosed asymmetric model

NASA Astrophysics Data System (ADS)

Usmani, Abdullah Y.; Muralidhar, K.

2016-12-01

Time-varying velocity field in an asymmetric constricted tube is experimentally studied using a two-dimensional particle image velocimetry system. The geometry resembles a vascular disease which is characterized by arterial narrowing due to plaque deposition. The present study compares the nature of flow patterns in rigid and compliant asymmetric constricted tubes for a range of dimensionless parameters appearing in a human artery. A blood analogue fluid is employed along with a pump that mimics cardioflow conditions. The peak Reynolds number range is Re 300-800, while the Womersley number range considered in experiments is Wo 6-8. These values are based on the peak velocity in a straight rigid tube connected to the model, over a pulsation frequency range of 1.2-2.4 Hz. The medial-plane velocity distribution is used to investigate the nature of flow patterns. Temporal distribution of stream traces and hemodynamic factors including WSS, TAWSS and OSI at important phases of the pulsation cycle are discussed. The flow patterns obtained from PIV are compared to a limited extent against numerical simulation. Results show that the region downstream of the constriction is characterized by a high-velocity jet at the throat, while a recirculation zone, attached to the wall, evolves in time. Compliant models reveal large flow disturbances upstream during the retrograde flow. Wall shear stress values are lower in a compliant model as compared to the rigid. Cross-plane flow structures normal to the main flow direction are visible at select phases of the cycle. Positive values of largest Lyapunov exponent are realized for wall movement and are indicative of chaotic motion transferred from the flow to the wall. These exponents increase with Reynolds number as well as compliance. Period doubling is observed in wall displacement of highly compliant models, indicating possible triggering of hemodynamic events in a real artery that may cause fissure in the plaque deposits.

FSI simulation of CSF hydrodynamic changes in a large population of non-communicating hydrocephalus patients during treatment process with regard to their clinical symptoms

PubMed Central

2018-01-01

3D fluid-structure interaction modelling was utilized for simulation of 13 normal subjects, 11 non-communicating hydrocephalus (NCH) patients at pre-treatment phase, and 3 patients at five post-treatment phases. Evaluation of ventricles volume and maximum CSF pressure (before shunting) following results validation indicated that these parameters were the most proper hydrodynamic indices and the NCH type doesn’t have any significant effect on changes in two indices. The results confirmed an appropriate correlation between these indices although the correlation decreased slightly after the occurrence of disease. NCH raises the intensity of vortex and pulsatility (2.4 times) of CSF flow while the flow remains laminar. On day 18 after shunting, the CSF pressure decreased 81.0% and all clinical symptoms of patients vanished except for headache. Continuing this investigation during the treatment process showed that maximum CSF pressure is the most sensitive parameter to patients’ clinical symptoms. Maximum CSF pressure has decreased proportional to the level of decrease in clinical symptoms and has returned close to the pressure range in normal subjects faster than other parameters and simultaneous with disappearance of patients’ clinical symptoms (from day 81 after shunting). However, phase lag between flow rate and pressure gradient functions and the degree of CSF pulsatility haven’t returned to normal subjects’ conditions even 981 days after shunting and NCH has also caused a permanent volume change (of 20.1%) in ventricles. Therefore, patients have experienced a new healthy state in new hydrodynamic conditions after shunting and healing. Increase in patients’ intracranial compliance was predicted with a more accurate non-invasive method than previous experimental methods up to more than 981 days after shunting. The changes in hydrodynamic parameters along with clinical reports of patients can help to gain more insight into the pathophysiology of NCH patients. PMID:29708982

An Experimental Study of Synthetic Jets from Rectangular Orifices

NASA Technical Reports Server (NTRS)

Milanovic, Ivana M.

2003-01-01

During the past two summers Professor Milanovic conducted Wind tunnel experiments on steady jets-in-cross-flow and synthetic jets. In her anticipated visit during the upcoming summer, she will continue and complete the research on synthetic jets involving 2-dimensional orifices of different aspect ratio as well as inclined slots. In addition, experiments will be conducted on pulsatile jets-in-cross-flow. The pulsation will be provided via an oscillating valve at controllable frequencies. The experiment will involve mainly hot-wire anemometer measurements in the low-speed wind tunnel. Overall goal will be to obtain database and investigate flow control strategies. The research will be of fundamental nature.

In Vitro Validation of Rapid MR Measurement of Wave Velocity

PubMed

Kraft; Fatouros; Corwin; Fei

1997-05-01

A one-dimensional time-of-flight MR sequence, having a total acquisition time of approximately 60 ms, has been employed to determine flow-wave propagation velocities for pulsatile flow in compliant latex tubes. The results were compared with those of two independent methods and were found to be in good agreement. An extension of the same MR method was used to test the validity of the "water-hammer" relationship as a means to assess pulse pressure. Very good agreement was found with direct manometric determinations of pulse pressure.

Pulsatile tinnitus as the presenting symptom in a patient with posterior reversible encephalopathy syndrome.

PubMed

Mohammed, Hassan; Briggs, Mayen; Phillips, John

2016-09-01

We present a case of posterior reversible encephalopathy syndrome (PRES) presenting with pulsatile tinnitus. We highlight the significance of a detailed neurological and cardiovascular assessment including the measurement of blood pressure in patients presenting with pulsatile tinnitus. Case presentation and literature review. One patient with undiagnosed PRES, who presented to our ear, nose and throat surgery department with pulsatile tinnitus is discussed. Symptoms, signs, investigations and treatments are presented. A literature review is also included. Pulsatile tinnitus can be the presenting symptom of neurovascular disorders, some of which might have serious sequelae if not treated promptly. Detailed neurological and cardiovascular history is recommended in addition to radiological investigations in patients presenting with pulsatile tinnitus.

Intraoperative laser speckle contrast imaging for monitoring cerebral blood flow: results from a 10-patient pilot study

NASA Astrophysics Data System (ADS)

Richards, Lisa M.; Weber, Erica L.; Parthasarathy, Ashwin B.; Kappeler, Kaelyn L.; Fox, Douglas J.; Dunn, Andrew K.

2012-02-01

Monitoring cerebral blood flow (CBF) during neurosurgery can provide important physiological information for a variety of surgical procedures. Although multiple intraoperative vascular monitoring technologies are currently available, a quantitative method that allows for continuous monitoring is still needed. Laser speckle contrast imaging (LSCI) is an optical imaging method with high spatial and temporal resolution that has been widely used to image CBF in animal models in vivo. In this pilot clinical study, we adapted a Zeiss OPMI Pentero neurosurgical microscope to obtain LSCI images by attaching a camera and a laser diode. This LSCI adapted instrument has been used to acquire full field flow images from 10 patients during tumor resection procedures. The patient's ECG was recorded during acquisition and image registration was performed in post-processing to account for pulsatile motion artifacts. Digital photographs confirmed alignment of vasculature and flow images in four cases, and a relative change in blood flow was observed in two patients after bipolar cautery. The LSCI adapted instrument has the capability to produce real-time, full field CBF image maps with excellent spatial resolution and minimal intervention to the surgical procedure. Results from this study demonstrate the feasibility of using LSCI to monitor blood flow during neurosurgery.

Investigation of the mechanism of soft tissue conduction explains several perplexing auditory phenomena.

PubMed

Adelman, Cahtia; Chordekar, Shai; Perez, Ronen; Sohmer, Haim

2014-09-01

Soft tissue conduction (STC) is a recently expounded mode of auditory stimulation in which the clinical bone vibrator delivers auditory frequency vibratory stimuli to skin sites on the head, neck, and thorax. Investigation of the mechanism of STC stimulation has served as a platform for the elucidation of the mechanics of cochlear activation, in general, and to a better understanding of several perplexing auditory phenomena. This review demonstrates that it is likely that the cochlear hair cells can be directly activated at low sound intensities by the fluid pressures initiated in the cochlea; that the fetus in utero, completely enveloped in amniotic fluid, hears by STC; that a speaker hears his/her own voice by air conduction and by STC; and that pulsatile tinnitus is likely due to pulsatile turbulent blood flow producing fluid pressures that reach the cochlea through the soft tissues.

Right ventricular response to pulsatile load is associated with early right heart failure and mortality after left ventricular assist device.

PubMed

Grandin, E Wilson; Zamani, Payman; Mazurek, Jeremy A; Troutman, Gregory S; Birati, Edo Y; Vorovich, Esther; Chirinos, Julio A; Tedford, Ryan J; Margulies, Kenneth B; Atluri, Pavan; Rame, J Eduardo

2017-01-01

Right ventricular (RV) adaptation to afterload is crucial for patients undergoing continuous-flow left ventricular assist device (cf-LVAD) implantation. We hypothesized that stratifying patients by RV pulsatile load, using pulmonary arterial compliance (PAC), and RV response to load, using the ratio of central venous to pulmonary capillary wedge pressure (CVP:PCWP), would identify patients at high risk for early right heart failure (RHF) and 6-month mortality after cf-LVAD. During the period from January 2008 to June 2014, we identified 151 patients at our center with complete hemodynamics prior to cf-LVAD. Pulsatile load was estimated using PAC indexed to body surface area (BSA), according to the formula: indexed PAC (PACi) = [SV / (PA systolic - PA diastolic )] / BSA, where SV is stroke volume and PA is pulmonary artery. Patients were divided into 4 hemodynamic groups by PACi and CVP:PCWP. RHF was defined as the need for unplanned RVAD, inotropic support ≥14 days or death due to RHF within 14 days. Risk factors for RHF and 6-month mortality were examined using logistic regression and Cox proportional hazards modeling. Sixty-one patients (40.4%) developed RHF and 34 patients (22.5%) died within 6 months. Patients with RHF had lower PACi (0.92 vs 1.17 ml/mm Hg/m 2 , p = 0.008) and higher CVP:PCWP (0.48 vs 0.37, p = 0.001). Higher PACi was associated with reduced risk of RHF (adjusted odds ratio [adj-OR] 0.61, 95% confidence interval [CI] 0.39 to 0.94, p = 0.025) and low PACi with increased risk of 6-month mortality (adjusted hazard ratio [adj-HR] 3.18, 95% CI 1.40 to 7.25, p = 0.006). Compared to patients with low load (high PACi) and adequate right heart response to load (low CVP:PCWP), patients with low PACi and high CVP:PCWP had an increased risk of RHF (OR 4.74, 95% CI 1.23 to 18.24, p = 0.02) and 6-month mortality (HR 8.68, 95% CI 2.79 to 26.99, p < 0.001). A hemodynamic profile combining RV pulsatile load and response to load identifies patients at high risk for RHF and 6-month mortality after cf-LVAD. Copyright © 2016 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Intra-aneurysmal flow disruption after implantation of the Medina® Embolization Device depends on aneurysm neck coverage.

PubMed

Frölich, Andreas Maximilian; Nawka, Marie Teresa; Ernst, Marielle; Frischmuth, Isabell; Fiehler, Jens; Buhk, Jan-Hendrik

2018-01-01

Flow disruption achieved by braided intrasaccular implants is a novel treatment strategy for cerebrovascular aneurysms. We hypothesized that the degree of intra-aneurysmal flow disruption can be quantified in vitro and is influenced by device position across the aneurysm neck. We tested this hypothesis using the Medina® Embolization Device (MED). Ten different patient-specific elastic vascular models were manufactured. Models were connected to a pulsatile flow circuit, filled with a blood-mimicking fluid and treated by two operators using a single MED. Intra-aneurysmal flow velocity was measured using conventional and high-frequency digital subtraction angiography (HF-DSA) before and after each deployment. Aneurysm neck coverage by the implanted devices was assessed with flat detector computed tomography on a three-point Likert scale. A total of 80 individual MED deployments were performed by the two operators. The mean intra-aneurysmal flow velocity reduction after MED implantation was 33.6% (27.5-39.7%). No significant differences in neck coverage (p = 0.99) or flow disruption (p = 0.84) were observed between operators. The degree of flow disruption significantly correlated with neck coverage (ρ = 0.42, 95% CI: 0.21-0.59, p = 0.002) as well as with neck area (ρ = -0,35, 95% CI: -0.54 --0.13, p = 0.024). On multiple regression analysis, both neck coverage and total neck area were independent predictors of flow disruption. The degree of intra-aneurysmal flow disruption after MED implantation can be quantified in vitro and varies considerably between different aneurysms and different device configurations. Optimal device coverage across the aneurysm neck improves flow disruption and may thus contribute to aneurysm occlusion.

Cerebral versus systemic hemodynamics during graded orthostatic stress in humans

NASA Technical Reports Server (NTRS)

Levine, B. D.; Giller, C. A.; Lane, L. D.; Buckey, J. C.; Blomqvist, C. G.

1994-01-01

BACKGROUND: Orthostatic syncope is usually attributed to cerebral hypoperfusion secondary to systemic hemodynamic collapse. Recent research in patients with neurocardiogenic syncope has suggested that cerebral vasoconstriction may occur during orthostatic hypotension, compromising cerebral autoregulation and possibly contributing to the loss of consciousness. However, the regulation of cerebral blood flow (CBF) in such patients may be quite different from that of healthy individuals, particularly when assessed during the rapidly changing hemodynamic conditions associated with neurocardiogenic syncope. To be able to interpret the pathophysiological significance of these observations, a clear understanding of the normal responses of the cerebral circulation to orthostatic stress must be obtained, particularly in the context of the known changes in systemic and regional distributions of blood flow and vascular resistance during orthostasis. Therefore, the specific aim of this study was to examine the changes that occur in the cerebral circulation during graded reductions in central blood volume in the absence of systemic hypotension in healthy humans. We hypothesized that cerebral vasoconstriction would occur and CBF would decrease due to activation of the sympathetic nervous system. We further hypothesized, however, that the magnitude of this change would be small compared with changes in systemic or skeletal muscle vascular resistance in healthy subjects with intact autoregulation and would be unlikely to cause syncope without concomitant hypotension. METHODS AND RESULTS: To test this hypothesis, we studied 13 healthy men (age, 27 +/- 7 years) during progressive lower body negative pressure (LBNP). We measured systemic flow (Qc is cardiac output; C2H2 rebreathing), regional forearm flow (FBF; venous occlusion plethysmography), and blood pressure (BP; Finapres) and calculated systemic (SVR) and forearm (FVR) vascular resistances. Changes in brain blood flow were estimated from changes in the blood flow velocity in the middle cerebral artery (VMCA) using transcranial Doppler. Pulsatility (systolic minus diastolic/mean velocity) normalized for systemic arterial pressure pulsatility was used as an index of distal cerebral vascular resistance. End-tidal PACO2 was closely monitored during LBNP. From rest to maximal LBNP before the onset of symptoms or systemic hypotension, Qc and FBF decreased by 29.9% and 34.4%, respectively. VMCA decreased less, by 15.5% consistent with a smaller decrease in CBF. Similarly, SVR and FVR increased by 62.8% and 69.8%, respectively, whereas pulsatility increased by 17.2%, suggestive of a mild degree of small-vessel cerebral vasoconstriction. Seven of 13 subjects had presyncope during LBNP, all associated with a sudden drop in BP (29 +/- 9%). By comparison, hyperventilation alone caused greater changes in VMCA (42 +/- 2%) and pulsatility but never caused presyncope. In a separate group of 3 subjects, superimposition of hyperventilation during highlevel LBNP caused a further decrease in VMCA (31 +/- 7%) but no change in BP or level of consciousness. CONCLUSIONS: We conclude that cerebral vasoconstriction occurs in healthy humans during graded reductions in central blood volume caused by LBNP. However, the magnitude of this response is small compared with changes in SVR or FVR during LBNP or other stimuli known to induce cerebral vasoconstriction (hypocapnia). We speculate that this degree of cerebral vasoconstriction is not by itself sufficient to cause syncope during orthostatic stress. However, it may exacerbate the decrease in CBF associated with hypotension if hemodynamic instability develops.

Microvascular Branching as a Determinant of Blood Flow by Intravital Particle Imaging Velocimetry

NASA Technical Reports Server (NTRS)

Parsons-Wingerter, Patricia; McKay, Terri L.; Vickerman, Mary B.; Wernet, Mark P.; Myers, Jerry G.; Radhakrishnan, Krishnan

2007-01-01

The effects of microvascular branching on blood flow were investigated in vivo by microscopic particle imaging velocimetry (micro-PIV). We use micro-PIV to measure blood flow by tracking red blood cells (RBC) as the moving particles. Velocity flow fields, including flow pulsatility, were analyzed for the first four branching orders of capillaries, postcapillary venules and small veins of the microvascular network within the developing avian yolksac at embryonic day 5 (E5). Increasing volumetric flowrates were obtained from parabolic laminar flow profiles as a function of increasing vessel diameter and branching order. Maximum flow velocities increased approximately twenty-fold as the function of increasing vessel diameter and branching order compared to flow velocities of 100 - 150 micron/sec in the capillaries. Results from our study will be useful for the increased understanding of blood flow within anastomotic, heterogeneous microvascular networks.

Particle Image Velocimetry studies of bicuspid aortic valve hemodynamics

NASA Astrophysics Data System (ADS)

Saikrishnan, Neelakantan; Yap, Choon-Hwai; Yoganathan, Ajit P.

2010-11-01

Bicuspid aortic valves (BAVs) are a congenital anomaly of the aortic valve with two fused leaflets, affecting about 1-2% of the population. BAV patients have much higher incidence of valve calcification & aortic dilatation, which may be related to altered mechanical forces from BAV hemodynamics. This study aims to characterize BAV hemodynamics using Particle Image Velocimetry(PIV). BAV models are constructed from normal explanted porcine aortic valves by suturing two leaflets together. The valves are mounted in an acrylic chamber with two sinuses & tested in a pulsatile flow loop at physiological conditions. 2D PIV is performed to obtain flow fields in three planes downstream of the valve. The stenosed BAV causes an eccentric jet, resulting in a very strong vortex in the normal sinus. The bicuspid sinus vortex appears much weaker, but more unstable. Unsteady oscillatory shear stresses are also observed, which have been associated with adverse biological response; characterization of the hemodynamics of BAVs will provide the first step to understanding these processes better. Results from multiple BAV models of varying levels of stenosis will be presented & higher stenosis corresponded to stronger jets & increased aortic wall shear stresses.

Experimental investigation of the effects of inserting a bovine venous valve in the inferior vena cava of Fontan circulation

NASA Astrophysics Data System (ADS)

Santhanakrishnan, Arvind; Johnson, Jacob; Kotz, Monica; Tang, Elaine; Khiabani, Reza; Yoganathan, Ajit; Maher, Kevin

2012-11-01

The Fontan procedure is a palliative surgery performed on patients with single ventricle (SV) congenital heart defects. The SV is used for systemic circulation and the venous return from the inferior vena cava (IVC) and superior vena cava (SVC) is routed to the pulmonary arteries (PA), resulting in a total cavopulmonary connection (TCPC). Hepatic venous hypertension is commonly manifested in the Fontan circulation, leading to long-term complications including liver congestion and cirrhosis. Respiratory intrathoracic pressure changes affect the venous return from the IVC to the PA. Using a physical model of an idealized TCPC, we examine placement of a unidirectional bovine venous valve within the IVC as a method of alleviating hepatic venous hypertension. A piston pump is used to provide pulsatility in the internal flow through the TCPC, while intrathoracic pressure fluctuations are imposed on the external walls of the model using a pair of linear actuators. When implanted in the extrathoracic position, the hepatic venous pressure is lowered from baseline condition. The effects of changing caval flow distribution and intrathoracic pressure on TCPC hemodynamics will be examined.

Effects of vascular structures on the pressure drop in stenotic coronary arteries

NASA Astrophysics Data System (ADS)

Kim, Jaerim; Choi, Haecheon; Kweon, Jihoon; Kim, Young-Hak; Yang, Dong Hyun; Kim, Namkug

2016-11-01

A stenosis, which is a narrowing of a blood vessel, of the coronary arteries restricts the flow to the heart and it may lead to sudden cardiac death. Therefore, the accurate determination of the severity of a stenosis is a critical issue. Due to the convenience of visual assessments, geometric parameters such as the diameter stenosis and area stenosis have been used, but the decision based on them sometimes under- or overestimates the functional severity of a stenosis, i.e., pressure drop. In this study, patient-specific models that have similar area stenosis but different pressure drops are considered, and their geometries are reconstructed from the coronary computed tomography angiography (CCTA). Both steady and pulsatile inflows are considered for the simulations. Comparison between two models that have a bifurcation right after a stenosis shows that the parent to daughter vessel angle results in different secondary flow patterns and wall shear stress distributions which affect the pressure downstream. Thus, the structural features of the lower and upper parts of a stenosis significantly affect the pressure drop. Supported by 20152020105600.

Initial simulated FFR investigation using flow measurements in patient-specific 3D printed coronary phantoms

NASA Astrophysics Data System (ADS)

Shepard, Lauren; Sommer, Kelsey; Izzo, Richard; Podgorsak, Alexander; Wilson, Michael; Said, Zaid; Rybicki, Frank J.; Mitsouras, Dimitrios; Rudin, Stephen; Angel, Erin; Ionita, Ciprian N.

2017-03-01

Purpose: Accurate patient-specific phantoms for device testing or endovascular treatment planning can be 3D printed. We expand the applicability of this approach for cardiovascular disease, in particular, for CT-geometry derived benchtop measurements of Fractional Flow Reserve, the reference standard for determination of significant individual coronary artery atherosclerotic lesions. Materials and Methods: Coronary CT Angiography (CTA) images during a single heartbeat were acquired with a 320x0.5mm detector row scanner (Toshiba Aquilion ONE). These coronary CTA images were used to create 4 patientspecific cardiovascular models with various grades of stenosis: severe, <75% (n=1); moderate, 50-70% (n=1); and mild, <50% (n=2). DICOM volumetric images were segmented using a 3D workstation (Vitrea, Vital Images); the output was used to generate STL files (using AutoDesk Meshmixer), and further processed to create 3D printable geometries for flow experiments. Multi-material printed models (Stratasys Connex3) were connected to a programmable pulsatile pump, and the pressure was measured proximal and distal to the stenosis using pressure transducers. Compliance chambers were used before and after the model to modulate the pressure wave. A flow sensor was used to ensure flow rates within physiological reported values. Results: 3D model based FFR measurements correlated well with stenosis severity. FFR measurements for each stenosis grade were: 0.8 severe, 0.7 moderate and 0.88 mild. Conclusions: 3D printed models of patient-specific coronary arteries allows for accurate benchtop diagnosis of FFR. This approach can be used as a future diagnostic tool or for testing CT image-based FFR methods.

Effect of Outflow Graft Size on Flow in the Aortic Arch and Cerebral Blood Flow in Continuous Flow Pumps: Possible Relevance to Strokes.

PubMed

Bhat, Sindhoor; Mathew, Jayakala; Balakrishnan, Komrakshi R; Krishna Kumar, Ramarathnam

One of the most devastating complications of continuous flow left ventricular devices (CFLVADS) is stroke, with a higher incidence in HeartWare Ventricular Assist Device (HVAD) as compared with HEARTMATE II. The reason for the observed difference in stroke rates is unclear. Because outflow graft diameters are different, we hypothesized that this could contribute to the difference in stroke rates. A computational fluid-structure interaction model was created from the computed tomography (CT) scan of a patient. Pressures were used as the boundary condition and the flow through the cerebral vessels was derived as outputs. Flow into the innominate artery was very sensitive to the anastomosis angle for a 10 mm as compared with a 14 mm graft, with the net innominate flow severely compromised with a 10 mm graft at 45° angle. Aortic insufficiency seems to affect cerebral blood flow nonlinearly with an 80% decrease at certain angles of outflow graft anastomosis. Arterial return in to the arch through a narrow graft has important jet effects and results in significant flow perturbations in the aortic arch and cerebral vessels and stasis. A 10 mm graft is more sensitive to angle of insertion than a 14 mm graft. Under some conditions, serious hypoperfusion of the innominate artery is possible. Aortic incompetence results in significant decrease of cerebral blood flow. No stasis was found in the pulsatile flow compared with LVAD flow.

Increasing awareness with recognition of pulsatile tinnitus for nurse practitioners in the primary care setting: A case study.

PubMed

Vecchiarelli, Kelly; Amar, Arun Paul; Emanuele, Donna

2017-09-01

Pulsatile tinnitus is a whooshing sound heard synchronous with the heartbeat. It is an uncommon symptom affecting fewer than 10% of patients with tinnitus. It often goes unrecognized in the primary care setting. Failure to recognize this symptom can result in a missed or delayed diagnosis of a potentially life-threatening condition known as a dural arteriovenous fistula. The purpose of this case study is to provide a structured approach to the identification of pulsatile tinnitus and provide management recommendations. A case study and review of pertinent literature. Pulsatile tinnitus usually has a vascular treatable cause. A comprehensive history and physical examination will alert the nurse practitioner (NP) when pulsatile tinnitus is present. Auscultation in specific areas of the head can detect audible or objective pulsatile tinnitus. Pulsatile tinnitus that is audible to the examiner is an urgent medical condition requiring immediate consultation and referral. Knowledge of pulsatile tinnitus and awareness of this often treatable condition directs the NP to perform a detailed assessment when patients present with tinnitus, directs appropriate referral for care and treatment, and can reduce the risk of delayed or missed diagnosis. ©2017 American Association of Nurse Practitioners.

An intriguing design concept to enhance the pulsatile fatigue life of self-expanding stents.

PubMed

Hsiao, Hao-Ming; Yin, Ming-Ting

2014-02-01

Intravascular stenting has emerged as the primary treatment for vascular diseases and has received great attention from the medical community since its introduction two decades ago. The endovascular self-expanding stent is used to treat peripheral artery diseases; however, once implanted, these stents suffer from various cyclic motions caused by pulsatile blood pressure and daily activities. Due to this challenging environment, fatigue performance has become a critical issue for stent design. In this paper, a simple yet intriguing concept of stent design aimed at enhancing pulsatile fatigue life is investigated. The concept of this design is to shift the highly concentrated stresses/strains away from the crown and re-distribute them along the stress-free bar arm by tapering its strut width. Finite element models were developed to evaluate the mechanical integrity and pulsatile fatigue resistance of the stent to various loading conditions. Results show that the fatigue safety factor jumped to 2.5-3.0 times that of the standard stent with constant strut width. This is astonishing considering that the stent profile and scaffolding were not compromised. The findings of this paper provide an excellent approach to the optimization of future stent design to greatly improve stent fatigue performance.

Method and Apparatus for Non-Invasive Measurement of Changes in Intracranial Pressure

NASA Technical Reports Server (NTRS)

Yost, William T. (Inventor); Cantrell, John H., Jr. (Inventor)

2004-01-01

A method and apparatus for measuring intracranial pressure. In one embodiment, the method comprises the steps of generating an information signal that comprises components (e.g., pulsatile changes and slow changes) that are related to intracranial pressure and blood pressure, generating a reference signal comprising pulsatile components that are solely related to blood pressure, processing the information and reference signals to determine the pulsatile components of the information signal that have generally the same phase as the pulsatile components of the reference signal, and removing from the information signal the pulsatile components determined to have generally the same phase as the pulsatile components of the reference signal so as to provide a data signal having components wherein substantially all of the components are related to intracranial pressure.

Tomographic PIV behind a prosthetic heart valve

NASA Astrophysics Data System (ADS)

Hasler, D.; Landolt, A.; Obrist, D.

2016-05-01

The instantaneous three-dimensional velocity field past a bioprosthetic heart valve was measured using tomographic particle image velocimetry. Two digital cameras were used together with a mirror setup to record PIV images from four different angles. Measurements were conducted in a transparent silicone phantom with a simplified geometry of the aortic root. The refraction indices of the silicone phantom and the working fluid were matched to minimize optical distortion from the flow field to the cameras. The silicone phantom of the aorta was integrated in a flow loop driven by a piston pump. Measurements were conducted for steady and pulsatile flow conditions. Results of the instantaneous, ensemble and phase-averaged flow field are presented. The three-dimensional velocity field reveals a flow topology, which can be related to features of the aortic valve prosthesis.

Evaluation of a turbine flow meter (Ventilometer Mark 2) in the measurement of ventilation.

PubMed

Cooper, C B; Harris, N D; Howard, P

1990-01-01

We have evaluated a turbine flow meter (Ventilometer Mark 2, PK Morgan, Kent, UK) at low flow rates and levels of ventilation which are likely to be encountered during exercise in patients with chronic respiratory disease. Pulsatile flows were generated from a volume-cycled mechanical ventilator, the flow wave-form was modified by damping to simulate a human breathing pattern. Comparative measurements of ventilation were made whilst varying tidal volume (VT) from 0.22 to 1.131 and respiratory rate (fR) from 10 to 35 min-1. At lower levels of ventilation the instrument tended to underread especially with increasing fR. The calibration factor must be adjusted to match the level of ventilation if the measurement errors are to be within 5%.

Flow Instability and Wall Shear Stress Ocillation in Intracranial Aneurysms

NASA Astrophysics Data System (ADS)

Baek, Hyoungsu; Jayamaran, Mahesh; Richardson, Peter; Karniadakis, George

2009-11-01

We investigate the flow dynamics and oscillatory behavior of wall shear stress (WSS) vectors in intracranial aneurysms using high-order spectral/hp simulations. We analyze four patient- specific internal carotid arteries laden with aneurysms of different characteristics : a wide-necked saccular aneurysm, a hemisphere-shaped aneurysm, a narrower-necked saccular aneurysm, and a case with two adjacent saccular aneurysms. Simulations show that the pulsatile flow in aneurysms may be subject to a hydrodynamic instability during the decelerating systolic phase resulting in a high-frequency oscillation in the range of 30-50 Hz. When the aneurysmal flow becomes unstable, both the magnitude and the directions of WSS vectors fluctuate. In particular, the WSS vectors around the flow impingement region exhibit significant spatial and temporal changes in direction as well as in magnitude.

Retinal nerve fiber layer thickness map and blood flow pulsation measured with SDOCT

NASA Astrophysics Data System (ADS)

Mujat, Mircea; Chan, Raymond C.; Cense, Barry; Pierce, Mark; Park, Hyle; Joo, Chulmin; Chen, Teresa C.; de Boer, Johannes F.

2006-02-01

Spectral-Domain Optical Coherence Tomography (SDOCT) allows for in-vivo video-rate investigation of biomedical tissue depth structure intended for non-invasive optical diagnostics. It has been suggested that OCT can be used for di-agnosis of glaucoma by measuring the thickness of the Retinal Nerve Fiber Layer (RNLF). We present an automated method for determining the RNFL thickness from a 3-D dataset based on edge detection using a deformable spline algo-rithm. The RNFL thickness map is combined with an integrated reflectance map and retinal cross-sectional images to provide the ophthalmologist with a familiar image for interpreting the OCT data. The video-rate capabilities of our SDOCT system allow for mapping the true retinal topography since motion artifacts are significantly reduced as com-pared to slower time-domain systems. Combined with Doppler Velocimetry, SDOCT also provides information on retinal blood flow dynamics. We analyzed the pulsatile nature of the bidirectional flow dynamics in an artery-vein pair for a healthy volunteer at different locations and for different blood vessel diameters. The Doppler phase shift is determined as the phase difference at the same point of adjacent depth profiles, and is integrated over the area delimited by two circles corresponding to the blood vessels location. Its temporal evolution clearly shows the blood flow pulsatile nature, the cardiac cycle, in both artery and vein. The artery is identified as having a stronger variation of the integrated phase shift. We observe that artery pulsation is always easily detectable, while vein pulsation seems to depend on the veins diameter.

Description of a flow optimized oxygenator with integrated pulsatile pump.

PubMed

Borchardt, Ralf; Schlanstein, Peter; Arens, Jutta; Graefe, Roland; Schreiber, Fabian; Schmitz-Rode, Thomas; Steinseifer, Ulrich

2010-11-01

Extracorporeal membrane oxygenation (ECMO) is a well-established therapy for several lung and heart diseases in the field of neonatal and pediatric medicine (e.g., acute respiratory distress syndrome, congenital heart failure, cardiomyopathy). Current ECMO systems are typically composed of an oxygenator and a separate nonpulsatile blood pump. An oxygenator with an integrated pulsatile blood pump for small infant ECMO was developed, and this novel concept was tested regarding functionality and gas exchange rate. Pulsating silicone tubes (STs) were driven by air pressure and placed inside the cylindrical fiber bundle of an oxygenator to be used as a pump module. The findings of this study confirm that pumping blood with STs is a viable option for the future. The maximum gas exchange rate for oxygen is 48mL/min/L(blood) at a medium blood flow rate of about 300mL/min. Future design steps were identified to optimize the flow field through the fiber bundle to achieve a higher gas exchange rate. First, the packing density of the hollow-fiber bundle was lower than commercial oxygenators due to the manual manufacturing. By increasing this packing density, the gas exchange rate would increase accordingly. Second, distribution plates for a more uniform blood flow can be placed at the inlet and outlet of the oxygenator. Third, the hollow-fiber membranes can be individually placed to ensure equal distances between the surrounding hollow fibers. © 2010, Copyright the Authors. Artificial Organs © 2010, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

User-guided automated segmentation of time-series ultrasound images for measuring vasoreactivity of the brachial artery induced by flow mediation

NASA Astrophysics Data System (ADS)

Sehgal, Chandra M.; Kao, Yen H.; Cary, Ted W.; Arger, Peter H.; Mohler, Emile R.

2005-04-01

Endothelial dysfunction in response to vasoactive stimuli is closely associated with diseases such as atherosclerosis, hypertension and congestive heart failure. The current method of using ultrasound to image the brachial artery along the longitudinal axis is insensitive for measuring the small vasodilatation that occurs in response to flow mediation. The goal of this study is to overcome this limitation by using cross-sectional imaging of the brachial artery in conjunction with the User-Guided Automated Boundary Detection (UGABD) algorithm for extracting arterial boundaries. High-resolution ultrasound imaging was performed on rigid plastic tubing, on elastic rubber tubing phantoms with steady and pulsatile flow, and on the brachial artery of a healthy volunteer undergoing reactive hyperemia. The area of cross section of time-series images was analyzed by UGABD by propagating the boundary from one frame to the next. The UGABD results were compared by linear correlation with those obtained by manual tracing. UGABD measured the cross-sectional area of the phantom tubing to within 5% of the true area. The algorithm correctly detected pulsatile vasomotion in phantoms and in the brachial artery. A comparison of area measurements made using UGABD with those made by manual tracings yielded a correlation of 0.9 and 0.8 for phantoms and arteries, respectively. The peak vasodilatation due to reactive hyperemia was two orders of magnitude greater in pixel count than that measured by longitudinal imaging. Cross-sectional imaging is more sensitive than longitudinal imaging for measuring flow-mediated dilatation of brachial artery, and thus may be more suitable for evaluating endothelial dysfunction.

Gas exchange efficiency of an oxygenator with integrated pulsatile displacement blood pump for neonatal patients.

PubMed

Schlanstein, Peter C; Borchardt, Ralf; Mager, Ilona; Schmitz-Rode, Thomas; Steinseifer, Ulrich; Arens, Jutta

2014-01-01

Oxygenators have been used in neonatal extracorporeal membrane oxygenation (ECMO) since the 1970s. The need to develop a more effective oxygenator for this patient cohort exists due to their size and blood volume limitations. This study sought to validate the next design iteration of a novel oxygenator for neonatal ECMO with an integrated pulsatile displacement pump, thereby superseding an additional blood pump. Pulsating blood flow within the oxygenator is generated by synchronized active air flow expansion and contraction of integrated silicone pump tubes and hose pinching valves located at the oxygenator inlet and outlet. The current redesign improved upon previous prototypes by optimizing silicone pump tube distribution within the oxygenator fiber bundle; introduction of an oval shaped inner fiber bundle core, and housing; and a higher fiber packing density, all of which in combination reduced the priming volume by about 50% (50 to 27 mL and 41 to 20 mL, respectively). Gas exchange efficiency was tested for two new oxygenators manufactured with different fiber materials: one with coating and one with smaller pore size, both capable of long-term use (OXYPLUS® and CELGARD®). Results demonstrated that the oxygen transfer for both oxygenators was 5.3-24.7 mlO2/min for blood flow ranges of 100-500 mlblood/min. Carbon dioxide transfer for both oxygenators was 3.7-26.3 mlCO2/min for the same blood flow range. These preliminary results validated the oxygenator redesign by demonstrating an increase in packing density and thus in gas transfer, an increase in pumping capacity and a reduction in priming volume.

An original valveless artificial heart providing pulsatile flow tested in mock circulatory loops.

PubMed

Tozzi, Piergiorgio; Maertens, Audrey; Emery, Jonathan; Joseph, Samuel; Kirsch, Matthias; Avellan, François

2017-11-24

We present the test bench results of a valveless total artificial heart that is potentially compatible with the pediatric population. The RollingHeart is a valveless volumetric pump generating pulsatile flow. It consists of a single spherical cavity divided into 4 chambers by 2 rotating disks. The combined rotations of both disks produce changes in the volumes of the 4 cavities (suction and ejection). The blood enters/exits the spherical cavity through 4 openings that are symmetrical to the fixed rotation axis of the first disk.Mock circulatory system: The device pumps a 37% glycerin solution through 2 parallel circuits, simulating the pulmonary and systemic circulations. Flow rates are acquired with a magnetic inductive flowmeter, while pressure sensors collect pressure in the left and right outflow and inflow tracts.In vitro test protocol: The pump is run at speeds ranging from 20 to 180 ejections per minute. The waveform of the pressure generated at the inflow and outflow of the 4 chambers and the flow rate in the systemic circulation are measured. At an ejection rate of 178 min-1, the RollingHeart pumps 5.3 L/min for a systemic maximal pressure gradient of 174 mmHg and a pulmonary maximal pressure gradient of 75 mmHg. The power input was 14 W, corresponding to an efficiency of 21%. The RollingHeart represents a new approach in the domain of total artificial heart. This preliminary study endorses the feasibility of a single valveless device acting as a total artificial heart.

Fabrication of novel high surface area mushroom gilled fibers and their effects on human adipose derived stem cells under pulsatile fluid flow for tissue engineering applications.

PubMed

Tuin, Stephen A; Pourdeyhimi, Behnam; Loboa, Elizabeth G

2016-05-01

The fabrication and characterization of novel high surface area hollow gilled fiber tissue engineering scaffolds via industrially relevant, scalable, repeatable, high speed, and economical nonwoven carding technology is described. Scaffolds were validated as tissue engineering scaffolds using human adipose derived stem cells (hASC) exposed to pulsatile fluid flow (PFF). The effects of fiber morphology on the proliferation and viability of hASC, as well as effects of varied magnitudes of shear stress applied via PFF on the expression of the early osteogenic gene marker runt related transcription factor 2 (RUNX2) were evaluated. Gilled fiber scaffolds led to a significant increase in proliferation of hASC after seven days in static culture, and exhibited fewer dead cells compared to pure PLA round fiber controls. Further, hASC-seeded scaffolds exposed to 3 and 6dyn/cm(2) resulted in significantly increased mRNA expression of RUNX2 after one hour of PFF in the absence of soluble osteogenic induction factors. This is the first study to describe a method for the fabrication of high surface area gilled fibers and scaffolds. The scalable manufacturing process and potential fabrication across multiple nonwoven and woven platforms makes them promising candidates for a variety of applications that require high surface area fibrous materials. We report here for the first time the successful fabrication of novel high surface area gilled fiber scaffolds for tissue engineering applications. Gilled fibers led to a significant increase in proliferation of human adipose derived stem cells after one week in culture, and a greater number of viable cells compared to round fiber controls. Further, in the absence of osteogenic induction factors, gilled fibers led to significantly increased mRNA expression of an early marker for osteogenesis after exposure to pulsatile fluid flow. This is the first study to describe gilled fiber fabrication and their potential for tissue engineering applications. The repeatable, industrially scalable, and versatile fabrication process makes them promising candidates for a variety of scaffold-based tissue engineering applications. Copyright © 2016 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Spatial-temporal three-dimensional ultrasound plane-by-plane active cavitation mapping for high-intensity focused ultrasound in free field and pulsatile flow.

PubMed

Ding, Ting; Hu, Hong; Bai, Chen; Guo, Shifang; Yang, Miao; Wang, Supin; Wan, Mingxi

2016-07-01

Cavitation plays important roles in almost all high-intensity focused ultrasound (HIFU) applications. However, current two-dimensional (2D) cavitation mapping could only provide cavitation activity in one plane. This study proposed a three-dimensional (3D) ultrasound plane-by-plane active cavitation mapping (3D-UPACM) for HIFU in free field and pulsatile flow. The acquisition of channel-domain raw radio-frequency (RF) data in 3D space was performed by sequential plane-by-plane 2D ultrafast active cavitation mapping. Between two adjacent unit locations, there was a waiting time to make cavitation nuclei distribution of the liquid back to the original state. The 3D cavitation map equivalent to the one detected at one time and over the entire volume could be reconstructed by Marching Cube algorithm. Minimum variance (MV) adaptive beamforming was combined with coherence factor (CF) weighting (MVCF) or compressive sensing (CS) method (MVCS) to process the raw RF data for improved beamforming or more rapid data processing. The feasibility of 3D-UPACM was demonstrated in tap-water and a phantom vessel with pulsatile flow. The time interval between temporal evolutions of cavitation bubble cloud could be several microseconds. MVCF beamformer had a signal-to-noise ratio (SNR) at 14.17dB higher, lateral and axial resolution at 2.88times and 1.88times, respectively, which were compared with those of B-mode active cavitation mapping. MVCS beamformer had only 14.94% time penalty of that of MVCF beamformer. This 3D-UPACM technique employs the linear array of a current ultrasound diagnosis system rather than a 2D array transducer to decrease the cost of the instrument. Moreover, although the application is limited by the requirement for a gassy fluid medium or a constant supply of new cavitation nuclei that allows replenishment of nuclei between HIFU exposures, this technique may exhibit a useful tool in 3D cavitation mapping for HIFU with high speed, precision and resolution, especially in a laboratory environment where more careful analysis may be required under controlled conditions. Copyright © 2016 Elsevier B.V. All rights reserved.

Sigmoid Sinus Diverticulum, Dehiscence, and Venous Sinus Stenosis: Potential Causes of Pulsatile Tinnitus in Patients with Idiopathic Intracranial Hypertension?

PubMed

Lansley, J A; Tucker, W; Eriksen, M R; Riordan-Eva, P; Connor, S E J

2017-09-01

Pulsatile tinnitus is experienced by most patients with idiopathic intracranial hypertension. The pathophysiology remains uncertain; however, transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence have been proposed as potential etiologies. We aimed to determine whether the prevalence of transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence was increased in patients with idiopathic intracranial hypertension and pulsatile tinnitus relative to those without pulsatile tinnitus and a control group. CT vascular studies of patients with idiopathic intracranial hypertension with pulsatile tinnitus ( n = 42), without pulsatile tinnitus ( n = 37), and controls ( n = 75) were independently reviewed for the presence of severe transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence according to published criteria. The prevalence of transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence in patients with idiopathic intracranial hypertension with pulsatile tinnitus was compared with that in the nonpulsatile tinnitus idiopathic intracranial hypertension group and the control group. Further comparisons included differing degrees of transverse sinus stenosis (50% and 75%), laterality of transverse sinus stenosis/sigmoid sinus diverticulum/dehiscence, and ipsilateral transverse sinus stenosis combined with sigmoid sinus diverticulum/dehiscence. Severe bilateral transverse sinus stenoses were more frequent in patients with idiopathic intracranial hypertension than in controls ( P < .001), but there was no significant association between transverse sinus stenosis and pulsatile tinnitus within the idiopathic intracranial hypertension group. Sigmoid sinus dehiscence (right- or left-sided) was also more common in patients with idiopathic intracranial hypertension compared with controls ( P = .01), but there was no significant association with pulsatile tinnitus within the idiopathic intracranial hypertension group. While our data corroborate previous studies demonstrating increased prevalence of sigmoid sinus diverticulum/dehiscence and transverse sinus stenosis in idiopathic intracranial hypertension, we did not establish an increased prevalence in patients with idiopathic intracranial hypertension with pulsatile tinnitus compared with those without. It is therefore unlikely that these entities represent a direct structural correlate of pulsatile tinnitus in patients with idiopathic intracranial hypertension. © 2017 by American Journal of Neuroradiology.

Numerical simulation of the non-Newtonian blood flow through a mechanical aortic valve. Non-Newtonian blood flow in the aortic root

NASA Astrophysics Data System (ADS)

De Vita, F.; de Tullio, M. D.; Verzicco, R.

2016-04-01

This work focuses on the comparison between Newtonian and non-Newtonian blood flows through a bileaflet mechanical heart valve in the aortic root. The blood, in fact, is a concentrated suspension of cells, mainly red blood cells, in a Newtonian matrix, the plasma, and consequently its overall behavior is that of a non-Newtonian fluid owing to the action of the cells' membrane on the fluid part. The common practice, however, assumes the blood in large vessels as a Newtonian fluid since the shear rate is generally high and the effective viscosity becomes independent of the former. In this paper, we show that this is not always the case even in the aorta, the largest artery of the systemic circulation, owing to the pulsatile and transitional nature of the flow. Unexpectedly, for most of the pulsating cycle and in a large part of the fluid volume, the shear rate is smaller than the threshold level for the blood to display a constant effective viscosity and its shear thinning character might affect the system dynamics. A direct inspection of the various flow features has shown that the valve dynamics, the transvalvular pressure drop and the large-scale features of the flow are very similar for the Newtonian and non-Newtonian fluid models. On the other hand, the mechanical damage of the red blood cells (hemolysis), induced by the altered stress values in the flow, is larger for the non-Newtonian fluid model than for the Newtonian one.

A whole-body mathematical model for intracranial pressure dynamics.

PubMed

Lakin, William D; Stevens, Scott A; Tranmer, Bruce I; Penar, Paul L

2003-04-01

Most attempts to study intracranial pressure using lumped-parameter models have adopted the classical "Kellie-Monro Doctrine," which considers the intracranial space to be a closed system that is confined within the nearly-rigid skull, conserves mass, and has equal inflow and outflow. The present work revokes this Doctrine and develops a mathematical model for the dynamics of intracranial pressures, volumes, and flows that embeds the intracranial system in extensive whole-body physiology. The new model consistently introduces compartments representing the tissues and vasculature of the extradural portions of the body, including both the thoracic region and the lower extremities. In addition to vascular connections, a spinal-subarachnoid cerebrospinal fluid (CSF) compartment bridges intracranial and extracranial physiology allowing explict buffering of intracranial pressure fluctuations by the spinal theca. The model contains cerebrovascular autoregulation, regulation of systemic vascular pressures by the sympathetic nervous system, regulation of CSF production in the choroid plexus, a lymphatic system, colloid osmotic pressure effects, and realistic descriptions of cardiac output. To validate the model in situations involving normal physiology, the model's response to a realistic pulsatile cardiac output is examined. A well-known experimentally-derived intracranial pressure-volume relationship is recovered by using the model to simulate CSF infusion tests, and the effect on cerebral blood flow of a change in body position is also examined. Cardiac arrest and hemorrhagic shock are simulated to demonstrate the predictive capabilities of the model in pathological conditions.

An efficient semi-implicit method for three-dimensional non-hydrostatic flows in compliant arterial vessels.

PubMed

Fambri, Francesco; Dumbser, Michael; Casulli, Vincenzo

2014-11-01

Blood flow in arterial systems can be described by the three-dimensional Navier-Stokes equations within a time-dependent spatial domain that accounts for the elasticity of the arterial walls. In this article, blood is treated as an incompressible Newtonian fluid that flows through compliant vessels of general cross section. A three-dimensional semi-implicit finite difference and finite volume model is derived so that numerical stability is obtained at a low computational cost on a staggered grid. The key idea of the method consists in a splitting of the pressure into a hydrostatic and a non-hydrostatic part, where first a small quasi-one-dimensional nonlinear system is solved for the hydrostatic pressure and only in a second step the fully three-dimensional non-hydrostatic pressure is computed from a three-dimensional nonlinear system as a correction to the hydrostatic one. The resulting algorithm is robust, efficient, locally and globally mass conservative, and applies to hydrostatic and non-hydrostatic flows in one, two and three space dimensions. These features are illustrated on nontrivial test cases for flows in tubes with circular or elliptical cross section where the exact analytical solution is known. Test cases of steady and pulsatile flows in uniformly curved rigid and elastic tubes are presented. Wherever possible, axial velocity development and secondary flows are shown and compared with previously published results. Copyright © 2014 John Wiley & Sons, Ltd.

Effect of upright tilt on ventricular/vascular coupling in chronically instrumented primates

NASA Technical Reports Server (NTRS)

Tran, C. C.; Latham, R. D.; Self, D. A.; Fanton, J. W.; White, C. D.; Owens, R. W.

1993-01-01

Studies of the hydraulic loading conditions on the heart in humans, especially pulsatile load, have primarily been limited to the supine state. Therefore, we have chosen a nonhuman primate model, the baboon, to assess left ventricular/vascular coupling in both supine and upright positions. Primate subjects were studied by catheterization under sedation and then after surgical implantation of transducers. This allowed the evaluation of postural stress in the chronically instrumented conscious baboon and then after light dissociative doses of ketamine. Basic hemodynamic variables were evaluated for baboons in supine and upright positions. Fourier analysis was applied to aortic pressure and flow to obtain input and characteristic impedance and the ratio of pulsatile (Wp) to total (Wt) left ventricular power (Wp/Wt). The aortic reflected, or backward, pressure was also calculated. Peripheral resistance increased (P = 0.01) and reflected pressure decreased (17.74 +/- 1.50 vs. 15.21 +/- 2 mmHg; P < 0.01) in upright subjects. Characteristic impedance and Wp/Wt were unchanged. Postoperatively, peripheral resistance increased (2,651 +/- 311 vs. 3,667 +/- 276; P < 0.05) and mean power and Wt decreased (P < 0.01) without changes in reflected pressure. All variables were unchanged after light dissociative doses of ketamine. Thus there is no significant change in efficiency of left ventricular/vascular coupling formulated in terms of Wp/Wt or input impedance with postural stress.

Usefulness of B-mode and doppler sonography for the diagnosis of severe acute viral hepatitis A.

PubMed

Shin, Sang Wook; Kim, Tae Yeob; Jeong, Woo Kyoung; Kim, Yongsoo; Kim, Jinoo; Kim, Young Hwan; Park, Hwan Cheol; Sohn, Joo Hyun

2015-01-01

To investigate B-mode and Doppler ultrasonography (US) features correlating with laboratory findings for the diagnosis of severe acute hepatitis (SAH) in patients with hepatitis A virus infection. Thirty-nine consecutive serologically proven patients were enrolled. Decreased parenchymal echotexture, periportal tracking, gallbladder wall change, and splenomegaly were assessed on B-mode images. Blood flow velocities were measured in the main portal (V(PORTAL)) and in the hepatic veins, and the hepatic venous pulsatility index was calculated. SAH was defined as high model for end-stage liver disease (MELD) score ≥ 15 with or without coagulopathy. The relationship between US features and laboratory findings was assessed, and SAH diagnosis was evaluated. Serum alanine transaminase and prothrombin time were significantly different depending on the presence of gallbladder wall change and splenomegaly (p < 0.05). V(PORTAL) was inversely correlated with MELD score (r = -0.485) and several laboratory markers. The hepatic venous waveform and hepatic venous pulsatility index were significantly correlated with MELD score. For the diagnosis of SAH, the area under the receiver operating characteristic curve of V(PORTAL) was 0.798. It reached 0.869 in the patients with typical GB change. Both B-mode and Doppler US correlated well with several laboratory variables and may be helpful to diagnose SAH in patients with hepatitis A virus infection. © 2014 Wiley Periodicals, Inc.

A comparative CFD study on the hemodynamics of flow through an idealized symmetric and asymmetric stenosed arteries

NASA Astrophysics Data System (ADS)

Prashantha, B.; Anish, S.

2017-04-01

The aim of the present study is to numerically evaluate the hemodynamic factors which affect the formation of atherosclerosis and plaque rupture in the human artery. An increase of atherosclerosis in the artery causes geometry changes, which results in hemodynamic changes such as flow separation, reattachment and adhesion of new cells (chemotactic) in the artery. Hence, geometry plays an important role in the determining the nature of hemodynamic patterns. Influence of stenosis in the non-bifurcating artery, under pulsatile flow condition has been studied on an idealized geometry. Analysis of flow through symmetric and asymmetric stenosis in the artery revealed the significance of oscillating shear index (OSI), flow separation, low wall shear stress (WSS) zones and secondary flow patterns on plaque formation. The observed characteristic of flow in the post-stenotic region highlight the importance of plaque eccentricity on the formation of secondary stenosis on the arterial wall.

Recent Advancement and Technological Aspects of Pulsatile Drug Delivery System - A Laconic Review.

PubMed

Pandit, Vinay; Kumar, Ajay; Ashawat, Mahendra S; Verma, Chander P; Kumar, Pravin

2017-01-01

Pulsatile drug delivery system (PDDS) shows potential significance in the field of drug delivery to release the maximum amount of drug at a definite site and at specific time. PDDS are mainly time controlled delivery devices having a definite pause period for drug release, which is not affected by acidity, alkalinity, motility and enzymes present in the gastrointestinal tract. Pulsatile medication possess the potential to deliver the drugs in the therapy of diseases where drug dose is essential during sleep, drugs having greater first pass metabolism and absorption at precise location in digestive tract. The review article, discuss the general concepts, marketed formulations and patents or any other recent advancement in pulsatile release technology. It also highlights on diseases requiring therapy by pulsatile release, various researches on herbal pulsatile formulations and quality control aspects of PDDS. Pulsatile medication possess the potential to deliver the drugs in the therapy of diseases where drug dose is essential during sleep, drugs having greater first pass metabolism and absorption at precise location in digestive tract. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Lung function and pulmonary artery blood flow following prenatal maternal retinoic acid and imatinib in the nitrofen model of congenital diaphragmatic hernia.

PubMed

Burgos, Carmen Mesas; Davey, Marcus G; Riley, John S; Jia, Huimin; Flake, Alan W; Peranteau, William H

2017-12-19

Lung and pulmonary vascular maldevelopment in congenital diaphragmatic hernia (CDH) results in significant morbidity and mortality. Retinoic acid (RA) and imatinib have been shown to improve pulmonary morphology following prenatal administration in the rat nitrofen-induced CDH model. It remains unclear if these changes translate into improved function. We evaluated the effect of prenatal RA and imatinib on postnatal lung function, structure, and pulmonary artery (PA) blood flow in the rat CDH model. Olive oil or nitrofen was administered alone or in combination with RA or imatinib to pregnant rats. Pups were assessed for PA blood flow by ultrasound and pulmonary function/morphology following delivery, intubation, and short-term ventilation. Neither RA nor imatinib had a negative effect on lung and body growth. RA accelerated lung maturation indicated by increased alveoli number and thinner interalveolar septa and was associated with decreased PA resistance and improved oxygenation. With the exception of a decreased PA pulsatility index, no significant changes in morphology and pulmonary function were noted following imatinib. Prenatal treatment with RA but not imatinib was associated with improved pulmonary morphology and function, and decreased pulmonary vascular resistance. This study highlights the potential of prenatal pharmacologic therapies, such as RA, for management of CDH. Copyright © 2017 Elsevier Inc. All rights reserved.

Gastrointestinal hemodynamics in dogs with nonfood induced atopic dermatitis.

PubMed

Bruet, V; Brune, J; Pastor, A; Imparato, L; Roussel, A; Bourdeau, P; Desfontis, J C

2013-01-01

Canine atopic dermatitis can be a result of exposure to aeroallergens or trophallergens. Hemodynamic alterations occur in dogs with food hypersensitivity. To evaluate if hemodynamic alterations occur in dogs with NFICAD with lowered resistance to diastolic flow at fasting, after feeding, or both. Ten healthy dogs and 22 dogs with NFICAD were included from the hospital population. Blinded prospective study. Peak systolic velocity (PSV), end diastolic velocity (EDV), mean velocity (MV), pulsatility index (PI), resistive index (RI) and PSV/EDV ratio were measured at fasting for both arteries (cranial mesenteric artery [CMA], celiac artery [CA]) and at 40 minutes after feeding in CMA and at 60 minutes in CA. The results were analyzed statistically with a mixed model. There was no difference detected between groups of dogs for any variable except EDV during fasting (P = .01). There is no decrease in resistance in NFICAD to diastolic flow. This observation could be explained by the absence intestinal inflammation in NFICAD. Copyright © 2013 by the American College of Veterinary Internal Medicine.

Unraveling the relationship between arterial flow and intra-aneurysmal hemodynamics.

PubMed

Morales, Hernán G; Bonnefous, Odile

2015-02-26

Arterial flow rate affects intra-aneurysmal hemodynamics but it is not clear how their relationship is. This uncertainty hinders the comparison among studies, including clinical evaluations, like a pre- and post-treatment status, since arterial flow rates may differ at each time acquisition. The purposes of this work are as follows: (1) To study how intra-aneurysmal hemodynamics changes within the full physiological range of arterial flow rates. (2) To provide characteristic curves of intra-aneurysmal velocity, wall shear stress (WSS) and pressure as functions of the arterial flow rate. Fifteen image-based aneurysm models were studied using computational fluid dynamics (CFD) simulations. The full range of physiological arterial flow rates reported in the literature was covered by 11 pulsatile simulations. For each aneurysm, the spatiotemporal-averaged blood flow velocity, WSS and pressure were calculated. Spatiotemporal-averaged velocity inside the aneurysm linearly increases as a function of the mean arterial flow (minimum R(2)>0.963). Spatiotemporal-averaged WSS and pressure at the aneurysm wall can be represented by quadratic functions of the arterial flow rate (minimum R(2)>0.996). Quantitative characterizations of spatiotemporal-averaged velocity, WSS and pressure inside cerebral aneurysms can be obtained with respect to the arterial flow rate. These characteristic curves provide more information of the relationship between arterial flow and aneurysm hemodynamics since the full range of arterial flow rates is considered. Having these curves, it is possible to compare experimental studies and clinical evaluations when different flow conditions are used. Copyright © 2015 Elsevier Ltd. All rights reserved.

Computational fluid dynamics comparisons of wall shear stress in patient-specific coronary artery bifurcation using coronary angiography and optical coherence tomography

NASA Astrophysics Data System (ADS)

Poon, Eric; Thondapu, Vikas; Chin, Cheng; Scheerlinck, Cedric; Zahtila, Tony; Mamon, Chris; Nguyen, Wilson; Ooi, Andrew; Barlis, Peter

2016-11-01

Blood flow dynamics directly influence biology of the arterial wall, and are closely linked with the development of coronary artery disease. Computational fluid dynamics (CFD) solvers may be employed to analyze the hemodynamic environment in patient-specific reconstructions of coronary arteries. Although coronary X-ray angiography (CA) is the most common medical imaging modality for 3D arterial reconstruction, models reconstructed from CA assume a circular or elliptical cross-sectional area. This limitation can be overcome with a reconstruction technique fusing CA with intravascular optical coherence tomography (OCT). OCT scans the interior of an artery using near-infrared light, achieving a 10-micron resolution and providing unprecedented detail of vessel geometry. We compared 3D coronary artery bifurcation models generated using CA alone versus OCT-angiography fusion. The model reconstructed from CA alone is unable to identify the detailed geometrical variations of diseased arteries, and also under-estimates the cross-sectional vessel area compared to OCT-angiography fusion. CFD was performed in both models under pulsatile flow in order to identify and compare regions of low wall shear stress, a hemodynamic parameter directly linked with progression of atherosclerosis. Supported by ARC LP150100233 and VLSCI VR0210.

Optimization studies on compression coated floating-pulsatile drug delivery of bisoprolol.

PubMed

Jagdale, Swati C; Bari, Nilesh A; Kuchekar, Bhanudas S; Chabukswar, Aniruddha R

2013-01-01

The purpose of the present work was to design and optimize compression coated floating pulsatile drug delivery systems of bisoprolol. Floating pulsatile concept was applied to increase the gastric residence of the dosage form having lag phase followed by a burst release. The prepared system consisted of two parts: a core tablet containing the active ingredient and an erodible outer shell with gas generating agent. The rapid release core tablet (RRCT) was prepared by using superdisintegrants with active ingredient. Press coating of optimized RRCT was done by polymer. A 3² full factorial design was used for optimization. The amount of Polyox WSR205 and Polyox WSR N12K was selected as independent variables. Lag period, drug release, and swelling index were selected as dependent variables. Floating pulsatile release formulation (FPRT) F13 at level 0 (55 mg) for Polyox WSR205 and level +1 (65 mg) for Polyox WSR N12K showed lag time of 4 h with >90% drug release. The data were statistically analyzed using ANOVA, and P < 0.05 was statistically significant. Release kinetics of the optimized formulation best fitted the zero order model. In vivo study confirms burst effect at 4 h in indicating the optimization of the dosage form.

Optimization Studies on Compression Coated Floating-Pulsatile Drug Delivery of Bisoprolol

PubMed Central

Jagdale, Swati C.; Bari, Nilesh A.; Kuchekar, Bhanudas S.; Chabukswar, Aniruddha R.

2013-01-01

The purpose of the present work was to design and optimize compression coated floating pulsatile drug delivery systems of bisoprolol. Floating pulsatile concept was applied to increase the gastric residence of the dosage form having lag phase followed by a burst release. The prepared system consisted of two parts: a core tablet containing the active ingredient and an erodible outer shell with gas generating agent. The rapid release core tablet (RRCT) was prepared by using superdisintegrants with active ingredient. Press coating of optimized RRCT was done by polymer. A 32 full factorial design was used for optimization. The amount of Polyox WSR205 and Polyox WSR N12K was selected as independent variables. Lag period, drug release, and swelling index were selected as dependent variables. Floating pulsatile release formulation (FPRT) F13 at level 0 (55 mg) for Polyox WSR205 and level +1 (65 mg) for Polyox WSR N12K showed lag time of 4 h with >90% drug release. The data were statistically analyzed using ANOVA, and P < 0.05 was statistically significant. Release kinetics of the optimized formulation best fitted the zero order model. In vivo study confirms burst effect at 4 h in indicating the optimization of the dosage form. PMID:24367788

A comparison of dobutamine and levosimendan on hepatic blood flow in patients with a low cardiac output state after cardiac surgery: a randomised controlled study.

PubMed

Alvarez, J; Baluja, A; Selas, S; Otero, P; Rial, M; Veiras, S; Caruezo, V; Taboada, M; Rodriguez, I; Castroagudin, J; Tome, S; Rodriguez, A; Rodriguez, J

2013-11-01

Liver dysfunction due to a low cardiac output state after cardiac surgery is associated with a poor prognosis, but whether one inotrope is superior to another in improving hepatic perfusion remains uncertain. This study compared the systemic and hepatic haemodynamic effects of levosimendan to dobutamine in patients with a low cardiac output state (cardiac index < 2.2 l/min/m2) after on-pump cardiac surgery. A total of 25 patients were randomised to receive either an intravenous bolus of levosimendan (12 µg/kg) over 15 minutes, followed by an infusion of 0.2 µg/kg/min for 24 hours, or an infusion of dobutamine 7.5 µg/kg/min for 24 hours and completed the study. The systemic and hepatic haemodynamics at 24 and 48 hours were all better after levosimendan than dobutamine (dobutamine group: cardiac index (l/min/m2)=2.51 [standard deviation ±0.29], 2.40±0.23; portal vein flow (ml/min): 614.0±124.7, 585.9±144.8; pulsatility index: 2.02±0,28, 2.98±0.27 versus the levosimendan group: cardiac index: 3.02± 0.27, 2.98± 0.30; portal vein flow: 723.0± 143.5, 702.9±117.8; pulsatility index: 1.71±0.26, 1.73±0.27). The improvement in portal vein blood flow at 48 hours was significantly better after levosimendan than dobutamine (41% vs. 11% increment from baseline, P<0.05). In addition, there was a significant reduction in hepatic artery resistance after levosimendan but not dobutamine (resistance index reduction 6.5% vs. 0%, P<0.05). In summary, levosimendan can be considered as a selective liver vasodilator and can improve hepatic blood flow through both the hepatic artery and portal venous system, whereas dobutamine can only improve the portal venous blood flow without vasodilating the hepatic artery.

Pulsatile release of biomolecules from polydimethylsiloxane (PDMS) chips with hydrolytically degradable seals.

PubMed

Intra, Janjira; Glasgow, Justin M; Mai, Hoang Q; Salem, Aliasger K

2008-05-08

We demonstrate, for the first time, a robust novel polydimethylsiloxane (PDMS) chip that can provide controlled pulsatile release of DNA based molecules, proteins and oligonucleotides without external stimuli or triggers. The PDMS chip with arrays of wells was constructed by replica molding. Poly(lactic acid-co-glycolic acid) (PLGA) polymer films of varying composition and thickness were used as seals to the wells. The composition, molecular weight and thickness of the PLGA films were all parameters used to control the degradation rate of the seals and therefore the release profiles. Degradation of the films followed the PLGA composition order of 50:50 PLGA>75:25 PLGA>85:15 PLGA at all time-points beyond week 1. Scanning electron microscopy images showed that films were initially smooth, became porous and ruptured as the osmotic pressure pushed the degrading PLGA film outwards. Pulsatile release of DNA was controlled by the composition and thickness of the PLGA used to seal the well. Transfection experiments in a model Human Embryonic Kidney 293 (HEK293) cell line showed that plasmid DNA loaded in the wells was functional after pulsatile release in comparison to control plasmid DNA at all time-points. Thicker films degraded faster than thinner films and could be used to fine-tune the release of DNA over day length periods. Finally the PDMS chip was shown to provide repeated sequential release of CpG oligonucleotides and a model antigen, Ovalbumin (OVA), indicating significant potential for this device for vaccinations or applications that require defined complex release patterns of a variety of chemicals, drugs and biomolecules.

Estimating Pressure Reactivity Using Noninvasive Doppler-Based Systolic Flow Index.

PubMed

Zeiler, Frederick A; Smielewski, Peter; Donnelly, Joseph; Czosnyka, Marek; Menon, David K; Ercole, Ari

2018-04-05

The study objective was to derive models that estimate the pressure reactivity index (PRx) using the noninvasive transcranial Doppler (TCD) based systolic flow index (Sx_a) and mean flow index (Mx_a), both based on mean arterial pressure, in traumatic brain injury (TBI). Using a retrospective database of 347 patients with TBI with intracranial pressure and TCD time series recordings, we derived PRx, Sx_a, and Mx_a. We first derived the autocorrelative structure of PRx based on: (A) autoregressive integrative moving average (ARIMA) modeling in representative patients, and (B) within sequential linear mixed effects (LME) models with various embedded ARIMA error structures for PRx for the entire population. Finally, we performed sequential LME models with embedded PRx ARIMA modeling to find the best model for estimating PRx using Sx_a and Mx_a. Model adequacy was assessed via normally distributed residual density. Model superiority was assessed via Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC), log likelihood (LL), and analysis of variance testing between models. The most appropriate ARIMA structure for PRx in this population was (2,0,2). This was applied in sequential LME modeling. Two models were superior (employing random effects in the independent variables and intercept): (A) PRx ∼ Sx_a, and (B) PRx ∼ Sx_a + Mx_a. Correlation between observed and estimated PRx with these two models was: (A) 0.794 (p < 0.0001, 95% confidence interval (CI) = 0.788-0.799), and (B) 0.814 (p < 0.0001, 95% CI = 0.809-0.819), with acceptable agreement on Bland-Altman analysis. Through using linear mixed effects modeling and accounting for the ARIMA structure of PRx, one can estimate PRx using noninvasive TCD-based indices. We have described our first attempts at such modeling and PRx estimation, establishing the strong link between two aspects of cerebral autoregulation: measures of cerebral blood flow and those of pulsatile cerebral blood volume. Further work is required to validate.

Unexpected trapping of particles at a T junction.

PubMed

Vigolo, Daniele; Radl, Stefan; Stone, Howard A

2014-04-01

A common element in physiological flow networks, as well as most domestic and industrial piping systems, is a T junction that splits the flow into two nearly symmetric streams. It is reasonable to assume that any particles suspended in a fluid that enters the bifurcation will leave it with the fluid. Here we report experimental evidence and a theoretical description of a trapping mechanism for low-density particles in steady and pulsatile flows through T-shaped junctions. This mechanism induces accumulation of particles, which can form stable chains, or give rise to significant growth of bubbles due to coalescence. In particular, low-density material dispersed in the continuous phase fluid interacts with a vortical flow that develops at the T junction. As a result suspended particles can enter the vortices and, for a wide range of common flow conditions, the particles do not leave the bifurcation. Via 3D numerical simulations and a model of the two-phase flow we predict the location of particle accumulation, which is in excellent agreement with experimental data. We identify experimentally, as well as confirm by numerical simulations and a simple force balance, that there is a wide parameter space in which this phenomenon occurs. The trapping effect is expected to be important for the design of particle separation and fractionation devices, as well as used for better understanding of system failures in piping networks relevant to industry and physiology.

Unexpected trapping of particles at a T junction

PubMed Central

Vigolo, Daniele; Radl, Stefan; Stone, Howard A.

2014-01-01

A common element in physiological flow networks, as well as most domestic and industrial piping systems, is a T junction that splits the flow into two nearly symmetric streams. It is reasonable to assume that any particles suspended in a fluid that enters the bifurcation will leave it with the fluid. Here we report experimental evidence and a theoretical description of a trapping mechanism for low-density particles in steady and pulsatile flows through T-shaped junctions. This mechanism induces accumulation of particles, which can form stable chains, or give rise to significant growth of bubbles due to coalescence. In particular, low-density material dispersed in the continuous phase fluid interacts with a vortical flow that develops at the T junction. As a result suspended particles can enter the vortices and, for a wide range of common flow conditions, the particles do not leave the bifurcation. Via 3D numerical simulations and a model of the two-phase flow we predict the location of particle accumulation, which is in excellent agreement with experimental data. We identify experimentally, as well as confirm by numerical simulations and a simple force balance, that there is a wide parameter space in which this phenomenon occurs. The trapping effect is expected to be important for the design of particle separation and fractionation devices, as well as used for better understanding of system failures in piping networks relevant to industry and physiology. PMID:24639547

Demonstration of uneven distribution of intracranial pulsatility in hydrocephalus patients.

PubMed

Eide, Per K

2008-11-01

Data from intracranial pressure (ICP) recordings in patients with hydrocephalus were reviewed to determine whether intracranial pulsatility within the cerebrospinal fluid (CSF) of cerebral ventricles (ICP(LV)) may differ from that within the brain parenchyma (ICP(PAR)), and whether pulsatility may differ between noncommunicating ventricles. The authors retrieved data from recordings previously obtained in 7 patients with hydrocephalus (noncommunicating in 4 and communicating in 3) and shunt failure who received both an external ventricular drainage (EVD) and an ICP sensor as part of surveillance during intensive care. Simultaneous ICP(LV) and ICP(PAR) signals were available in 6 cases, and simultaneous signals from the lateral and fourth ventricles (ICP(LV) and ICP4V, respectively) were recorded in 1 case. The recordings with both signals were parsed into 6-second time windows. Pulsatility was characterized by the wave amplitude and rise time coefficient, and differences in pulsatility between the ICP(LV) and ICP(PAR) signals (6 cases) or ICP(LV) and ICP4V signals (1 case) were determined. There was uneven distribution of intracranial pulsatility in all 7 patients, shown as significantly elevated pulsatility (that is, higher wave amplitudes and rise time coefficients) within the ventricles (ICP(LV)) than within brain parenchyma (ICP(PAR)) in 6 patients, and significantly higher pulsatility in the fourth (ICP4V) than in the lateral (ICP(LV)) ventricles in 1 patient. Differences > or = 1 mm Hg in ICP wave amplitude were found in 0.5-100% (median 9.4%) of observations in the 7 patients (total number of 6-second time windows, 68,242). The present observations demonstrate uneven distribution of intracranial pulsatility in patients with hydrocephalus, higher pulse pressure amplitudes within the ventricular CSF (ICP(LV)) than within the brain parenchyma (ICP(PAR)). This may be one mechanism behind ventricular enlargement in hydrocephalus.

Feasibility of a nickel-metal hydride battery for totally implantable artificial hearts.

PubMed

Okamoto, E; Yoshida, T; Fujiyoshi, M; Shimanaka, M; Takeuchi, A; Mitamura, Y; Mikami, T

1996-01-01

An implantable rechargeable battery is one of the key technologies for totally implantable artificial hearts. The nickel-metal hydride (Ni-MH) battery is promising for its high energy density of 1.5-2.0 times that of a nickel-cadmium battery. In this study, the effects of pulsatile discharge loads on the operating time and cycle life of Ni-MH batteries at 39 degrees C were studied. Two battery cells (TH-3M, 1,200 mAh, phi 14.5 x 49 mm; Toshiba, Tokyo, Japan) in series were charge/discharge cycled at 39 degrees C using a charge current of 1CA (1,200 mA) and then were fully discharged to 1.0 V/cell under either pulsatile discharge loads, which mimicked a systole (1 A for 0.3 sec) and a diastole (0.4 A for 0.3 sec), or a non pulsatile discharge load equivalent to the average of the pulsatile loads (0.7 A). Each cycle life test was interrupted on the 482nd cycle under pulsatile load, and on the 423rd cycle under non pulsatile load, because of malfunction of each battery charger. The tests showed that the pulsatile discharge cells had significantly (p < 0.001) less operating time (74.0 +/- 7.15 min) throughout the test period (up to 482 days) compared to the cells under equivalent non pulsatile discharge loads (93.7 +/- 7.74 min). The pulsatile-discharged Ni-MH cells provide significantly less operating time than the constantly discharged cells; the Ni-MH battery has an operating time of over 78 min and a cycle life of almost 500 cycles at 39 degrees C. In conclusion, the Ni-MH battery is feasible as an implantable back-up battery for a totally implantable artificial heart system.

Determination of secondary flow morphologies by wavelet analysis in a curved artery model with physiological inflow

NASA Astrophysics Data System (ADS)

Bulusu, Kartik V.; Hussain, Shadman; Plesniak, Michael W.

2014-11-01

Secondary flow vortical patterns in arterial curvatures have the potential to affect several cardiovascular phenomena, e.g., progression of atherosclerosis by altering wall shear stresses, carotid atheromatous disease, thoracic aortic aneurysms and Marfan's syndrome. Temporal characteristics of secondary flow structures vis-à-vis physiological (pulsatile) inflow waveform were explored by continuous wavelet transform (CWT) analysis of phase-locked, two-component, two-dimensional particle image velocimeter data. Measurements were made in a 180° curved artery test section upstream of the curvature and at the 90° cross-sectional plane. Streamwise, upstream flow rate measurements were analyzed using a one-dimensional antisymmetric wavelet. Cross-stream measurements at the 90° location of the curved artery revealed interesting multi-scale, multi-strength coherent secondary flow structures. An automated process for coherent structure detection and vortical feature quantification was applied to large ensembles of PIV data. Metrics such as the number of secondary flow structures, their sizes and strengths were generated at every discrete time instance of the physiological inflow waveform. An autonomous data post-processing method incorporating two-dimensional CWT for coherent structure detection was implemented. Loss of coherence in secondary flow structures during the systolic deceleration phase is observed in accordance with previous research. The algorithmic approach presented herein further elucidated the sensitivity and dependence of morphological changes in secondary flow structures on quasiperiodicity and magnitude of temporal gradients in physiological inflow conditions.

Experimental Investigation of Secondary Flow Structures Downstream of a Model Type IV Stent Failure in a 180° Curved Artery Test Section.

PubMed

Bulusu, Kartik V; Plesniak, Michael W

2016-07-19

The arterial network in the human vasculature comprises of ubiquitously present blood vessels with complex geometries (branches, curvatures and tortuosity). Secondary flow structures are vortical flow patterns that occur in curved arteries due to the combined action of centrifugal forces, adverse pressure gradients and inflow characteristics. Such flow morphologies are greatly affected by pulsatility and multiple harmonics of physiological inflow conditions and vary greatly in size-strength-shape characteristics compared to non-physiological (steady and oscillatory) flows (1 - 7). Secondary flow structures may ultimately influence the wall shear stress and exposure time of blood-borne particles toward progression of atherosclerosis, restenosis, sensitization of platelets and thrombosis (4 - 6, 8 - 13). Therefore, the ability to detect and characterize these structures under laboratory-controlled conditions is precursor to further clinical investigations. A common surgical treatment to atherosclerosis is stent implantation, to open up stenosed arteries for unobstructed blood flow. But the concomitant flow perturbations due to stent installations result in multi-scale secondary flow morphologies (4 - 6). Progressively higher order complexities such as asymmetry and loss in coherence can be induced by ensuing stent failures vis-à-vis those under unperturbed flows (5). These stent failures have been classified as "Types I-to-IV" based on failure considerations and clinical severity (14). This study presents a protocol for the experimental investigation of the complex secondary flow structures due to complete transverse stent fracture and linear displacement of fractured parts ("Type IV") in a curved artery model. The experimental method involves the implementation of particle image velocimetry (2C-2D PIV) techniques with an archetypal carotid artery inflow waveform, a refractive index matched blood-analog working fluid for phase-averaged measurements (15 - 18). Quantitative identification of secondary flow structures was achieved using concepts of flow physics, critical point theory and a novel wavelet transform algorithm applied to experimental PIV data (5, 6, 19 - 26).

Locally optimal extracellular stimulation for chaotic desynchronization of neural populations.

PubMed

Wilson, Dan; Moehlis, Jeff

2014-10-01

We use optimal control theory to design a methodology to find locally optimal stimuli for desynchronization of a model of neurons with extracellular stimulation. This methodology yields stimuli which lead to positive Lyapunov exponents, and hence desynchronizes a neural population. We analyze this methodology in the presence of interneuron coupling to make predictions about the strength of stimulation required to overcome synchronizing effects of coupling. This methodology suggests a powerful alternative to pulsatile stimuli for deep brain stimulation as it uses less energy than pulsatile stimuli, and could eliminate the time consuming tuning process.

Application of a magnetic fluid seal to rotary blood pumps

NASA Astrophysics Data System (ADS)

Mitamura, Y.; Arioka, S.; Sakota, D.; Sekine, K.; Azegami, M.

2008-05-01

A magnetic fluid seal enables mechanical contact-free rotation of a shaft without frictional heat and material wear and hence has excellent durability. However, the durability of a magnetic fluid seal decreases in liquid. The life of a seal applied to a rotary blood pump is not known. We have developed a magnetic fluid seal that has a shield mechanism minimizing the influence of the rotary pump on the magnetic fluid. The developed magnetic fluid seal worked for over 286 days in a continuous flow condition, for 24 days (on-going) in a pulsatile flow condition and for 24 h (electively terminated) in blood flow. The magnetic fluid seal is promising as a shaft seal for rotary blood pumps.

Application of a magnetic fluid seal to rotary blood pumps.

PubMed

Mitamura, Y; Arioka, S; Sakota, D; Sekine, K; Azegami, M

2008-05-21

A magnetic fluid seal enables mechanical contact-free rotation of a shaft without frictional heat and material wear and hence has excellent durability. However, the durability of a magnetic fluid seal decreases in liquid. The life of a seal applied to a rotary blood pump is not known. We have developed a magnetic fluid seal that has a shield mechanism minimizing the influence of the rotary pump on the magnetic fluid. The developed magnetic fluid seal worked for over 286 days in a continuous flow condition, for 24 days (on-going) in a pulsatile flow condition and for 24 h (electively terminated) in blood flow. The magnetic fluid seal is promising as a shaft seal for rotary blood pumps.

Pulsatile tinnitus: imaging and differential diagnosis.

PubMed

Hofmann, Erich; Behr, Robert; Neumann-Haefelin, Tobias; Schwager, Konrad

2013-06-01

Pulsatile tinnitus, unlike idiopathic tinnitus, usually has a specific, identifiable cause. Nonetheless, uncertainty often arises in clinical practice about the findings to be sought and the strategy for work-up. Selective literature review and evaluation of our own series of patients. Pulsatile tinnitus can have many causes. No prospective studies on this subject are available to date. Pulsatile tinnitus requires both a functional organ of hearing and a genuine, physical source of sound, which can, under certain conditions, even be objectified by an examiner. Pulsatile tinnitus can be classified by its site of generation as arterial, arteriovenous, or venous. Typical arterial causes are arteriosclerosis, dissection, and fibromuscular dysplasia. Common causes at the arteriovenous junction include arteriovenous fistulae and highly vascularized skull base tumors. Common venous causes are intracranial hypertension and, as predisposing factors, anomalies and normal variants of the basal veins and sinuses. In our own series of patients, pulsatile tinnitus was most often due to highly vascularized tumors of the temporal bone (16%), followed by venous normal variants and anomalies (14%) and vascular stenoses (9%). Dural arteriovenous fistulae, inflammatory hyperemia, and intracranial hypertension were tied for fourth place (8% each). The clinical findings and imaging studies must always be evaluated together. Thorough history-taking and clinical examination are the basis for the efficient use of imaging studies to reveal the cause of pulsatile tinnitus.

Partial renal coverage in endovascular aneurysm repair causes unfavorable renal flow patterns in an infrarenal aneurysm model.

PubMed

van de Velde, Lennart; Donselaar, Esmé J; Groot Jebbink, Erik; Boersen, Johannes T; Lajoinie, Guillaume P R; de Vries, Jean-Paul P M; Zeebregts, Clark J; Versluis, Michel; Reijnen, Michel M P J

2018-05-01

To achieve an optimal sealing zone during endovascular aneurysm repair, the intended positioning of the proximal end of the endograft fabric should be as close as possible to the most caudal edge of the renal arteries. Some endografts exhibit a small offset between the radiopaque markers and the proximal fabric edge. Unintended partial renal artery coverage may thus occur. This study investigated the consequences of partial coverage on renal flow patterns and wall shear stress (WSS). In vitro models of an abdominal aortic aneurysm were used to visualize pulsatile flow using two-dimensional particle image velocimetry under physiologic resting conditions. One model served as control and two models were stented with an Endurant endograft (Medtronic Inc, Minneapolis, Minn), one without and one with partial renal artery coverage with 1.3 mm of stent fabric extending beyond the marker (16% area coverage). The magnitude and oscillation of WSS, relative residence time, and backflow in the renal artery were analyzed. In both stented models, a region along the caudal renal artery wall presented with low and oscillating WSS, not present in the control model. A region with very low WSS (<0.1 Pa) was present in the model with partial coverage over a length of 7 mm compared with a length of 2 mm in the model without renal coverage. Average renal backflow area percentage in the renal artery incrementally increased from control (0.9%) to the stented model without (6.4%) and with renal coverage (18.8%). In this flow model, partial renal coverage after endovascular aneurysm repair causes low and marked oscillations in WSS, potentially promoting atherosclerosis and subsequent renal artery stenosis. Awareness of the device-dependent offset between the fabric edge and the radiopaque markers is therefore important in endovascular practice. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Time-dependent electrokinetic flows of non-Newtonian fluids in microchannel-array for energy conversion

NASA Astrophysics Data System (ADS)

Chun, Myung-Suk; Chun, Byoungjin; Lee, Ji-Young; Complex Fluids Team

2016-11-01

We investigate the externally time-dependent pulsatile electrokinetic viscous flows by extending the previous simulations concerning the electrokinetic microfluidics for different geometries. The external body force originated from between the nonlinear Poisson-Boltzmann field and the flow-induced electric field is employed in the Cauchy momentum equation, and then the Nernst-Planck equation in connection with the net current conservation is coupled. Our explicit model allows one to quantify the effects of the oscillating frequency and conductance of the Stern layer, considering the shear thinning effect and the strong electric double layer interaction. This presentation reports the new results regarding the implication of optimum frequency pressure pulsations toward realizing mechanical to electrical energy transfer with high conversion efficiencies. These combined factors for different channel dimension are examined in depth to obtain possible enhancements of streaming current, with taking advantage of pulsating pressure field. From experimental verifications by using electrokinetic power chip, it is concluded that our theoretical framework can serve as a useful basis for micro/nanofluidics design and potential applications to the enhanced energy conversion. NRF of Korea (No.2015R1A2A1A15052979) and KIST (No.2E26490).

Numerical simulation of magnetic nano drug targeting in patient-specific lower respiratory tract

NASA Astrophysics Data System (ADS)

Russo, Flavia; Boghi, Andrea; Gori, Fabio

2018-04-01

Magnetic nano drug targeting, with an external magnetic field, can potentially improve the drug absorption in specific locations of the body. However, the effectiveness of the procedure can be reduced due to the limitations of the magnetic field intensity. This work investigates this technique with the Computational Fluid Dynamics (CFD) approach. A single rectangular coil generates the external magnetic field. A patient-specific geometry of the Trachea, with its primary and secondary bronchi, is reconstructed from Digital Imaging and Communications in Medicine (DICOM) formatted images, throughout the Vascular Modelling Tool Kit (VMTK) software. A solver, coupling the Lagrangian dynamics of the magnetic nanoparticles with the Eulerian dynamics of the air, is used to perform the simulations. The resistive pressure, the pulsatile inlet velocity and the rectangular coil magnetic field are the boundary conditions. The dynamics of the injected particles is investigated without and with the magnetic probe. The flow field promotes particles adhesion to the tracheal wall. The particles volumetric flow rate in both cases has been calculated. The magnetic probe is shown to increase the particles flow in the target region, but at a limited extent. This behavior has been attributed to the small particle size and the probe configuration.

Two ways to feel the pressure: an endothelial Ca(2+) entry channel with dual mechanosensitivity.

PubMed

Groschner, Klaus

2002-01-01

One impressive function of the vascular endothelium is its ability to adjust the release of vasoactive mediators such as NO and PGI(2) almost instantaneously to changes in blood flow or blood pressure. Besides this fast feedback response to hemodynamic alterations, the endothelium is subject to long-term adaptations that are crucial for prevention of pathological processes such as atherogenesis. Among the various signals that are sensed by endothelial cells, mechanical forces which arise from pulsatile blood flow are probably most important for fast as well as long-term control of blood vessel function by the endothelium.

Numerical study of oxygen transport in a carotid bifurcation

NASA Astrophysics Data System (ADS)

Tada, Shigeru

2010-07-01

This study investigates the oxygen mass transport in the region around the human carotid bifurcation, particularly addressing the effects of bifurcation geometry and pulsatile blood flow on the oxygen transport between the blood flow and artery wall tissue, coupled with the metabolic oxygen consumption and oxygen diffusion in the artery wall tissue. The temporal variations and spatial distributions of the oxygen tension are predicted quantitatively using a geometric model of the human carotid bifurcation and realistic blood flow waveforms. Results reveal that the flow separation at the outside wall of the sinus of the internal carotid artery (ICA) can markedly alter the flow pattern, oxygen tension and the oxygen wall flux. Results also clarify that the flow unsteadiness has a secondary effect on the oxygen tension inside the wall. The non-dimensional oxygen flux, the Sherwood number Sh, at the outside wall of the ICA sinus, takes markedly lower values of about 45 than at other sites because the rates of oxygen transport by the convective flow are reduced at the outside wall of the ICA sinus. The transverse distributions of the oxygen tension inside the artery wall show parabolic profiles having minima in the middle of the wall thickness, with the lowest value of 35 mmHg. These predicted distributions of the oxygen tension inside the wall closely resemble those obtained from experiments. The results demonstrate that hypoxic zones appear inside the artery walls at locations where atherosclerotic lesions are prone to develop.

Hemodynamics in a Pediatric Ascending Aorta Using a Viscoelastic Pediatric Blood Model

PubMed Central

Good, Bryan C.; Deutsch, Steven; Manning, Keefe B.

2015-01-01

Congenital heart disease is the leading cause of infant death in the United States with over 36,000 newborns affected each year. Despite this growing problem there are few mechanical circulatory support devices designed specifically for pediatric and neonate patients. Previous research has been done investigating pediatric ventricular assist devices (PVADs) assuming blood to be a Newtonian fluid in computational fluid dynamics (CFD) simulations, ignoring its viscoelastic and shear-thinning properties. In contrast to adult VADs, PVADs may be more susceptible to hemolysis and thrombosis due to altered flow into the aorta, and therefore, a more accurate blood model should be used. A CFD solver that incorporates a modified Oldroyd-B model designed specifically for pediatric blood is used to investigate important hemodynamic parameters in a pediatric aortic model under pulsatile flow conditions. These results are compared to Newtonian blood simulations at three physiological pediatric hematocrits. Minor differences are seen in both velocity and WSS during early stages of the cardiac systole between the Newtonian and viscoelastic models. During diastole, significant differences are seen in the velocities in the descending aorta (up to 12%) and in the aortic branches (up to 30%) between the two models. Additionally, peak wall shear stress (WSS) differences are seen between the models throughout the cardiac cycle. At the onset of diastole, peak WSS differences of 43% are seen between the Newtonian and viscoelastic model and between the 20 and 60% hematocrit viscoelastic models at peak systole of 41%. PMID:26159560

Vascular loop in the cerebellopontine angle causing pulsatile tinnitus and headache: a case report

PubMed Central

Ramly, NA; Roslenda, AR; Suraya, A; Asma, A

2014-01-01

Tinnitus is a common disorder, it can be classified as pulsatile and non-pulsatile or objective and subjective. Pulsatile tinnitus is less common than non-pulsatile and can be due to vascular tumour such as glomus or vascular abnormality. We presented an interesting case of a 30 year-old Malay lady with a two-year history of pulsatile tinnitus which was worsening in three months duration. It was associated with intermittent headache. Clinical examination and tuning fork test were unremarkable. Apart from mild hearing loss at high frequency on the left ear, the pure tone audiogram (PTA) was otherwise normal. In view of the patient’s young age with no risk factor for high frequency loss, a magnetic resonance imaging (MRI) was performed to look for any abnormality in the cerebellopontine angle. It revealed a single vessel looping around the left vestibulocochlear and facial nerves at the cisternal portion, likely a branch of the anteroinferior cerebellar artery (AICA). Literature review on the pathophysiology and treatment option in this condition is discussed. PMID:26417253

Physiological control of a rotary blood pump with selectable therapeutic options: control of pulsatility gradient.

PubMed

Arndt, Andreas; Nüsser, Peter; Graichen, Kurt; Müller, Johannes; Lampe, Bernhard

2008-10-01

A control strategy for rotary blood pumps meeting different user-selectable control objectives is proposed: maximum support with the highest feasible flow rate versus medium support with maximum ventricular washout and controlled opening of the aortic valve (AoV). A pulsatility index (PI) is calculated from the pressure difference, which is deduced from the axial thrust measured by the magnetic bearing of the pump. The gradient of PI with respect to pump speed (GPI) is estimated via online system identification. The outer loop of a cascaded controller regulates GPI to a reference value satisfying the selected control objective. The inner loop controls the PI to a reference value set by the outer loop. Adverse pumping states such as suction and regurgitation can be detected on the basis of the GPI estimates and corrected by the controller. A lumped-parameter computer model of the assisted circulation was used to simulate variations of ventricular contractility, pulmonary venous pressure, and aortic pressure. The performance of the outer control loop was demonstrated by transitions between the two control modes. Fast reaction of the inner loop was tested by stepwise reduction of venous return. For maximum support, a low PI was maintained without inducing ventricular collapse. For maximum washout, the pump worked at a high PI in the transition region between the opening and the permanently closed AoV. The cascaded control of GPI and PI is able to meet different control objectives and is worth testing in vitro and in vivo.

Mitochondrial DNA damage and vascular function in patients with diabetes mellitus and atherosclerotic cardiovascular disease.

PubMed

Fetterman, Jessica L; Holbrook, Monica; Westbrook, David G; Brown, Jamelle A; Feeley, Kyle P; Bretón-Romero, Rosa; Linder, Erika A; Berk, Brittany D; Weisbrod, Robert M; Widlansky, Michael E; Gokce, Noyan; Ballinger, Scott W; Hamburg, Naomi M

2016-03-31

Prior studies demonstrate mitochondrial dysfunction with increased reactive oxygen species generation in peripheral blood mononuclear cells in diabetes mellitus. Oxidative stress-mediated damage to mitochondrial DNA promotes atherosclerosis in animal models. Thus, we evaluated the relation of mitochondrial DNA damage in peripheral blood mononuclear cells s with vascular function in patients with diabetes mellitus and with atherosclerotic cardiovascular disease. We assessed non-invasive vascular function and mitochondrial DNA damage in 275 patients (age 57 ± 9 years, 60 % women) with atherosclerotic cardiovascular disease alone (N = 55), diabetes mellitus alone (N = 74), combined atherosclerotic cardiovascular disease and diabetes mellitus (N = 48), and controls age >45 without diabetes mellitus or atherosclerotic cardiovascular disease (N = 98). Mitochondrial DNA damage measured by quantitative PCR in peripheral blood mononuclear cells was higher with clinical atherosclerosis alone (0.55 ± 0.65), diabetes mellitus alone (0.65 ± 1.0), and combined clinical atherosclerosis and diabetes mellitus (0.89 ± 1.32) as compared to control subjects (0.23 ± 0.64, P < 0.0001). In multivariable models adjusting for age, sex, and relevant cardiovascular risk factors, clinical atherosclerosis and diabetes mellitus remained associated with higher mitochondrial DNA damage levels (β = 0.14 ± 0.13, P = 0.04 and β = 0.21 ± 0.13, P = 0.002, respectively). Higher mitochondrial DNA damage was associated with higher baseline pulse amplitude, a measure of arterial pulsatility, but not with flow-mediated dilation or hyperemic response, measures of vasodilator function. We found greater mitochondrial DNA damage in patients with diabetes mellitus and clinical atherosclerosis. The association of mitochondrial DNA damage and baseline pulse amplitude may suggest a link between mitochondrial dysfunction and excessive small artery pulsatility with potentially adverse microvascular impact.

Morphological instabilities of rapidly solidified binary alloys under weak flow

NASA Astrophysics Data System (ADS)

Kowal, Katarzyna; Davis, Stephen

2017-11-01

Additive manufacturing, or three-dimensional printing, offers promising advantages over existing manufacturing techniques. However, it is still subject to a range of undesirable effects. One of these involves the onset of flow resulting from sharp thermal gradients within the laser melt pool, affecting the morphological stability of the solidified alloys. We examine the linear stability of the interface of a rapidly solidifying binary alloy under weak boundary-layer flow by performing an asymptotic analysis for a singular perturbation problem that arises as a result of departures from the equilibrium phase diagram. Under no flow, the problem involves cellular and pulsatile instabilities, stabilised by surface tension and attachment kinetics. We find that travelling waves appear as a result of flow and we map out the effect of flow on two absolute stability boundaries as well as on the cells and solute bands that have been observed in experiments under no flow. This work is supported by the National Institute of Standards and Technology [Grant Number 70NANB14H012].

Implantation of a HeartMate II left ventricular assist device via left thoracotomy.

PubMed

Cho, Yang Hyun; Deo, Salil V; Schirger, John A; Pereira, Naveen L; Stulak, John M; Park, Soon J

2012-11-01

Left thoracotomy was used as an approach for the implantation of pulsatile ventricular assist devices. Avoiding the standard approach of median sternotomy is attractive in patients undergoing complicated redo cardiac surgery, especially with prior mediastinal radiation. We report a case of the use of left thoracotomy for the implantation of the HeartMate II axial-flow pump. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Design and validation of a pulsatile perfusion bioreactor for 3D high cell density cultures.

PubMed

Chouinard, Julie A; Gagnon, Serge; Couture, Marc G; Lévesque, Alain; Vermette, Patrick

2009-12-15

This study presents the design and validation of a pulsatile flow perfusion bioreactor able to provide a suitable environment for 3D high cell density cultures for tissue engineering applications. Our bioreactor system is mobile, does not require the use of traditional cell culture incubators and is easy to sterilize. It provides real-time monitoring and stable control of pH, dissolved oxygen concentration, temperature, pressure, pulsation frequency, and flow rate. In this bioreactor system, cells are cultured in a gel within a chamber perfused by a culture medium fed by hollow fibers. Human umbilical vein endothelial cells (HUVEC) suspended in fibrin were found to be living, making connections and proliferating up to five to six times their initial seeding number after a 48-h culture period. Cells were uniformly dispersed within the 14.40 mm x 17.46 mm x 6.35 mm chamber. A larger fraction of the cells suspended in 6.35-mm thick gels and cultured in a traditional CO(2) incubator were found to be round and dead [corrected]. In control experiments carried out in a traditional cell culture incubator, the scarcely found living cells were mostly on top of the gels, while cells cultured under perfusion bioreactor conditions were found to be alive and uniformly distributed across the gel. 2009 Wiley Periodicals, Inc.

Topical fundus pulsation measurement in patients with active central serous chorioretinopathy.

PubMed

Tittl, Michael; Polska, Elzbieta; Kircher, Karl; Kruger, Andreas; Maar, Noemi; Stur, Michael; Schmetterer, Leopold

2003-07-01

To determine regional pulsatile choroidal blood flow using laser interferometry in patients with active central serous chorioretinopathy (CSC). The study compared an equally sized age-, sex-, and refractive error-matched control group of healthy volunteers obtained from the Department of Clinical Pharmacology with 18 consecutive patients who had newly diagnosed active, unilateral CSC obtained from the University of Vienna Eye Clinic, Vienna, Austria. Regional fundus pulsation amplitude as assessed using laser interferometry. The median age of the patients was 40 years; the male-female ratio was 16:2. Foveal fundus pulsation amplitude was significantly higher in eyes with CSC (mean [SD], 5.5 [1.7] micro m) than in the eyes of the control subjects (4.1 [1.1] micro m; P =.005). In addition, eyes with CSC had a significantly higher variability in fundus pulsation amplitude (mean [SD], 48% [20%]) assessed at different fundus locations around the leak than the controls did (20% [9%]; P<.001). To our knowledge, this is the first study that measures topical fundus pulsations in patients who have active, unilateral CSC. These data indicate a generally increased foveal pulsatile choroidal blood flow and an abnormal distribution of fundus pulsation amplitude in the area close to the leak. Whether these findings reinforce the concept that choroidal perfusion abnormalities play a role in the pathogenesis of CSC remains to be established.

The Manifestation of Vortical and Secondary Flow in the Cerebral Venous Outflow Tract: An In Vivo MR Velocimetry Study

PubMed Central

Kefayati, Sarah; Amans, Matthew; Faraji, Farshid; Ballweber, Megan; Kao, Evan; Ahn, Sinyeob; Meisel, Karl; Halbach, Van; Saloner, David

2016-01-01

Aberrations in flow in the cerebral venous outflow tract (CVOT) have been implicated as the cause of several pathologic conditions including idiopathic intracranial hypertension (IIH), multiple sclerosis (MS), and pulsatile tinnitus (PT). The advent of 4D Flow magnetic resonance imaging (4D-Flow MRI) has recently allowed researchers to evaluate blood flow patterns in the arterial structures with great success. We utilized similar imaging techniques and found several distinct flow characteristics in the CVOT of subjects with and without lumenal irregularities. We present the flow patterns of 8 out of 38 subjects who have varying heights of the internal jugular bulb and varying lumenal irregularities including stenosis and diverticulum. In the internal jugular vein (IJV) with an elevated jugular bulb (JB), 4DFlow MRI revealed a characteristic spiral flow that was dependent on the level of JB elevation. Vortical flow was also observed in the diverticula of the venous sinuses and IJV. The diversity of flow complexity in the CVOT illustrates the potential importance of hemodynamic investigations in elucidating venous pathologies. PMID:27894675

Induction of ovulation in clomiphene-resistant polycystic ovary syndrome with pulsatile GnRH.

PubMed

Tan, S L; Farhi, J; Homburg, R; Jacobs, H S

1996-08-01

To determine the efficacy of pulsatile GnRH alone and in combination with clomiphene citrate or gonadotropins in a stepwise approach for inducing ovulation in women with clomiphene-resistant polycystic ovary syndrome (PCOS). Eighty women with clomiphene-resistant anovulatory infertility and PCOS were given subcutaneous pulsatile GnRH (15 micrograms every 90 minutes) using a portable infusion pump. If no follicular development was seen, clomiphene citrate (100 mg/day for 5 days) was given concurrently with the hormone in the next cycle of treatment. Those who still failed to ovulate regularly were treated with combined pulsatile GnRH with intramuscular gonadotropins (one ampule per day for 5-7 days). RESULTS. Sixty-six of 131 (50%) pulsatile GnRH cycles, 94 of 142 (66%) pulsatile GnRH with clomiphene cycles, and 48 of 69 (70%) pulsatile GnRH with gonadotropin cycles were ovulatory. Monofollicular response (one follicle at least 14 mm on the day of ovulation) occurred in 80.6, 83.9, and 53.6% of cycles, and multifollicular response occurred in 4.8, 3.1, and 21.6% of cycles in the three groups, respectively. Mild ovarian hyperstimulation occurred in one of the 342 cycles. The cumulative conception rate was 30% after three cycles, 60% after six cycles, and 73% after nine cycles. The miscarriage rate was 22% (ten of 45 pregnancies), and 35 women (78%) had live births (33 singletons and two sets of twins). The use of subcutaneous pulsatile GnRH alone and in combination with clomiphene citrate or gonadotropins for induction of ovulation in clomiphene-resistant PCOS in a stepwise approach produces a high cumulative conception rate associated with a low rate of multiple pregnancy and ovarian hyperstimulation syndrome.

Metastatic breast carcinoma presenting as unilateral pulsatile tinnitus: a case report.

PubMed

Moore, Andrew; Cunnane, Max; Fleming, Jason C

2015-02-01

Pulsatile tinnitus is a rare symptom, yet it may herald life-threatening pathology in the absence of other symptoms or signs. Pulsatile tinnitus tends to imply a vascular cause, but metastatic disease also can present in this way. Clinicians should therefore adopt a specific diagnostic algorithm for pulsatile tinnitus and always consider the possibility of metastatic disease. A history of malignant disease and new cranial nerve palsies should raise clinical suspicion for skull base metastases. We describe the case of a 63-year-old woman presenting with unilateral subjective pulsatile tinnitus and a middle ear mass visible on otoscopy. Her background included the diagnosis of idiopathic unilateral vagal and hypoglossal nerve palsies 4 years previously, with normal magnetic resonance imaging (MRI). Repeat MRI and computed tomography imaging were consistent with metastatic breast carcinoma. This case raises important questions about imaging protocols and the role of serial scanning in patients at high risk of metastatic disease.

Stent-Assisted Coil Embolization of a Transverse-Sigmoid Sinus Diverticulum Presenting with Pulsatile Tinnitus.

PubMed

Li, Baomin; Lv, Xianli; Wu, Zhongxue; Cao, Xiangyu; Wang, Jun; Ge, Aili; Liu, Xinfeng; Li, Sheng

When tinnitus is pulse-synchronous, a vascular etiology is suggested. We present a case of persistent and troublesome pulsatile tinnitus caused by a transverse-sigmoid sinus diverticulum that was endovascularly treated with stent-assisted coiling. A 39-yearold woman presented with a 4-year history of progressive pulsatile tinnitus involving the right ear. Slight pulsatile bruit was heard on the right mastoid bone by auscultation. Cerebral angiography demonstrated a diverticulum of the transverse-sigmoid sinus. The procedure was performed with an 8F guiding catheter (Cordis, USA) catheterized into the right sigmoid sinus. The diverticulum was completely coiled following deployment of a 5.5 mm-50 mm Leo stent. This patient awakened without any neurological deficit and with immediate resolution of her tinnitus. This case report describes a stent-assisted coil embolization of venous sinus diverticulum, which provides immediate resolution of pulsatile tinnitus.

Shear stress induced stimulation of mammalian cell metabolism

NASA Technical Reports Server (NTRS)

Mcintire, L. V.; Frangos, J. A.; Eskin, S. G.

1988-01-01

A flow apparatus was developed for the study of the metabolic response of anchorage dependent cells to a wide range of steady and pulsatile shear stresses under well controlled conditions. Human umbilical vein endothelial cell monolayers were subjected to steady shear stresses of up to 24 dynes/sq cm, and the production of prostacyclin was determined. The onset of flow led to a burst in prostacyclin production which decayed to a long term steady state rate (SSR). The SSR of cells exposed to flow was greater than the basal release level, and increased linearly with increasing shear stress. It is demonstrated that shear stresses in certain ranges may not be detrimental to mammalian cell metabolism. In fact, throughout the range of shear stresses studied, metabolite production is maximized by maximizing shear stress.

Syringomyelia: A review of the biomechanics

NASA Astrophysics Data System (ADS)

Elliott, N. S. J.; Bertram, C. D.; Martin, B. A.; Brodbelt, A. R.

2013-07-01

Syringomyelia is a neurological disorder caused by the development of one or more macroscopic fluid-filled cavities in the spinal cord. While the aetiology remains uncertain, hydrodynamics appear to play a role. This has led to the involvement of engineers, who have modelled the system in silico and on the bench. In the process, hypotheses from the neurosurgical literature have been tested, and others generated, while aspects of the system mechanics have been clarified. The spinal cord is surrounded by cerebrospinal fluid (CSF) which is subject both to the periodic excitation of CSF expelled from the head with each heartbeat, and to intermittent larger transients from cough, sneeze, etc., via vertebral veins. The resulting pulsatile flow and pressure wave propagation, and their possible effects on cord cavities and cord stresses, have been elucidated. These engineering contributions are here reviewed for the first time.

Pulsatile insulin secretion, impaired glucose tolerance and type 2 diabetes

PubMed Central

Satin, Leslie S.; Butler, Peter C.; Ha, Joon; Sherman, Arthur S.

2015-01-01

Type 2 diabetes (T2DM) results when increases in beta cell function and/or mass cannot compensate for rising insulin resistance. Numerous studies have documented the longitudinal changes in metabolism that occur during the development of glucose intolerance and lead to T2DM. However, the role of changes in insulin secretion, both amount and temporal pattern has been understudied. Most of the insulin secreted from pancreatic beta cells of the pancreas is released in a pulsatile pattern, which is disrupted in T2DM. Here we review the evidence that changes in beta cell pulsatility occur during the progression from glucose intolerance to T2DM in humans, and contribute significantly to the etiology of the disease. We review the evidence that insulin pulsatility improves the efficacy of secreted insulin on its targets, particularly hepatic glucose production, but also examine evidence that pulsatility alters or is altered by changes in peripheral glucose uptake. Finally, we summarize our current understanding of the biophysical mechanisms responsible for oscillatory insulin secretion. Understanding how insulin pulsatility contributes to normal glucose homeostasis and is altered in metabolic disease states may help improve the treatment of T2DM. PMID:25637831

Cerebrospinal fluid bulk flow is driven by the cardiac cycle

NASA Astrophysics Data System (ADS)

Tithof, Jeffrey; Mestre, Humberto; Thomas, John; Nedergaard, Maiken; Kelley, Douglas

2017-11-01

Recent discoveries have uncovered a cerebrospinal fluid (CSF) transport system in the perivascular spaces (PVS) of the mammalian brain which clears excess extracellular fluid and protein waste products. The oscillatory pattern of CSF flow has long been attributed to arterial pulsations due to cardiac contractility but limitations in imaging techniques have impeded quantitative measurement of flow rates within the PVS. In this talk, we describe quantitative measurements from the first ever direct imaging of CSF flow in the PVS of a mouse brain. We perform particle tracking velocimetry to obtain time-resolved velocity measurements. To identify the cardiac and/or respiratory dependence of the flow, while imaging, we simultaneously record the mouse's electrocardiogram and respiration. Our measurements conclusively indicate that CSF pulsatility in the arterial PVS is directly driven by the cardiac cycle and not by the respiratory cycle or cerebral vasomotion. These results offer a substantial step forward in understanding bulk flow of CSF in the mammalian brain and may have important implications related to neurodegenerative diseases.

Effect of a Flared Renal Stent on the Performance of Fenestrated Stent-Grafts at Rest and Exercise Conditions.

PubMed

Kandail, Harkamaljot; Hamady, Mohamad; Xu, Xiao Yun

2016-10-01

To quantify the hemodynamic impact of a flared renal stent on the performance of fenestrated stent-grafts (FSGs) by analyzing flow patterns and wall shear stress-derived parameters in flared and nonflared FSGs in different physiologic scenarios. Hypothetical models of FSGs were created with and without flaring of the proximal portion of the renal stent. Flared FSGs with different dilation angles and protrusion lengths were examined, as well as a nonplanar flared FSG to account for lumbar curvature. Laminar and pulsatile blood flow was simulated by numerically solving Navier-Stokes equations. A physiologically realistic flow rate waveform was prescribed at the inlet, while downstream vasculature was modeled using a lumped parameter 3-element windkessel model. No slip boundary conditions were imposed at the FSG walls, which were assumed to be rigid. While resting simulations were performed on all the FSGs, exercise simulations were also performed on a flared FSG to quantify the effect of flaring in different physiologic scenarios. For cycle-averaged inflow of 2.94 L/min (rest) and 4.63 L/min (exercise), 27% of blood flow was channeled into each renal branch at rest and 21% under exercise for all the flared FSGs examined. Although the renal flow waveform was not affected by flaring, flow within the flared FSGs was disturbed. This flow disturbance led to high endothelial cell activation potential (ECAP) values at the renal ostia for all the flared geometries. Reducing the dilation angle or protrusion length and exercise lowered the ECAP values for flared FSGs. Flaring of renal stents has a negligible effect on the time dependence of renal flow rate waveforms and can maintain sufficient renal perfusion at rest and exercise. Local flow patterns are, however, strongly dependent on renal flaring, which creates a local flow disturbance and may increase the thrombogenicity at the renal ostia. Smaller dilation angles, shorter protrusion lengths, and moderate lower limb exercise are likely to reduce the risk of thrombosis in flared geometries. © The Author(s) 2016.

Mathematical modelling of the maternal cardiovascular system in the three stages of pregnancy.

PubMed

Corsini, Chiara; Cervi, Elena; Migliavacca, Francesco; Schievano, Silvia; Hsia, Tain-Yen; Pennati, Giancarlo

2017-09-01

In this study, a mathematical model of the female circulation during pregnancy is presented in order to investigate the hemodynamic response to the cardiovascular changes associated with each trimester of pregnancy. First, a preliminary lumped parameter model of the circulation of a non-pregnant female was developed, including the heart, the systemic circulation with a specific block for the uterine district and the pulmonary circulation. The model was first tested at rest; then heart rate and vascular resistances were individually varied to verify the correct response to parameter alterations characterising pregnancy. In order to simulate hemodynamics during pregnancy at each trimester, the main changes applied to the model consisted in reducing vascular resistances, and simultaneously increasing heart rate and ventricular wall volumes. Overall, reasonable agreement was found between model outputs and in vivo data, with the trends of the cardiac hemodynamic quantities suggesting correct response of the heart model throughout pregnancy. Results were reported for uterine hemodynamics, with flow tracings resembling typical Doppler velocity waveforms at each stage, including pulsatility indexes. Such a model may be used to explore the changes that happen during pregnancy in female with cardiovascular diseases. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

[Diagnosis and management of pulsatile tinnitus of venous origin].

PubMed

Zhang, Yibo; Wang, Wuqing; Dai, Chunfu; Chen, Liang

2010-03-01

To discuss the diagnosis and management of pulsatile tinnitus of venous origin. A retrospective study was conducted on 12 patients who were diagnosed with pulsatile tinnitus of venous origin and treated with ligation of internal jugular veins. We reevaluated the evidences of identifying pulsatile tinnitus of venous origin and reviewed the short-term and long-term postoperative effects and complications. We also reviewed associated articles in this report. Seven patients got relief of tinnitus in less than one week after the surgery, while the other 5 patients had no relief. Seven patients were inquired in this study and the other five lost to follow-up. According to the long review (from one to five years postoperatively), two patients who acquired immediate effect got relief of tinnitus, four including complained of no relief and the seventh aggravated into roaring. Three patients who got no immediate relief got no improvement at all. No one in our review complained of any complications. It's assumed that a history of pulsatile tinnitus, alleviation of tinnitus when pressing jugular veins, tinnitus changing with head position or posture and no occupying lesion in temporal CT scan or cranial MRI are inadequate in diagnosing pulsatile tinnitus of venous origin. Vascular imaging is also necessary to exclude other pathological changes like dura arteriovenous fistula, sigmoid diverticulum and so on. CT arteriography and venography are recommended preferentially. Ligation of internal jugular veins is controversial in patients who have no absence of transverse and sigmoid sinus and identified as pulsatile tinnitus of venous origin.

Spatial model of convective solute transport in brain extracellular space does not support a “glymphatic” mechanism

PubMed Central

Jin, Byung-Ju; Smith, Alex J.

2016-01-01

A “glymphatic system,” which involves convective fluid transport from para-arterial to paravenous cerebrospinal fluid through brain extracellular space (ECS), has been proposed to account for solute clearance in brain, and aquaporin-4 water channels in astrocyte endfeet may have a role in this process. Here, we investigate the major predictions of the glymphatic mechanism by modeling diffusive and convective transport in brain ECS and by solving the Navier–Stokes and convection–diffusion equations, using realistic ECS geometry for short-range transport between para-arterial and paravenous spaces. Major model parameters include para-arterial and paravenous pressures, ECS volume fraction, solute diffusion coefficient, and astrocyte foot-process water permeability. The model predicts solute accumulation and clearance from the ECS after a step change in solute concentration in para-arterial fluid. The principal and robust conclusions of the model are as follows: (a) significant convective transport requires a sustained pressure difference of several mmHg between the para-arterial and paravenous fluid and is not affected by pulsatile pressure fluctuations; (b) astrocyte endfoot water permeability does not substantially alter the rate of convective transport in ECS as the resistance to flow across endfeet is far greater than in the gaps surrounding them; and (c) diffusion (without convection) in the ECS is adequate to account for experimental transport studies in brain parenchyma. Therefore, our modeling results do not support a physiologically important role for local parenchymal convective flow in solute transport through brain ECS. PMID:27836940

Spatial model of convective solute transport in brain extracellular space does not support a "glymphatic" mechanism.

PubMed

Jin, Byung-Ju; Smith, Alex J; Verkman, Alan S

2016-12-01

A "glymphatic system," which involves convective fluid transport from para-arterial to paravenous cerebrospinal fluid through brain extracellular space (ECS), has been proposed to account for solute clearance in brain, and aquaporin-4 water channels in astrocyte endfeet may have a role in this process. Here, we investigate the major predictions of the glymphatic mechanism by modeling diffusive and convective transport in brain ECS and by solving the Navier-Stokes and convection-diffusion equations, using realistic ECS geometry for short-range transport between para-arterial and paravenous spaces. Major model parameters include para-arterial and paravenous pressures, ECS volume fraction, solute diffusion coefficient, and astrocyte foot-process water permeability. The model predicts solute accumulation and clearance from the ECS after a step change in solute concentration in para-arterial fluid. The principal and robust conclusions of the model are as follows: (a) significant convective transport requires a sustained pressure difference of several mmHg between the para-arterial and paravenous fluid and is not affected by pulsatile pressure fluctuations; (b) astrocyte endfoot water permeability does not substantially alter the rate of convective transport in ECS as the resistance to flow across endfeet is far greater than in the gaps surrounding them; and (c) diffusion (without convection) in the ECS is adequate to account for experimental transport studies in brain parenchyma. Therefore, our modeling results do not support a physiologically important role for local parenchymal convective flow in solute transport through brain ECS. © 2016 Jin et al.

A new blood pump for cardiopulmonary bypass: the HiFlow centrifugal pump.

PubMed

Göbel, C; Eilers, R; Reul, H; Schwindke, P; Jörger, M; Rau, G

1997-07-01

Centrifugal blood pumps are considered to be generally superior to the traditionally used roller pumps in cardiopulmonary bypass. In our institute a new lightweight centrifugal sealless blood pump with a unique spherical thrust bearing and with a magnetic coupling was developed, the HiFlow. The small design makes the pump suitable for applications in complex devices or close to a patient. Hemolysis tests were carried out in which the BioMedicus pump BP-80 and a roller pump were used as reference. The centrifugal pump HiFlow showed the least blood trauma within the group of investigated pumps. In summary, the HiFlow pump concept with its low priming volume and limited contact surfaces shows great potential for clinical applications in cardiopulmonary bypass. Also, the possibility of using the pump as a short-term assist device with an option of a pulsatile driving mode was demonstrated.

Monitoring patients with continuous-flow ventricular assist devices outside of the intensive care unit: novel challenges to bedside nursing.

PubMed

O'Shea, Genevieve; Teuteberg, Jeffrey J; Severyn, Donald A

2013-03-01

Ventricular assist devices provide therapeutic options for patients with severe heart failure who have exhausted available medical therapies. With restoration of organ perfusion with ventricular assist devices, the heart failure resolves and quality of life and functional status improve. The current generation of continuous-flow devices present novel challenges to the clinical assessment of patients by substantially reducing or nearly eliminating any palpable pulse. Patients therefore generally have inadequate arterial pulsatility for most noninvasive monitoring devices such as pulse oximeters or automated blood pressure cuffs to work accurately. This article describes the function of continuous-flow devices and how this function affects common monitoring options, as well as how to clinically assess recipients of continuous-flow devices to promptly identify those whose condition may be deteriorating or who may be receiving inadequate perfusion.

Closure technique after carotid endarterectomy influences local hemodynamics.

PubMed

Harrison, Gareth J; How, Thien V; Poole, Robert J; Brennan, John A; Naik, Jagjeeth B; Vallabhaneni, S Rao; Fisher, Robert K

2014-08-01

Meta-analysis supports patch angioplasty after carotid endarterectomy (CEA); however, studies indicate considerable variation in practice. The hemodynamic effect of a patch is unclear and this study attempted to elucidate this and guide patch width selection. Four groups were selected: healthy volunteers and patients undergoing CEA with primary closure, trimmed patch (5 mm), or 8-mm patch angioplasty. Computer-generated three-dimensional models of carotid bifurcations were produced from transverse ultrasound images recorded at 1-mm intervals. Rapid prototyping generated models for flow visualization studies. Computational fluid dynamic studies were performed for each model and validated by flow visualization. Mean wall shear stress (WSS) and oscillatory shear index (OSI) maps were created for each model using pulsatile inflow at 300 mL/min. WSS of <0.4 Pa and OSI >0.3 were considered pathological, predisposing to accretion of intimal hyperplasia. The resultant WSS and OSI maps were compared. The four groups comprised 8 normal carotid arteries, 6 primary closures, 6 trimmed patches, and seven 8-mm patches. Flow visualization identified flow separation and recirculation at the bifurcation increased with a patch and was related to the patch width. Computational fluid dynamic identified that primary closure had the fewest areas of low WSS or elevated OSI but did have mild common carotid artery stenoses at the proximal arteriotomy that caused turbulence. Trimmed patches had more regions of abnormal WSS and OSI at the bifurcation, but 8-mm patches had the largest areas of deleteriously low WSS and high OSI. Qualitative comparison among the four groups confirmed that incorporation of a patch increased areas of low WSS and high OSI at the bifurcation and that this was related to patch width. Closure technique after CEA influences the hemodynamic profile. Patching does not appear to generate favorable flow dynamics. However, a trimmed 5-mm patch may offer hemodynamic benefits over an 8-mm patch and may be the preferred option. Copyright © 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Renal hemodynamics: the influence of the renal artery ostium flow diverter

NASA Astrophysics Data System (ADS)

Rossmann, Jenn Stroud; Albert, Scott; Balaban, Robert

2013-11-01

The recently identified renal artery ostium flow diverter may preferentially direct blood flow to the renal arteries, and may also influence flow patterns and recirculation known to be involved in atherogenesis. Three-dimensional computational fluid dynamics (CFD) simulations of steady and pulsatile blood flow are performed to investigate the influence of diverter size and position, and vascular geometry, on the flow patterns and fluid mechanical forces in the neighborhood of the diverter. CFD results show that the flow diverter does affect the blood distribution: depending on the diverter's position, the flow to the renal arteries may be increased or reduced. The results of simulations also show the diverter's effect on the Wall Shear Stress (WSS) distribution, and suggest that the diverter contributes to an atherogenic environment in the abdominal aorta, while being atheroprotective in the renal arteries themselves. These results support previous clinical findings, and suggest directions for further clinical study. The results of this work have direct implications in understanding the physiological significance of the diverter, and its potential role in the pathophysiological development of atherosclerosis.

Aberrant sylvian vein: A newly described cause of pulsatile tinnitus.

PubMed

Liu, Zhaohui; Yu, Jingge; Zhao, Pengfei; Zhang, Hanjuan; Wang, Qian; Wang, Zhenchang

2017-10-01

We herein report a newly described cause of venous pulsatile tinnitus: protrusion of an aberrant sylvian vein into the tympanum. A 60-year-old woman presented with a 4-month history of objective persistent pulsatile tinnitus in the right ear with no other complaints. The pulsatile tinnitus diminished with rotation of the head to the right side or by compression of the right cervical vascular structures. The frequency and intensity of the tinnitus were 125 Hz and 20 dB HL, respectively. Audiometry and otoscopic examination findings were normal. Radiologic examination showed that the right sylvian vein protruded into the tympanum through the dehiscent anterior cortical plate of the tympanum.

Pulsatile Hyperglycaemia Induces Vascular Oxidative Stress and GLUT 1 Expression More Potently than Sustained Hyperglycaemia in Rats on High Fat Diet

PubMed Central

Rakipovski, Günaj; Lykkesfeldt, Jens; Raun, Kirsten

2016-01-01

Introduction Pulsatile hyperglycaemia resulting in oxidative stress may play an important role in the development of macrovascular complications. We investigated the effects of sustained vs. pulsatile hyperglycaemia in insulin resistant rats on markers of oxidative stress, enzyme expression and glucose metabolism in liver and aorta. We hypothesized that liver’s ability to regulate the glucose homeostasis under varying states of hyperglycaemia may indirectly affect oxidative stress status in aorta despite the amount of glucose challenged with. Methods Animals were infused with sustained high (SHG), low (SLG), pulsatile (PLG) glucose or saline (VEH) for 96 h. Oxidative stress status and key regulators of glucose metabolism in liver and aorta were investigated. Results Similar response in plasma lipid oxidation was observed in PLG as in SHG. Likewise, in aorta, PLG and SHG displayed increased expression of glucose transporter 1 (GLUT1), gp-91PHOX and super oxide dismutase (SOD), while only the PLG group showed increased accumulation of oxidative stress and oxidised low density lipoprotein (oxLDL) in aorta. Conclusion Pulsatile hyperglycaemia induced relatively higher levels of oxidative stress systemically and in aorta in particular than overt sustained hyperglycaemia thus supporting the clinical observations that pulsatile hyperglycaemia is an independent risk factor for diabetes related macrovascular complications. PMID:26790104

Pulsatile Hyperglycaemia Induces Vascular Oxidative Stress and GLUT 1 Expression More Potently than Sustained Hyperglycaemia in Rats on High Fat Diet.

PubMed

Rakipovski, Günaj; Lykkesfeldt, Jens; Raun, Kirsten

2016-01-01

Pulsatile hyperglycaemia resulting in oxidative stress may play an important role in the development of macrovascular complications. We investigated the effects of sustained vs. pulsatile hyperglycaemia in insulin resistant rats on markers of oxidative stress, enzyme expression and glucose metabolism in liver and aorta. We hypothesized that liver's ability to regulate the glucose homeostasis under varying states of hyperglycaemia may indirectly affect oxidative stress status in aorta despite the amount of glucose challenged with. Animals were infused with sustained high (SHG), low (SLG), pulsatile (PLG) glucose or saline (VEH) for 96 h. Oxidative stress status and key regulators of glucose metabolism in liver and aorta were investigated. Similar response in plasma lipid oxidation was observed in PLG as in SHG. Likewise, in aorta, PLG and SHG displayed increased expression of glucose transporter 1 (GLUT1), gp-91PHOX and super oxide dismutase (SOD), while only the PLG group showed increased accumulation of oxidative stress and oxidised low density lipoprotein (oxLDL) in aorta. Pulsatile hyperglycaemia induced relatively higher levels of oxidative stress systemically and in aorta in particular than overt sustained hyperglycaemia thus supporting the clinical observations that pulsatile hyperglycaemia is an independent risk factor for diabetes related macrovascular complications.

Magnetic Resonance Imaging Measurement of Transmission of Arterial Pulsation to the Brain on Propranolol Versus Amlodipine.

PubMed

Webb, Alastair J S; Rothwell, Peter M

2016-06-01

Cerebral arterial pulsatility is associated with leukoaraiosis and depends on central arterial pulsatility and arterial stiffness. The effect of antihypertensive drugs on transmission of central arterial pulsatility to the cerebral circulation is unknown, partly because of limited methods of assessment. In a technique-development pilot study, 10 healthy volunteers were randomized to crossover treatment with amlodipine and propranolol. At baseline and on each drug, we assessed aortic (Sphygmocor) and middle cerebral artery pulsatility (TCDtranscranial ultrasound). We also performed whole-brain, 3-tesla multiband blood-oxygen level dependent magnetic resonance imaging (multiband factor 6, repetition time=0.43s), concurrent with a novel method of continuous noninvasive blood pressure monitoring. Drug effects on relationships between cardiac cycle variation in blood pressure and blood-oxygen level dependent imaging were determined (fMRI Expert Analysis Tool, fMRIB Software Library [FEAT-FSL]). Aortic pulsatility was similar on amlodipine (27.3 mm Hg) and propranolol (27.9 mm Hg, P diff=0.33), while MCA pulsatility increased nonsignificantly more from baseline on propranolol (+6%; P=0.09) than amlodipine (+1.5%; P=0.58). On magnetic resonance imaging, cardiac frequency blood pressure variations were found to be significantly more strongly associated with blood-oxygen level dependent imaging on propranolol than amlodipine. We piloted a novel method of assessment of arterial pulsatility with concurrent high-frequency blood-oxygen level dependent magnetic resonance imaging and noninvasive blood pressure monitoring. This method was able to identify greater transmission of aortic pulsation on propranolol than amlodipine, which warrants further investigation. © 2016 American Heart Association, Inc.

The Syncardia™ total artificial heart: in vivo, in vitro, and computational modeling studies

PubMed Central

Slepian, Marvin J.; Alemu, Yared; Soares, João Silva; Smith, Richard G.; Einav, Shmuel; Bluestein, Danny

2014-01-01

The SynCardia™ total artificial heart (TAH) is the only FDA-approved TAH in the world. The SynCardia™ TAH is a pneumatically driven, pulsatile system capable of flows of >9 L/min. The TAH is indicated for use as a bridge to transplantation (BTT) in patients at imminent risk of death from non-reversible bi-ventricular failure. In the Pivotal US approval trial the TAH achieved a BTT rate of >79%. Recently a multi-center, post-market approval study similarly demonstrated a comparable BTT rate. A major milestone was recently achieved for the TAH, with over 1100 TAHs having been implanted to date, with the bulk of implantation occurring at an ever increasing rate in the past few years. The TAH is most commonly utilized to save the lives of patients dying from end-stage bi-ventricular heart failure associated with ischemic or non-ischemic dilated cardiomyopathy. Beyond progressive chronic heart failure, the TAH has demonstrated great efficacy in supporting patients with acute irreversible heart failure associated with massive acute myocardial infarction. In recent years several diverse clinical scenarios have also proven to be well served by the TAH including severe heart failure associated with advanced congenital heart disease. failed or burned-out transplants, infiltrative and restrictive cardiomyopathies and failed ventricular assist devices. Looking to the future a major unmet need remains in providing total heart support for children and small adults. As such, the present TAH design must be scaled to fit the smaller patient, while providing equivalent, if not superior flow characteristics, shear profiles and overall device thrombogenicity. To aid in the development of a new “pediatric,” TAH an engineering methodology known as “Device Thrombogenicity Emulation (DTE)”, that we have recently developed and described, is being employed. Recently, to further our engineering understanding of the TAH, as steps towards next generation designs we have: (1) assessed of the degree of platelet reactivity induced by the present clinical 70 cc TAH using a closed loop platelet activity state assay, (2) modeled the motion of the TAH pulsatile mobile diaphragm, and (3) performed fluid-structure interactions and assessment of the flow behavior through inflow and outflow regions of the TAH fitted with modern bi-leaflet heart valves. Developing a range of TAH devices will afford biventricular replacement therapy to a wide range of patients, for both short and long-term therapy. PMID:23305813

Connexin 36 mediates blood cell flow in mouse pancreatic islets

PubMed Central

Short, Kurt W.; Head, W. Steve

2013-01-01

The insulin-secreting β-cells are contained within islets of Langerhans, which are highly vascularized. Blood cell flow rates through islets are glucose-dependent, even though there are no changes in blood cell flow within in the surrounding exocrine pancreas. This suggests a specific mechanism of glucose-regulated blood flow in the islet. Pancreatic islets respond to elevated glucose with synchronous pulses of electrical activity and insulin secretion across all β-cells in the islet. Connexin 36 (Cx36) gap junctions between islet β-cells mediate this synchronization, which is lost in Cx36 knockout mice (Cx36−/−). This leads to glucose intolerance in these mice, despite normal plasma insulin levels and insulin sensitivity. Thus, we sought to investigate whether the glucose-dependent changes in intraislet blood cell flow are also dependent on coordinated pulsatile electrical activity. We visualized and quantified blood cell flow using high-speed in vivo fluorescence imaging of labeled red blood cells and plasma. With the use of a live animal glucose clamp, blood cell flow was measured during either hypoglycemia (∼50 mg/dl) or hyperglycemia (∼300 mg/dl). In contrast to the large glucose-dependent islet blood velocity changes observed in wild-type mice, only minimal differences are observed in both Cx36+/− and Cx36−/− mice. This observation supports a novel model where intraislet blood cell flow is regulated by the coordinated electrical activity in the islet β-cells. Because Cx36 expression and function is reduced in type 2 diabetes, the resulting defect in intraislet blood cell flow regulation may also play a significant role in diabetic pathology. PMID:24326425

Increasing LH Pulsatility in Women With Hypothalamic Amenorrhoea Using Intravenous Infusion of Kisspeptin-54

PubMed Central

Jayasena, Channa N.; Abbara, Ali; Veldhuis, Johannes D.; Comninos, Alexander N.; Ratnasabapathy, Risheka; De Silva, Akila; Nijher, Gurjinder M. K.; Ganiyu-Dada, Zainab; Mehta, Amrish; Todd, Catriona; Ghatei, Mohammad A.; Bloom, Stephen R.

2014-01-01

Background: Hypothalamic amenorrhea (HA) is the one of the most common causes of period loss in women of reproductive age and is associated with deficient LH pulsatility. High-dose kisspeptin-54 acutely stimulates LH secretion in women with HA, but chronic administration causes desensitization. GnRH has paradoxical effects on reproductive activity; we therefore hypothesized that a dose-dependent therapeutic window exists within which kisspeptin treatment restores the GnRH/LH pulsatility in women with HA. Aim: The aim of the study was to determine whether constant iv infusion of kisspeptin-54 temporarily increases pulsatile LH secretion in women with HA. Methods: Five patients with HA each underwent six assessments of LH pulsatility. Single-blinded continuous iv infusion of vehicle or kisspeptin-54 (0.01, 0.03, 0.10, 0.30, or 1.00 nmol/kg/h) was administered. The LH pulses were detected using blinded deconvolution. Results: Kisspeptin increased LH pulsatility in all patients with HA, with peak responses observed at different doses in each patient. The mean peak number of pulses during infusion of kisspeptin-54 was 3-fold higher when compared with vehicle (number of LH pulses per 8 h: 1.6 ± 0.4, vehicle; 5.0 ± 0.5, kisspeptin-54, P < .01 vs vehicle). The mean peak LH pulse secretory mass during kisspeptin-54 was 6-fold higher when compared with vehicle (LH pulse secretory mass in international units per liter: 3.92 ± 2.31, vehicle; 23.44 ± 12.59, kisspeptin-54; P < .05 vs vehicle). Conclusions: Kisspeptin-54 infusion temporarily increases LH pulsatility in women with HA. Furthermore, we have determined the dose range within which kisspeptin-54 treatment increases basal and pulsatile LH secretion in women with HA. This work provides a basis for studying the potential of kisspeptin-based therapies to treat women with HA. PMID:24517142

Instabilities in rapid directional solidification under weak flow

NASA Astrophysics Data System (ADS)

Kowal, Katarzyna N.; Davis, Stephen H.; Voorhees, Peter W.

2017-12-01

We examine a rapidly solidifying binary alloy under directional solidification with nonequilibrium interfacial thermodynamics viz. the segregation coefficient and the liquidus slope are speed dependent and attachment-kinetic effects are present. Both of these effects alone give rise to (steady) cellular instabilities, mode S , and a pulsatile instability, mode P . We examine how weak imposed boundary-layer flow of magnitude |V | affects these instabilities. For small |V | , mode S becomes a traveling and the flow stabilizes (destabilizes) the interface for small (large) surface energies. For small |V | , mode P has a critical wave number that shifts from zero to nonzero giving spatial structure. The flow promotes this instability and the frequencies of the complex conjugate pairs each increase (decrease) with flow for large (small) wave numbers. These results are obtained by regular perturbation theory in powers of V far from the point where the neutral curves cross, but requires a modified expansion in powers of V1 /3 near the crossing. A uniform composite expansion is then obtained valid for all small |V | .

Arterial wall histology in chronic pulsatile-flow and continuous-flow device circulatory support.

PubMed

Potapov, Evgenij V; Dranishnikov, Nikolay; Morawietz, Lars; Stepanenko, Alexander; Rezai, Sajjad; Blechschmidt, Cristiane; Lehmkuhl, Hans B; Weng, Yuguo; Pasic, Miralem; Hübler, Michael; Hetzer, Roland; Krabatsch, Thomas

2012-11-01

Continuous-flow (CF) ventricular assist devices (VAD) are an established option for treatment of end-stage heart failure. However, the effect of long-term CF with lack of peripheral arterial wall motions on blood pressure regulation and end-organ arterial wall sclerosis, especially in the case of long-term support (> 3 years), remains unclear. Tissue samples obtained at autopsy from liver, kidney, coronary arteries, and brain from 27 VAD recipients supported for > 180 days between 2000 and 2010 were histologically examined to assess vascular alterations, including perivascular infiltrate, intravascular infiltrate, wall thickness, thrombosis, endothelial cell swelling, vessel wall necrosis, and peri-vascular fibrosis. Pulsatile-flow (PF) devices had been inserted in 9 patients and CF devices had been inserted in 16. The pathologist was blinded to the group distribution. Demographic, pharmacologic, and clinical data were retrospectively analyzed before surgery and during the follow-up period of up to 24 months. Median duration of support was 467 days (range, 235-1,588 days) in the PF group and 263 days (range, 182-942 days) in the CF group. Demographic and clinical data before and after surgery were similar. Amiodarone was more often used during follow-up in CF group than in the PF group (61% vs 10%, p = 0.009). Throughout the follow-up period, mean arterial pressure did not differ between recipients of the 2 pump types, nor did systolic and diastolic pressure, except at 2 weeks after VAD implantation, when systolic blood pressure was higher (p = 0.05) and diastolic lower (p = 0.03) in the PF group. Histologic studies did not identify any relevant differences in arterial wall characteristics between the 2 groups. Long-term mechanical circulatory support with CF devices does not adversely influence arterial wall properties of the end-organ vasculature. Copyright © 2012 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Ovarian parameters and ovarian blood flow of women living in the area of environmental crisis.

PubMed

Balmagambetova, Aru; Abdelazim, Ibrahim A; Bekmukhambetov, Erbol; Zhurabekova, Gulmira; Yehia, Amr H; AbuFaza, Mohannad

2016-05-01

Exposure to environmental hazards will destroy a number of ovarian primordial follicles, reduce ovarian reserve and subsequent reproductive ability. This study designed to evaluate ovarian parameters and ovarian blood flow of women living in the area of environmental crisis Shalkar city (Kazakhstan) compared to women living in Aktobe city (Kazakhstan). 220 women in their reproductive age studied and classified into two groups; study (Shalkar) group and control (Aktobe) group. Blood sample taken from studied women during follicular phase (day 3) for hormonal level evaluation including; follicle stimulating hormone (FSH) and anti-Mullerian hormone (AMH). Studied women evaluated using trans-vaginal ultrasound (TVS) to detect antral follicle count (AFC) during follicular scan and ovarian volume (OV), ovarian blood flow (OBF) using pulsatility index (PI) during follicular scan and luteal scan. Both ovaries AFC was significantly less in study (Shalkar) group compared to and control (Aktobe) group (p=0.0001). Mean ovarian volume was significantly less in Shalkar group in both follicular phase and luteal phase (5.86±0.23 and 6.19±0.22Cm(3); respectively) compared to Aktobe group (6.85±0.19 and 6.92±0.18Cm(3); respectively). In addition, mean ovarian pulsatility index was significantly high with subsequent decrease in ovarian blood flow in Shalkar group in both follicular phase and luteal phase (3.36±0.20 and 3.45±0.19Cm/s; respectively) compared to Aktobe group (2.96±0.16 and 2.92±0.15Cm/s; respectively). This study suggests definite environmental effect on ovarian parameters as indicated by decreased AFC, decreased both follicular and luteal OV and OBF in women living in environmental crisis Shalkar group compared to Aktobe group. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Preliminary report of 48-hours Atosiban administration in spontaneous preterm labor - Doppler blood flow assessment of placental and fetal circulation.

PubMed

Grzesiak, Mariusz; Wilczynski, Jan

2013-01-01

The aims were to investigate whether there are any changes in placental and fetal circulation during Atosiban tocolysis within the first 48 hours of therapy. Detailed Doppler evaluation of placental and fetal circulation was performed prior to Atosiban administration and thereafter at 24 and 48 hours. Maternal heart rate and the pulsatility index (PI) in both uterine arteries (R-UtA, L-UtA) were assessed. Fetal heart rate (FHR), the resistance (RI) and pulsatility index (PI) of umbilical (UA) and middle cerebral artery (MCA) were measured. Additionally cerebroplacental ratio was calculated. E-wave/A-wave ratio (E/A) for atrioventricular valves, the myocardial performance index (MPI) and shortening fraction (SF) for both ventricles were calculated for both ventricles independently. To determine changes over time in all study variables analysis of variance (ANOVA) for repeated measurements followed by Tukey-Kramer's post hoc test was used. The effects of additional clinical covariates were checked. Maternal heart rate and blood flow in (R-UtA/L-UtA) were not altered significantly during Atosiban administration. No significant changes in FHR as well as Doppler parameters (RI, PI, PSV) in UA and MCA were recorded after 24/48 hours of tocolytic treatment. The mean values of cerebroplacental ratio (CPR) remained unaltered during treatment. Detailed evaluation of fetal cardiac function parameters (E/A, SF, MPI) calculated independently for both ventricles, revealed no significant changes over the time. To our best knowledge this study has been first evaluation of placental and fetal circulation with assessment of cardiac hemodynamic function during 48-hours administration of Atosiban. This kind of tocolysis treatment seems not to alter uterine nor fetal arterial blood flow pattern seriously. Hemodynamic cardiac activity in fetuses has remained unaffected. We cannot conclude definitely that there are absolutely no changes in the fetal hemodynamic condition due to Atosiban. Further studies should be performed to verify its possible influence on fetal venous blood flow.

The effect of inlet waveforms on computational hemodynamics of patient-specific intracranial aneurysms.

PubMed

Xiang, J; Siddiqui, A H; Meng, H

2014-12-18

Due to the lack of patient-specific inlet flow waveform measurements, most computational fluid dynamics (CFD) simulations of intracranial aneurysms usually employ waveforms that are not patient-specific as inlet boundary conditions for the computational model. The current study examined how this assumption affects the predicted hemodynamics in patient-specific aneurysm geometries. We examined wall shear stress (WSS) and oscillatory shear index (OSI), the two most widely studied hemodynamic quantities that have been shown to predict aneurysm rupture, as well as maximal WSS (MWSS), energy loss (EL) and pressure loss coefficient (PLc). Sixteen pulsatile CFD simulations were carried out on four typical saccular aneurysms using 4 different waveforms and an identical inflow rate as inlet boundary conditions. Our results demonstrated that under the same mean inflow rate, different waveforms produced almost identical WSS distributions and WSS magnitudes, similar OSI distributions but drastically different OSI magnitudes. The OSI magnitude is correlated with the pulsatility index of the waveform. Furthermore, there is a linear relationship between aneurysm-averaged OSI values calculated from one waveform and those calculated from another waveform. In addition, different waveforms produced similar MWSS, EL and PLc in each aneurysm. In conclusion, inlet waveform has minimal effects on WSS, OSI distribution, MWSS, EL and PLc and a strong effect on OSI magnitude, but aneurysm-averaged OSI from different waveforms has a strong linear correlation with each other across different aneurysms, indicating that for the same aneurysm cohort, different waveforms can consistently stratify (rank) OSI of aneurysms. Copyright © 2014 Elsevier Ltd. All rights reserved.

PUCA pump and IABP comparison: analysis of hemodynamic and energetic effects using a digital computer model of the circulation.

PubMed

Fresiello, Libera; Gu, Y John; Ferrari, Gianfranco; Di Molfetta, Arianna; Rakhorst, Gerhard

2011-05-01

The pulsatile catheter pump (PUCA pump) is a left ventricular assist device that provides additional flow to the left ventricle. It is usually run in order to ensure a counterpulsation effect, as in the case of the intra-aortic balloon pump (IABP). Because of this similarity, a comparison between the PUCA pump and the IABP was conducted from both the hemodynamic and energetic points of view. Numerical models of the two devices were created and connected to the CARDIOSIM cardiovascular simulator. The PUCA and IABP models were then verified using in vivo experimental data and literature data, respectively. Numerical experiments were conducted for different values of left ventricular end systolic elastance (Els) and systemic arterial compliance (Csa). The energetic comparison was conducted taking into account the diastolic pressure time index and the endocardial viability ratio. Hemodynamic results expressed as cardiac output (CO) and mean coronary blood flow (CBF) show that both the IABP and the PUCA pump efficacy decrease with higher values of Els and Csa. The IABP especially shows higher sensitivity to these parameters, to the extent that in some cases CO actually drops and CBF does not increase. On the other hand, for lower values of Csa, IABP performance improves so much that the PUCA pump flow needs to be increased in order to ensure a hemodynamic effect comparable to that of the IABP. Energetic results show a trend similar to the hemodynamic ones. The study will be continued by investigating other energetic variables and the autonomic response of the cardiovascular system.

A numerical method to enhance the performance of a cam-type electric motor-driven left ventricular assist device.

PubMed

Huang, Huan; Yang, Ming; Lu, Cunyue; Xu, Liang; Zhuang, Xiaoqi; Meng, Fan

2013-10-01

Pulsatile left ventricular assist devices (LVADs) driven by electric motors have been widely accepted as a treatment of heart failure. Performance enhancement with computer assistance for this kind of LVAD has seldom been reported. In this article, a numerical method is proposed to assist the design of a cam-type pump. The method requires an integrated model of an LVAD system, consisting of a motor, a transmission mechanism, and a cardiovascular circulation. Performance indices, that is, outlet pressure, outlet flow, and pump efficiency, were used to select the best cam profile from six candidates. A prototype pump connected to a mock circulatory loop (MCL) was used to calibrate the friction coefficient of the cam groove and preliminarily evaluate modeling accuracy. In vitro experiments show that the mean outlet pressure and flow can be predicted with high accuracy by the model, and gross geometries of the measurements can also be reproduced. Simulation results demonstrate that as the total peripheral resistance (TPR) is fixed at 1.1 mm Hg.s/mL, the two-cycle 2/3-rise profile is the best. Compared with other profiles, the maximum increases of pressure and flow indices are 75 and 76%, respectively, and the maximum efficiency increase is over 51%. For different TPRs (0.5∼1.5 mm Hg.s/mL) and operation intervals (0.1∼0.4 s) in counterpulsation, the conclusion is also acceptable. © 2013 Wiley Periodicals, Inc. and International Center for Artificial Organs and Transplantation.

DIRECT NUMERICAL SIMULATION OF TRANSITIONAL FLOW IN A STENOSED CAROTID BIFURCATION

PubMed Central

Lee, Seung E.; Lee, Sang-Wook; Fischer, Paul F.; Bassiouny, Hisham S.; Loth, Francis

2008-01-01

The blood flow dynamics of a stenosed, subject-specific, carotid bifurcation were numerically simulated using the spectral element method. Pulsatile inlet conditions were based on in vivo color Doppler ultrasound measurements of blood velocity. The results demonstrated the transitional or weakly turbulent state of the blood flow, which featured rapid velocity and pressure fluctuations in the post-stenotic region of the internal carotid artery during systole and laminar flow during diastole. High-frequency vortex shedding was greatest downstream of the stenosis during the deceleration phase of systole. Velocity fluctuations had a frequency within the audible range of 100–300 Hz. Instantaneous wall shear stress within the stenosis was relatively high during systole (~25-45 Pa) compared to that in a healthy carotid. In addition, high spatial gradients of wall shear stress were present due to flow separation on the inner wall. Oscillatory flow reversal and low pressure were observed distal to the stenosis in the internal carotid artery. This study predicts the complex flow field, the turbulence levels and the distribution of the biomechanical stresses present in vivo within a stenosed carotid artery. PMID:18656199

Passive Wearable Skin Patch Sensor Measures Limb Hemodynamics Based on Electromagnetic Resonance.

PubMed

Cluff, Kim; Becker, Ryan; Jayakumar, Balakumar; Han, Kiyun; Condon, Ernie; Dudley, Kenneth; Szatkowski, George; Pipinos, Iraklis I; Amick, Ryan Z; Patterson, Jeremy

2018-04-01

The objectives of this study were to design and develop an open-circuit electromagnetic resonant skin patch sensor, characterize the fluid volume and resonant frequency relationship, and investigate the sensor's ability to measure limb hemodynamics and pulse volume waveform features. The skin patch was designed from an open-circuit electromagnetic resonant sensor comprised of a single baseline trace of copper configured into a square planar spiral which had a self-resonating response when excited by an external radio frequency sweep. Using a human arm phantom with a realistic vascular network, the sensor's performance to measure limb hemodynamics was evaluated. The sensor was able to measure pulsatile blood flow which registered as shifts in the sensor's resonant frequencies. The time-varying waveform pattern of the resonant frequency displayed a systolic upstroke, a systolic peak, a dicrotic notch, and a diastolic down stroke. The resonant frequency waveform features and peak systolic time were validated against ultrasound pulse wave Doppler. A statistical correlation analysis revealed a strong correlation () between the resonant sensor peak systolic time and the pulse wave Doppler peak systolic time. The sensor was able to detect pulsatile flow, identify hemodynamic waveform features, and measure heart rate with 98% accuracy. The open-circuit resonant sensor design leverages the architecture of a thin planar spiral which is passive (does not require batteries), robust and lightweight (does not have electrical components or electrical connections), and may be able to wirelessly monitor cardiovascular health and limb hemodynamics.

Comparison of the effects of continuous and pulsatile left ventricular-assist devices on ventricular unloading using a cardiac electromechanics model

PubMed Central

Lim, Ki Moo; Constantino, Jason; Gurev, Viatcheslav; Zhu, Renjun; Trayanova, Natalia A.

2012-01-01

Left ventricular-assist devices (LVADs) are used to supply blood to the body of patients with heart failure. Pressure unloading is greater for counter-pulsating LVADs than for continuous LVADs. However, several clinical trials have demonstrated that myocardial recovery is similar for both types of LVAD. This study examined the contractile energy consumption of the myocardium with continuous and counter-pulsating LVAD support to ascertain the effect of the different LVADs on myocardial recovery. We used a three-dimensional electromechanical model of canine ventricles, with models of the circulatory system and an LVAD. We compared the left ventricular peak pressure (LVPP) and contractile ATP consumption between pulsatile and continuous LVADs. With the continuous and counter-pulsating LVAD, the LVPP decreased to 46 and 10%, respectively, and contractile ATP consumption decreased to 60 and 50%. The small difference between the contractile ATP consumption of these two types of LVAD may explain the comparable effects of the two types on myocardial recovery. PMID:22076841

Pulsatile GnRH Therapy May Restore Hypothalamus-Pituitary-Testis Axis Function in Patients With Congenital Combined Pituitary Hormone Deficiency: A Prospective, Self-Controlled Trial.

PubMed

Zheng, Junjie; Mao, Jiangfeng; Xu, Hongli; Wang, Xi; Huang, Bingkun; Liu, Zhaoxiang; Cui, Mingxuan; Xiong, Shuyu; Ma, Wanlu; Min, Le; Kaiser, Ursula B; Nie, Min; Wu, Xueyan

2017-07-01

The effectiveness of pulsatile gonadotropin-releasing hormone (GnRH) therapy in patients with congenital combined pituitary hormone deficiency (CCPHD) has not been investigated because of the limited number of patients, as well as these patients' presumed pituitary hypoplasia, poor gonadotrophic cell reserve, and impaired gonadotrophic response to GnRH. To assess the pituitary response to pulsatile GnRH therapy in men with CCPHD. Prospective, self-controlled, 3-month clinical trial. University endocrine clinic. Men with hypogonadotropic hypogonadism caused by CCPHD. Pulsatile GnRH was administered subcutaneously for 3 months. Primary endpoints were total serum testosterone, testicular volume, and luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels. Secondary endpoints included occurrence of spermatogenesis. A total of 40 men with CCPHD completed the study. Of these, 60% (24 of 40) showed a good response to pulsatile GnRH treatment (response group). At 3 months, their LH and FSH levels increased to within the normal range and their testosterone levels increased to 8.67 ± 4.83 nmol/L. Of the patients in the response group, 33.3% (8 of 24) of them achieved spermatogenesis. The remaining 40% (16 of 40) of patients had a poor response to pulsatile GnRH treatment. Magnetic resonance imaging (MRI) did not reveal any correlation between pituitary response and pituitary height and/or integrity of the pituitary stalk. This study suggests that gonadotrophs in patients with CCPHD can exist and be functional-even with MRI evidence of pituitary hypoplasia or dysplasia. Pulsatile GnRH therapy restored pituitary-testis axis function in 60% of patients with CCPHD. These results may directly guide the clinical therapeutic choice. Copyright © 2017 Endocrine Society

Long-term subcutaneous pulsatile low dose LH-RH administration for treatment of infertile men with secondary hypogonadotrophic hypogonadism.

PubMed

Skarin, G; Nillius, S J; Wide, L

1984-01-01

Chronic pulsatile subcutaneous low dose LH-RH treatment was given to three infertile men with longstanding (2-4 years) secondary hypothalamic pituitary failure. Before the therapy they had very low serum concentrations of gonadotrophins and testosterone. They were impotent and could not produce any ejaculate for sperm analysis. The pulsatile LH-RH treatment, which was continued up to 250 days, was given by means of a small portable automatically-timed infusion pump. Fifty microliter of the LH-RH solution was infused during one min every 90 min. The LH-RH doses were 1, 5 and 20 micrograms. The serum concentrations of the gonadotrophins and testosterone were normalized in the three patients within 10 days of pulsatile low dose LH-RH therapy. Libido and potency returned. The first ejaculates contained no sperms. With continued LH-RH treatment spermatogenesis was induced and normalized. Two of the men fertilized their wives. The pregnancy tests were positive after 181 and 230 days of treatment, respectively. Two healthy girls have been born. Paternity tests were positive. The third man is still receiving pulsatile LH-RH therapy. He has up till now been treated for four months. Chronic pulsatile s.c. low dose LH-RH administration is a very promising new therapy for those hypogonadal men who previously have required human gonadotrophin treatment to restore fertility.