A Computational Study of a Thin-Walled Three-Dimensional Left Ventricle During Early Systole

1994 ◽  
Vol 116 (3) ◽  
pp. 307-314 ◽  
Author(s):  
Ajit P. Yoganathan ◽  
Jack D. Lemmon ◽  
Young H. Kim ◽  
Peter G. Walker ◽  
Robert A. Levine ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Numerical Study ◽  
Three Dimensional ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Model Parameters ◽  
Septal Wall ◽  
Early Systole ◽  
Thin Walled

A numerical study was conducted to solve the three-dimensional Navier-Stokes equations for time-dependent flow in a compliant thin-walled, anatomically correct left ventricle during early systole. Model parameters were selected so that the simulation results could be compared to clinical data. The results produced endocardial wall motion which was consistent with human heart data, and velocity fields consistent with those occurring in a normally-contracting left ventricle. During isovolumetric contraction the posterior wall moved basally and posteriorly, while the septal wall moved apically and anteriorly. During ejection, the short axis of the left ventricle decreased 1.1 mm and the long axis increased 4.2 mm. At the end of the isovolumetric contraction, most of the flow field was moving form the apex toward the base with recirculation regions at the small pocket formed by the concave anterior leaflet, adjacent to the septal wall and near the left ventricular posterior wall. Fluid velocities in the outflow tract matched NMR data to within 10 percent. The results were also consistent with clinical measurements of mitral valve-papillary muscle apparatus displacement, and changes in the mitral valve annular area. The results of the present study show that the thin-walled, three-dimensional left ventricular model simulates observed normal heart phenomena. Validation of this model permits further studies to be performed which involve altered ventricular function due to a variety of cardiac diseases.

Numerical Study on Diastolic Left Ventricular Hemodynamics Using Motion Models of Mitral Valve With/Without Edge-to-Edge Repair

2010 ◽  
Author(s):  
Yingying Hu ◽  
Liang Shi ◽  
Siva Parameswaran ◽  
Sergey A. Smirnov ◽  
Zhaoming He
Keyword(s):  
Shear Stress ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Platelet Activation ◽  
Numerical Study ◽  
Left Ventricular ◽  
High Shear ◽  
High Shear Stress ◽  
Orifice Area ◽  
Motion Models

Edge-to-edge repair (ETER) is a newly developed technique to correct such mitral valve (MV) malfunctions as regurgitation [1,2]. This technique changes MV geometric configuration by suturing the anterior and posterior leaflets at central or commissural edges, and consequently alters MV and left ventricle (LV) dynamics. For instance, stress in the MV elevated due to ETER may cause leaflets tearing near suture. Little has been known about shear stress on the MV and LV walls under MV ETER conditions, where high shear stress might cause platelet activation or hemolysis [3]. When ETER is done at the central leaflet edges, it generates two MV orifices, leads to two deflected jets, and completely changes vortices in the LV. ETER also reduces the orifice area, and increases jet velocity and transmitral pressure [1,2,4]. Flow patterns in the LV and ETER effects on the LV and MV functions have not been understood well.

scholarly journals P955 left ventricle cardiac remodeling among lithuanian football versus basketball players

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Aldujeli ◽  
J Laukaitiene ◽  
R Unikas
Keyword(s):  
Left Ventricle ◽  
Wall Thickness ◽  
Cardiac Remodeling ◽  
Interventricular Septum ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Relative Wall Thickness ◽  
Football Players ◽  
Basketball Players ◽  
Lv Mass

Abstract Background Regular physical exercise causes a continuous gradual increase of the cardiac left ventricular (LV) mass known as physiological adaptive hypertrophy. The extent of LV remodeling depends on the type, amount, and intensity of the exercise. Purpose The aim of this study was to compare structural changes of the heart among Lithuanian football, basketball players and unathletic controls. Methods A total of 50 Lithuanian males aged between 20-29 years volunteered to participate in the study. Football players (n = 15) playing for local II league football clubs,and Basketball players (n = 15) playing for local minor league basketball teams. All athletes had been regularly engaged in their sport for at least three years. Inactive healthy volunteers (n = 20) of similar age served as controls. Routine transthoracic echocardiographic examinations to measure end-diastolic LV dimensions were performed by cardiology fellow under the supervision of a fully licensed cardiologist. Statistical analyses were performed using the SPSS 20.0 software. The value of p < 0,05 was considered as statistically significant. Results No structural or functional pathologies were evident during the echocardiographic examination in any of the subjects. Absolute interventricular septum (IVS) thickness and LV posterior wall thickness, but not LV diameter, were higher in athletes than in inactive controls (P < 0,001). Indexed LV diameter was higher in football players as compared with non-athlete controls and basketball players (P < 0,05). Left ventricular mass of all athletes were higher as compared with controls (p < 0.001). Relative wall thickness was not increased in football players but was higher in basketball players as compared with controls (p < 0.05). Conclusion Cardiac remodeling in Lithuanian football players resulted in left ventricle eccentric hypertrophy due to the LV dilation, increased LV mass and relatively normal relative wall thickness. However in Lithuanian basketball players we noticed an increase in both relative wall thickness and LV mass resulting in LV concentric hypertrophy. Echocardiographic characteristics Groups n End-diastolic LV diameter(mm) End-diastolic Interventricular septum (mm) End-diastolic LV posterior wall LV mass Football Players 15 56.9 10.8 10.8 242 Basketball players 15 53.6 11.5 11.3 254 Inactive individuals 20 53.2 9.1 9.5 182 P value 0.01 <0.001 <0.001 <0.01 Abstract P955 Figure.

scholarly journals Basic values of M-mode echocardiographic parameters of the left ventricle in outbreed Wistar rats

2012 ◽  
Vol 57 (No. 1) ◽  
pp. 42-52 ◽  
Author(s):  
P. Scheer ◽  
V. Sverakova ◽  
J. Doubek ◽  
K. Janeckova ◽  
I. Uhrikova ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Wistar Rats ◽  
Minimum Weight ◽  
Interventricular Septum ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Regression Equations ◽  
Left Ventricular Dimension ◽  
Echocardiographic Parameters ◽  
Ventricular Dimension

This paper describes the partial results of an echocardiographic study in sixty outbreed Wistar rats. Animals of parity sex ratio were chosen for the experiment. The animals were grown up during the observation period (the minimum weight was 220 g; the maximum weight was 909 g) and were then sequentially anaesthetised (2&ndash;2.5% of isoflurane, 3 l/min O<sub>2</sub>). The second, fourth and fifth examinations were performed under anaesthesia maintained by intramuscular injections with diazepam (2 mg/kg), xylazine (5 mg/kg) and ketamine (35 mg/kg). Transthoracal examination was done using the SonoSite Titan echo system (SonoSite Ltd.) with a microconvex transducer C11 (8&ndash;5 MHz). M-mode (according to the leading-edge method of American Society of Echocardiography) echocardiography data were acquired at the papillary muscle: systolic and diastolic interventricular septum (IVSs, d) and left vetricular posterior wall (LVPWs, d) thickness, systolic and diastolic left ventricular dimension (LVDs, d), aorta (Ao) and left atrium (LA) dimensions. According to standard formulas, the following parameters were obtained: ejection fraction (EF), cardiac output (CO), stroke volume (SV), left ventricle end systolic volume (LVESV), left ventricle end diastolic volume (LVEDV), interventricular septum fractional thickening (IVSFT), left ventricular dimension fraction shortening (LVDFS), and left ventricle posterior wall fraction thickening (LVPWFS). In our study we performed 300 examinations both in male and female Wistar rats of various body weights and calculated regression equations to predict expected normal echocardiographic parameters for rats with arbitrary weights. The rats were examined by an echo scan. The first and third examinations were performed during mono-anaesthesia induced by inhalation of isoflurane. Correlations, with one exception (LVDs), were very close, which means that the results of the calculations based on regression equations are very reliable. &nbsp; &nbsp;

scholarly journals 1186 Three-dimensional analysis of right ventricle strain in transplanted hearts and rejection: an ongoing prospective study

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
RCPLD Costa ◽  
A C T Rodrigues ◽  
C H Fischer ◽  
E B Lira-Filho ◽  
C G Monaco ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Right Ventricle ◽  
Heart Transplantation ◽  
Three Dimensional ◽  
Posterior Wall ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Free Wall ◽  
Humoral Rejection ◽  
Cellular Rejection

Abstract Background The main obstacle for success after heart transplantation is graft rejection, since is mainly asymptomatic and diagnosed by endomyocardial biopsy (EMB). New echocardiographic technologies could bring benefits to that population if subtle changes in heart mechanics were related to an incipient state of rejection. Purpose To quantify echocardiographic parameters of right ventricle strain and volumes by a semi-automated offline software and to identify the presence of any relation between those findings and the histopathologic diagnose of rejection. Methods a prospective cohort of 35 postoperative heart transplant patients who were submitted to echocardiographic evaluation up to six hours after EMB, including two-dimensional chamber quantification of left ventricular (LV) volumes and ejection fraction; conventional and tissue Doppler measurements were used for flow and functional analysis. Offline assessment of the right ventricle (RV) was made by TOMTEC software, with the acquisition of RV volumes (EDV, ESV, SV) and ejection fraction, TAPSE, FAC and three-dimensional(3D) RV free wall and septal strain using speckle tracking. EMB results were classified as positive for cellular rejection if graded as 2R (two or more interstitial infiltrate spots and myocyte damage) and positive for humoral rejection if they show any response by immunofluorescence assay. Results We studied 35 patients, aged 50 ±11, 21 male (67%), totaling 58 examinations, and then we made two analysis of EMB: one in two groups regarding cellular rejection (53 negative and 5 positive) and other regarding humoral rejection (50 negative and 8 positive). RVEDV was higher in the cellular rejection group (112,5 ± 29,6 ml) compared to those with negative biopsy (86,8 ± 24,7 mL; p = 0,01). RV stroke volume showed a similar behavior (53,5 ± 22,3 mL vs. 34,5 ± 11,3 mL; p &lt; 0,01). Regarding humoral rejection by immunofluorescence, patients who tested positive showed lower RVEDV (79,5 ± 10,5 mL vs. 90,57 ± 27,31 mL; p = 0,02) and RVESV (45,53 ± 6,33 mL vs. 53,87 ± 19,87 mL; p = 0,01). RV free wall strain was lower in the group with positive immunofluorescence (-18,35 ± 2,79% vs. -15,34 ± 5,35%; p = 0,01). Regarding 2D measurements , interventricular septal (11,5 ± 1,06 mm vs. 10,56 ± 1,38 mm; p = 0,02) and left ventricular posterior wall (10,75 ± 1,03 mm vs. 10,04 ± 1,1 mm; p = 0,05) were also thicker in the group with positive immunofluorescence for rejection. Conclusion Both cellular and humoral rejection after heart transplantation are associated to increased 3D RV volumes whereas a decrease in RV free wall strain is only observed in humoral rejection; in patients with positive immunofluorescence results a significant increase is seen for septal and posterior wall thickness.

Origin of regional pressure gradients in the left ventricle during early diastole

1995 ◽  
Vol 268 (2) ◽  
pp. H550-H557 ◽  
Author(s):  
S. D. Nikolic ◽  
M. P. Feneley ◽  
O. E. Pajaro ◽  
J. S. Rankin ◽  
E. L. Yellin
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Dynamic Geometry ◽  
Major Axis ◽  
Left Ventricular ◽  
Elastic Recoil ◽  
Systolic Volume ◽  
Early Diastole ◽  
Shape Changes ◽  
Isovolumic Relaxation

Left ventricular (LV) pressure (P)-diameter, LVP-area, or LVP-volume relationships used to evaluate LV diastolic function assume uniform LV wall motion and constant LVP. Contrary to these assumptions, there are significant differences in ventricular dynamic geometry and in LV pressures measured simultaneously in different parts of the LV, particularly during early diastole. We instrumented six anesthetized open-chest dogs with three pairs of orthogonal ultrasonic crystals (anterior-posterior and septal-free wall minor axes, and base-apex major axis) and two micromanometers (in the apex and in the LV base). The mitral valve occluder was implanted during standard cardiopulmonary bypass in the mitral annulus. Data were recorded during 11 transient vena caval occlusions. The mitral valve was occluded for 1 beat every 6–8 beats during each vena caval occlusion to produce nonfilling diastole. With the decrease of the LV end-systolic volume (Ves) below the equilibrium volume Veq (volume of the completely relaxed LV at LVP = 0); the minimum negative LVP in nonfilling beats increases, the shape of the ventricle is more ellipsoidal in both filling and nonfilling beats, and the base-to-apex pressure gradient at the time of LVP minimum increases regardless of the presence or absence of filling. Thus heterogeneous myocardial stresses during isovolumic relaxation and early diastole result in ventricular shape changes, intraventricular redistribution of chamber volume, local accelerations of blood, and associated intraventricular LVP gradients. The role of elastic recoil assumes greater importance at Ves smaller than Veq, when the left ventricle becomes more ellipsoidal in shape during isovolumic relaxation, leading, in turn, to greater shape changes and greater LVP gradient.

scholarly journals Dynamic three-dimensional imaging of the mitral valve and left ventricle by rapid sonomicrometry array localization

1996 ◽  
Vol 112 (3) ◽  
pp. 712-724 ◽  
Author(s):  
Joseph H. Gorman ◽  
Krishanu B. Gupta ◽  
James T. Streicher ◽  
Robert C. Gorman ◽  
Benjamin M. Jackson ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Three Dimensional ◽  
Three Dimensional Imaging

Echocardiographic factors discriminating biventricular versus univentricular approach in the foetus with borderline left ventricle

2014 ◽  
Vol 25 (5) ◽  
pp. 941-950 ◽  
Author(s):  
David W. Jantzen ◽  
Sarah K. Gelehrter ◽  
Sunkyung Yu ◽  
Janet E. Donohue ◽  
Carlen G. Fifer
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Single Ventricle ◽  
Left Ventricular ◽  
Z Score ◽  
Biventricular Repair ◽  
Z Scores ◽  
Valve Annulus ◽  
Single Ventricle Palliation ◽  
Dimension Ratio

AbstractBackground: The term “borderline left ventricle” describes a small left heart that may be inadequate to provide systemic cardiac output and implies the potential need for a single-ventricle palliation. The aim of this study was to identify foetal echocardiographic features that help discriminate which infants will undergo single-ventricle palliation versus biventricular repair to aid in prenatal counselling. Methods: The foetal database at our institution was searched to identify all foetuses with borderline left ventricle, as determined subjectively by a foetal cardiologist, from 2000 to 2011. The foetal images were retrospectively analysed for morphologic and physiologic features to determine which best predicted the postnatal surgical choice. Results: Of 39 foetuses identified with borderline left ventricle, 15 were planned for a univentricular approach, and 24 were planned for a biventricular approach. There were significant differences between the two outcome groups in the Z-scores of the mitral valve annulus, left ventricular end-diastolic dimension, aortic valve annulus, and ascending aorta diameter (p<0.05). With respect to discriminating univentricular outcomes, cut-offs of mitral valve Z-score ⩽−1.9 and tricuspid:mitral valve ratio ⩾1.5 were extremely sensitive (100%), whereas a right:left ventricular end-diastolic dimension ratio ⩾2.1 provided the highest specificity (95.8%). Conclusion: In foetuses with borderline left ventricle, a mitral valve Z-score ⩾−1.9 or a tricuspid:mitral valve ratio ⩽1.5 suggests a high probability of biventricular repair, whereas a right:left ventricular end-diastolic dimension ratio ⩾2.1 confers a likelihood of single-ventricle palliation.

Differences in distensibility between the anterior and posterior walls of the left ventricle in dogs

1991 ◽  
Vol 69 (3) ◽  
pp. 334-340
Author(s):  
Zhao-Nian Zhou ◽  
Sheng-Jing Dong ◽  
Eldon R. Smith ◽  
John V. Tyberg
Keyword(s):  
Left Ventricle ◽  
Length Change ◽  
Posterior Wall ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Transmural Pressure ◽  
Segment Length ◽  
Anesthetized Dogs ◽  
Pericardial Pressure ◽  
The Difference

Nonuniformity of myocardial systolic and diastolic performance in the normal left ventricle has been recognized by a number of investigators. Lack of homogeneity in diastolic properties might be caused by or related to differences in the distensibility of different regions of the left ventricular (LV) wall. Thus, we compared the end-diastolic transmural pressure–strain relations in both the anterior and posterior LV walls in seven anesthetized dogs during two interventions (pulmonary artery constriction and aortic constriction). Transmural pressure was defined as the difference between LV intracavitary pressure and local pericardial pressure. LV pressure was measured using a micromanometer; pericardial pressures over the LV anterior and posterior wails were measured with balloon transducers. Circumferentially oriented pairs of sonomicrometer crystals were implanted in the midwall of the anterior and posterior walls of the LV to measure segment lengths. Strains were calculated as (L – L0)/L0, where L was the instantaneous segment length and L0 was the segment length when transmural pressure was zero. The pattern of end-diastolic transmural pressure–strain relations was similar in ail dogs. The change in strain in the posterior wall was always greater than that in the anterior wall. Opening the pericardium did not affect the difference in distensibility of the anterior and posterior walls. The results suggest that the posterior wall is more compliant than the anterior wall (that is, for a given difference in transmural pressure, the local segment length change of the posterior wall was greater). This seems consistent with other observations, which suggest that the posterior wall might make a greater contribution to diastolic filling.Key words: regional ventricular function, diastolic suction, elastic properties.

scholarly journals Early Left Ventricular Systolic and Diastolic Dysfunction in Patients with Newly Diagnosed Obstructive Sleep Apnoea and Normal Left Ventricular Ejection Fraction

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Lisulov Popovic Danica ◽  
Mirjana Krotin ◽  
Marija Zdravkovic ◽  
Ivan Soldatovic ◽  
Darko Zdravkovic ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Lv Function ◽  
Newly Diagnosed ◽  
Mitral Flow ◽  
Obstructive Sleep

The aim of the study was to evaluate whether obstructive sleep apnea (OSA) contributes directly to left ventricular (LV) diastolic and regional systolic dysfunction in newly diagnosed OSA with normal left ventricle ejection fraction.Methods. 125 consecutive patients were prospectively enrolled in the study. Control group consisted of 78 asymptomatic age-matched healthy subjects who did not have any cardiovascular and respiratory diseases. All patients had undergone overnight polysomnography and standard transthoracic and tissue Doppler imaging echocardiogram.Results. TheE/Aratio and the peakEwave at mitral flow were significantly lower and the peakAwave at mitral flow was significantly higher in OSA patients compared with control subjects. Left ventricle isovolumetric relaxation time (IVRT) and mitral valve flow propagation (MVFP) were significantly longer in OSA patients than in controls. Tissue Doppler derivedS′amplitude of lateral part at mitral valve (S′Lm) andE′wave amplitudes both at the lateral (E′Lm) and septal parts of the mitral valve (E′Sm) were significantly lower in OSA patients compared to controls.Conclusion. Newly diagnosed OSA patients with normal global LV function have significantly impaired diastolic function and regional longitudinal systolic function. OSA is independently associated with these changes in LV function.

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