Hemodynamic effects of myocardial bridging in patients with hypertrophic cardiomyopathy

Myocardial bridging (MB) is linked to angina and myocardial ischemia and may lead to sudden cardiac death in patients with hypertrophic cardiomyopathy (HCM). However, it remains unclear how MB affect the coronary blood flow in HCM patients. The aim of this study was to assess the effects of MB on coronary hemodynamics in HCM patients. Fifteen patients with MB (7 HCM and 8 non-HCM controls) in their left anterior descending (LAD) coronary artery were chosen. Transient computational fluid dynamics (CFD) simulations were conducted in anatomically realistic models of diseased (with MB) and virtually healthy (without MB) LAD from these patients, reconstructed from biplane angiograms. Our CFD simulation results demonstrated that dynamic compression of MB led to diastolic flow disturbances and could significantly reduce the coronary flow in HCM patients as compared with non-HCM group ( P < 0.01). The pressure drop coefficient was remarkably higher ( P < 0.05) in HCM patients. The flow rate change is strongly correlated with both upstream Reynolds number and MB compression ratio, while the MB length has less impact on coronary flow. The hemodynamic results and clinical outcomes revealed that HCM patients with an MB compression ratio higher than 65% required a surgical intervention. In conclusion, the transient MB compression can significantly alter the diastolic flow pattern and wall shear stress distribution in HCM patients. HCM patients with severe MB may need a surgical intervention. NEW & NOTEWORTHY In this study, the hemodynamic significance of myocardial bridging (MB) in patients with hypertrophic cardiomyopathy (HCM) was investigated to provide valuable information for surgical decision-making. Our results illustrated that the transient MB compression led to complex flow patterns, which can significantly alter the diastolic flow and wall shear stress distribution. The hemodynamic results and clinical outcomes demonstrated that patients with HCM and an MB compression ratio higher than 65% required a surgical intervention.

Comparisons of Flow Patterns over a Hierarchical and a Non-hierarchical Surface in Relation to Biofouling Control

Biofouling can be defined as unwanted deposition and development of organisms on submerged surfaces. It is a major problem as it causes water contamination, infrastructures damage and increase in maintenance and operational cost especially in the shipping industry. There are a few methods that can prevent this problem. One of the most effective methods which is using chemicals particularly Tributyltin has been banned due to adverse effects on the environment. One of the non-toxic methods found to be effective is surface modification which involves altering the surface topography so that it becomes a low-fouling or a non-stick surface to biofouling organisms. Current literature suggested that non-hierarchical topographies has lower antifouling performance compared to hierarchical topographies. It is still unclear if the effects of the flow on these topographies could have aided in their antifouling properties. This research will use Computational Fluid Dynamics (CFD) simulations to study the flow on these two topographies which also involves comparison study of the topographies used. According to the results obtained, it is shown that hierarchical topography has higher antifouling performance compared to non-hierarchical topography. This is because the fluid characteristics at the hierarchical topography is more favorable in controlling biofouling. In addition, hierarchical topography has higher wall shear stress distribution compared to non-hierarchical topography