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Biomedical subjects

D N Ku

Publications and source records attributed to D N Ku.

At least 37 records · Page 2Linked to original sources
PubMed1996

Pulsatile flow in the human left coronary artery bifurcation: average conditions.

The localization of atherosclerosis in the coronary arteries may be governed by local hemodynamic features. In this study, the pulsatile hemodynamics of the left coronary artery bifurcation was numerically simulated using the spectral element method for realistic in vivo anatomic and physiologic conditions. The velocity profiles were found to be skewed in both the left anterior descending and the circumflex coronary arteries. Velocity skewing arose from the bifurcation as well as from the curvature of the artery over the myocardial surface. Arterial wall shear stress was significantly lower in the bifurcation region, including the side walls. The greatest oscillatory behavior was localized to the outer wall of the circumflex artery. The time-averaged mean wall shear stress varied from about 3 to 98 dynes/cm2 in the left coronary artery system. The highly localized distribution of low and oscillatory shear stress along the walls strongly correlates with the focal locations of atheroma in the human left coronary artery.

Blood Flow Velocity↗
PubMed1996

The accuracy of magnetic resonance phase velocity measurements in stenotic flow.

Nuclear magnetic resonance (MR) can be used to measure velocities in fluid flow using the technique of phase velocity mapping. Advantages of MR velocimetry include the simultaneous mapping of the entire flow field through a non-contacting, magnetic window. The phase velocity mapping technique assumes that velocity is constant over the measurement time (typically around 10 ms). For many fluid flows, this assumption is not valid. The current study showed that MR phase velocity measurements of velocity through stenotic flow can be in error by over 100% immediately upstream and downstream of the stenosis throat and by 20% far downstream of the throat in comparison with laser Doppler anemometer measurements taken at the same location. Highly turbulent flow also led to significant errors in velocity measurement. These errors can be attributed to several sources including low signal-to-noise ratio, additional phase shifts due to non-constant velocities, and non-stationary transit-time effects. Velocity measurement errors could be reduced to under 30% at all measurement locations through the use of MR sequences with high signal-to-noise ratios, low echo times, and thick slices.

Arterial Occlusive Diseases↗
PubMed1995

Turbulent fluctuation velocity: the most significant determinant of signal loss in stenotic vessels.

Studies of flow in a 90%-stenosis phantom were conducted to elucidate the parameters and mechanisms responsible for signal loss in MR angiographic images. The studies independently evaluated the effect of velocity, Reynolds number, turbulent fluctuation velocity, and turbulence intensity on the amount of post-stenotic signal loss. Results suggested that the magnitude of the turbulent fluctuation velocity, not merely the presence of turbulence or the intensity of turbulence, was the parameter that determined the extent of the signal loss. The study suggests that future flow phantom studies should be conducted with fluids having physiologic velocities and viscosities to obtain accurate levels of turbulent fluctuation velocities and hence reproduce results of in-vivo signal-loss patterns. The mechanism for signal loss is that the temporal and spatial variations of the turbulent fluctuation velocity cause a range of phases to be present within a voxel. Examination of the theoretical aspects of fluid turbulence suggest that shortening gradient durations and imaging during diastole may help reduce signal loss.

Blood Flow Velocity↗
PubMed1994

Fluid wall shear stress measurements in a model of the human abdominal aorta: oscillatory behavior and relationship to atherosclerosis.

Clinically significant atherosclerosis in the human aorta is most common in the infrarenal segment. This study was initiated to test the hypothesis that flowfield properties are closely related to the localization of plaques in this segment of the arterial system. Wall shear stress was calculated from magnetic resonance velocity measurements of pulsatile flow in an anatomically accurate model of the human abdominal aorta. The wall shear stress values were compared with intimal thickening from 15 post-mortem aortas measured by quantitative morphometry of histological cross sections obtained at standard locations. Wall shear stress oscillated in direction throughout most of the infrarenal aorta, most prominently in the distal region. The time-averaged mean wall shear stress (-1.7 to 1.4 dyn/cm2) was lowest near the posterior wall in this region. These hemodynamic parameters coincided with the locations of maximal intimal thickening. Statistical correlation between oscillatory shear and intimal thickness yielded r = 0.79, P < 0.00001. Low mean shear stresses correlated nearly as well (r = -0.75, P < 0.00005). Comparison of our data with surface maps of Sudan Red staining and early lesions as reported by others revealed similar conclusions. In contrast, pulse and maximum shear stresses did not correlate with plaque localization as has been shown for other sites of selective involvement by atherosclerosis (r < 0.345). Simulated exercise conditions markedly changed the magnitude and pattern of wall shear stress in the distal abdominal aorta. These results demonstrate that in the infrarenal aorta, regions of low mean and oscillating wall shear stresses are predisposed to the development of plaque while regions of relatively high wall shear stress tend to be spared.

Adult↗
PubMed1994

Pulsatile velocity measurements in a model of the human abdominal aorta under simulated exercise and postprandial conditions.

This study examines the hemodynamics of the abdominal aorta during physiological changes in flow rates and pulse rate that occur under exercise and postprandial conditions. Hemodynamic measurements were performed using an in vitro model which took into account seven major branches, the curvature, and the pulsatile nature of blood flow of the abdominal aorta. Magnetic Resonance Imaging velocimetry employing phase-velocity encoding was used to measure the pulsatile axial velocity profiles for the entire cross-section at three axial locations. Under simulated exercise conditions, the forward velocities were approximately double those seen during rest, and the flow reversal seen for resting conditions was greatly reduced. Near the posterior wall of the infrarenal aorta, the velocities were negative for only 21 percent of the cardiac cycle as compared with 82 percent for resting conditions. Postprandial conditions produced a 25 percent reduction in peak velocity and a 33 percent reduction in mean velocity near the left anterior wall of the aorta just distal to the superior mesenteric artery (in comparison with resting conditions). The changes that can occur in abdominal aorta hemodynamics under different physiologic conditions may affect the rate of progression of atherosclerosis at this site.

Aorta, Abdominal↗
PubMed1994

Pulsatile velocity measurements in a model of the human abdominal aorta under resting conditions.

Oscillations in near-wall velocity direction have been found to correlate with atherosclerotic plaque localization in the carotid sinus bifurcation. However, it remains unproven whether these conditions could account for the localization of the disease at other sites where atherosclerosis forms. The abdominal aorta is an important site of clinical disease in a relatively straight segment of artery. This study was initiated to quantify the velocity field in the abdominal aorta in order to determine if local differences in hemodynamic velocity directions could account for the localization of disease in this segment. Magnetic Resonance Imaging velocimetry was used to measure the pulsatile velocity profiles in an anatomically accurate in vitro model of the abdominal aorta. Velocities measured in the suprarenal aorta were laminar and reversed minimally, comparing well with theoretical solutions of Womersley flow (r = 0.96). The time-averaged velocity was +3.0 cm/s near-wall at a distance of 1 mm away from the wall. In the infrarenal aorta, the maximal velocities were skewed toward the anterior wall. At the posterior wall, velocity oscillated in direction and was retrograde for 82 percent of the cardiac cycle. The time-averaged velocity near the posterior wall was -12.5 cm/s as compared to +3.00 cm/s near the anterior wall. At the aortic bifurcation, the locations of maximal and minimal velocities in this slice were concentrated near the lateral posterior walls. This study quantifies the magnitude of low and oscillatory velocity that may exist in the abdominal aorta and suggests that there is a strong relationship between the velocities in the retrograde direction under resting conditions and the distribution of atherosclerotic plaque.

Aorta, Abdominal↗
PubMed1994

Unsteady entrance flow development in a straight tube.

The entrance conditions for pulsatile flow are important in the understanding blood flow out of the heart and in developing regions at branches. The pulsatile entrance flow was solved using a spectral element simulation of the full unsteady Navier-Stokes equations. A mean Reynolds number of 200 and a range of Womersley parameters from 1.8 to 12.5 was used for a sinusoidal inlet flow waveform 1 + sin (omega t). Variations in the entrance length were observed during the pulsatile cycle. The amplitude of the entrance length variation decreased with an increase in the Womersley parameter. The phase lag between the entrance length and the inlet flow waveform increased for Womersley parameter alpha up to 5.0 and decreased for alpha larger than 5.0. For low alpha, the maximum entrance length during pulsatile flow was approximately the same as the steady entrance length for the peak flow. For high varies; is directly proportional to, the pulsatile entrance length was more uniform during the cycle and tended to the entrance length for the mean flow. The wall shear rate reached its far downstream value after only about half of the entrance length and also exhibited a dependence on alpha. The results quantify the entrance conditions typically encountered in studies of the arterial system.

Evaluation Studies as Topic↗
PubMed1994

A scaling law for wall shear rate through an arterial stenosis.

Atherosclerosis of the human arterial system produces major clinical symptoms when the plaque advances to create a high-grade stenosis. The hemodynamic shear rates produced in high-grade stenoses are important in the understanding of atheromatous plaque rupture and thrombosis. This study was designed to quantify the physiologic stress levels experienced by endothelial cells and platelets in the region of vascular stenoses. The steady hemodynamic flow field was solved for stenoses with percent area reductions of 50, 75, and 90 percent over a range of physiologic Reynolds numbers (100-400). The maximum wall shear rate in the throat region can be shown to vary by the square root of the Reynolds number. The shear rate results can be generalized to apply to a range of stenosis lengths and flow rates. Using dimensions typical for a human carotid or coronary artery, wall shear rates were found to vary from a maximum of 20,000 s-1 upstream of the throat to a minimum of -630 s-1 in the recirculation zone for a 90 percent stenosis. An example is given which illustrates how these values can be used to understand the relationship between hemodynamic shear and platelet deposition.

Arteriosclerosis↗
PubMed1994

Hemodynamics in the abdominal aorta: a comparison of in vitro and in vivo measurements.

In vivo measurements of blood velocity profiles are difficult to obtain and interpret, since the parameters that govern the normally highly complex flow situation may not be fully quantified or understood at the time of measurement. In vitro flow models have been used often to better understand vascular hemodynamics. The assumptions made in the design of these models limit the applicability of the results. In this study, in vitro flow measurements made in a carefully designed model of the abdominal aorta were compared with in vivo measurements obtained with magnetic resonance imaging. In the suprarenal aorta, the velocity profiles were mostly forward and axisymmetric in both the in vitro and in vivo cases. In the infrarenal aorta, there was extensive flow reversal noted near the posterior wall in both cases. In the aortic bifurcation, two peaks of flow reversal were noted near the lateral posterior walls, and M-shaped velocity profiles were observed in late diastole. The in vitro and in vivo measurements exhibited good qualitative agreement. The in vitro model was accurate in modeling the in vivo hemodynamics of the abdominal aorta. The complex phenomena observed in vivo were explained on the basis of knowledge gained from the in vitro study.

Adult↗
PubMed1993

Collapse of diseased arteries with eccentric cross section.

The mechanism of atherosclerotic plaque rupture is not fully understood. Mechanical stress may be one of the factors contributing to the instability of the fibrous plaque cap. The existence of a severe stenosis may lower the transmural pressure enough to cause the collapse of arteries leading to high concentrated compressive and tensile stresses. This study presents quantitative estimates of the stresses and deformations in the collapsed thick-walled artery. The results of large deformation finite element calculations identify the locations of the high stress concentrations and their magnitudes which cannot be precisely predicted under a thin-wall assumption. The maximum compressive stress calculated reached 80% of the Young's modulus for fairly small negative transmural pressures. Results are useful to predict likely locations of the plaque cap rupture due to compressive stresses. The tube law of area as a function of transmural pressure showed a large discrepancy from a thin-wall calculation. The buckling pressure calculated for the outer-to-inner wall surface radius ratio of 1.60 was nearly 30% lower than that of the elastic thin-wall buckling theory. An increase in eccentricity further reduced this buckling pressure. The results indicate that a thick plaque which is eccentric increases the likelihood of collapse of stenotic arteries.

Arteries↗
PubMed1992

Pulsatile flow visualization in the abdominal aorta under differing physiologic conditions: implications for increased susceptibility to atherosclerosis.

The infrarenal abdominal aorta is a common site for clinically significant atherosclerosis. As has been shown in other susceptible locations, vessel geometry, flow division rates, and pulsatility may result in hemodynamic conditions which influence the preferential localization of disease in the abdominal aorta segment. Pulsatile flow visualization was performed in a glass model of the aorta constructed from measurements of angiograms and cadaver aortas. Flow rates and pulsatile waveforms were varied to reflect typical physiological conditions. Under normal resting conditions, the flow patterns in the infrarenal aorta were more complex than those in the suprarenal location. Time varying vortex patterns appeared at the level of the renal arteries and propagated through the infrarenal aorta into the common iliac arteries. A region of oscillating velocity direction extended from the renal arteries to the aortic bifurcation along the posterior wall. Dye became trapped along the posterior wall, requiring several cardiac cycles for clearance. In contrast, there was rapid clearance of the dye in the anterior aorta. Under postprandial conditions, the flow patterns in the aorta were basically unchanged. Simulated exercise conditions created laminar hemodynamic features very different from the resting conditions, including a decrease in dye residence time. This study reveals significant time-dependent variations in the hemodynamics of the abdominal aorta under differing physiologic conditions. Hemodynamic factors such as low wall shear stress, oscillating shear direction, and high particle residence time may be related to the clinically seen preferential plaque localization in the infrarenal aorta.

Angiography↗
PubMed1991

Accuracy of velocity and shear rate measurements using pulsed Doppler ultrasound: a comparison of signal analysis techniques.

An experimental investigation was instituted to evaluate the performance of Doppler ultrasound signal processing techniques for measuring fluid velocity under well-defined flow conditions using a 10-MHz multigated pulsed ultrasound instrument. Conditions of fully developed flow in a rigid, circular tube were varied over a Reynolds number range between 500 and 8000. The velocity across the tube was determined using analog and digital zero crossing detectors and three digital spectrum estimators. Determination of the Doppler frequency from analog or digital zero crossing detectors gave accurate velocity values for laminar and moderately turbulent flow away from the wall (0.969 less than or equal to r less than or equal to 0.986). Three digital spectrum estimators, Fast Fourier Transform, Burg autoregressive method, and minimum variance method, were slightly more accurate than the zero crossing detector (0.984 less than or equal to r less than or equal to 0.994), especially at points close to the walls and with higher levels of turbulence. Steep velocity gradients and transit-time-effects from high velocities produced significantly larger errors in velocity measurement. Wall shear rate estimates were most precise when calculated using the position of the wall and two velocity points. The calculated wall shears were within 20%-30% of theoretically predicted values.

Blood Flow Velocity↗
PubMed1991

Hemodynamic consequences of carotid-carotid bypass for innominate artery stenosis.

The carotid-carotid cervical bypass is one surgical option for symptomatic atherosclerotic lesions of the innominate artery. Controversy exists regarding the necessity of surgically excluding the innominate plaque from the cerebral circuit. A canine study was instituted to characterize the hemodynamic alterations that occur in the right common carotid artery proximal to the bypass graft, termed the critical segment. The direction of flow in the critical segment determines whether emboli originating in the innominate may be propelled cranially despite a patent bypass graft. Six mongrel dogs underwent placement of an autogenous arterial crossover graft as a carotid-carotid bypass. A stenosis of the innominate artery was quantitatively altered, and an electromagnetic flowmeter measured the magnitude and direction of flow in the critical segment at three levels of diameter reduction in the innominate artery. For low-grade stenoses, flow in the critical segment was always prograde. For high-grade stenoses, the flow was always reversed. Stenoses between 57% and 67% yielded flow values of 10 +/- 24 ml/min, and it was in this range that mean flow reversal was found to occur. Even when the mean flow was near zero in the critical segment, flow was not stagnant but oscillated in antegrade and retrograde directions throughout the cardiac cycle. These data indicate that a carotid-carotid bypass causes complete flow reversal in the critical segment when there is high-grade stenosis in the innominate artery. Theoretical analysis of the hemodynamic circuit indicated that arm exercise would augment retrograde flow in the critical segment.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

A kinematic study of the oropharyngeal swallowing of a liquid.

Swallowing can become a problem for people with advanced age or laryngeal cancer, especially after surgical resection. The purpose of this study was to quantify the mechanical transport of the bolus through the throat by simultaneously comparing the instantaneous position and velocity of the bolus to the generation of pressure at different sites in the oropharyngeal cavity. Swallows of barium liquid were analyzed using Manofluorography, which simultaneously recorded pressure and barium position through a split screen display. Frame-by-frame analysis was used to describe bolus motion. The graph of head and tail movement showed an hourglass shape with an initial slow, then rapid movement of the bolus head. The peak bolus head velocity averaged 47 cm/s and the maximum acceleration was 460 cm/s2. Comparison of pressure traces with the kinematic curves revealed the relative timings of tongue movement, negative suction pressure from the pharyngoesophageal segment and the contraction wave. The magnitude of the gravity and resistance forces were estimated and relative strengths compared. The pharynx can be viewed as a dynamic conduit with changing diameters. The tongue driving force initially drove the bolus. Laryngeal elevation and the pharyngoesophageal segment developed a prebolus negative suction pressure ahead of the bolus. For vertical swallowing of the barium liquid, gravity played the dominant role in head transport. Contraction of the pharyngeal walls served to clear the tail of the bolus from the pharynx. These results aid in the understanding of the physiology of normal swallowing and provide quantitative data for the evaluation of oropharyngeal reconstruction.

Biomechanical Phenomena↗
PubMed1990

One-dimensional steady inviscid flow through a stenotic collapsible tube.

A one-dimensional inviscid solution for flow through a compliant tube with a stenosis is presented. The model is used to represent an artery with an atherosclerotic plaque and to investigate a range of conditions for which arterial collapse may occur. The coupled equations for flow through collapsible tubes are solved using a Runge-Kutta finite difference scheme. Quantitative results are given for specific physiological parameters including inlet and outlet pressure, flow rate, stenosis size, length and stiffness. The results suggest that high-grade stenotic arteries may exhibit collapse with typical physiological pressures. Critical stenoses may cause choking of flow at the throat followed by a transition to supercritical flow with tube collapse downstream. Greater amounts of stenosis produced a linear reduction of flow rate and a shortening of the collapsed region. Changes in stenosis length created proportional changes in the length of collapse. Increasing the stiffness of the stenosis to a value greater than the nominal tube stiffness caused a greater amount of flow limitation and more negative pressures, compared to a stenosis with constant stiffness. These findings assist in understanding the clinical consequences of flow through atherosclerotic arteries.

Animals↗
PubMed1990

Evaluation of magnetic resonance velocimetry for steady flow.

Whole body magnetic resonance (MR) imaging has recently become an important diagnostic tool for cardiovascular diseases. The technique of magnetic resonance phase velocity encoding allows the quantitative measurement of velocity for an arbitrary component direction. A study was initiated to determine the ability and accuracy of MR velocimetry to measure a wide range of flow conditions including flow separation, three-dimensional secondary flow, high velocity gradients, and turbulence. A steady flow system pumped water doped with manganese chloride through a variety of test sections. Images were produced using gradient echo sequences on test sections including a straight tube, a curved tube, a smoothly converging-diverging nozzle, and an orifice. Magnetic resonance measurements of laminar and turbulent flows were depicted as cross-sectional velocity profiles. MR velocity measurements revealed such flow behavior as spatially varying velocity, recirculation and secondary flows over a wide range of conditions. Comparisons made with published experimental laser Doppler anemometry measurements and theoretical calculations for similar flow conditions revealed excellent accuracy and precision levels. The successful measurement of velocity profiles for a variety of flow conditions and geometries indicate that magnetic resonance imaging is an accurate, non-contacting velocimeter.

Aorta, Thoracic↗