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PubMed2000

Reconstruction of blood flow patterns in a human carotid bifurcation: a combined CFD and MRI study.

The carotid bifurcation is a common site for clinically significant atherosclerosis, and the development of this disease may be influenced by the local hemodynamic environment. It has been shown that vessel geometry and pulsatile flow conditions are the predominant factors that determine the detailed blood flow patterns at the carotid bifurcation. This study was initiated to quantify the velocity profiles and wall shear stress (WSS) distributions in an anatomically true model of the human carotid bifurcation using data acquired from magnetic resonance (MR) imaging scans of an individual subject. A numerical simulation approach combining the image processing and computational fluid dynamics (CFD) techniques was developed. Individual vascular anatomy and pulsatile flow conditions were all incorporated into the computer model. It was found that the geometry of the carotid bifurcation was highly complex, involving helical curvature and out-of-plane branching. These geometrical features resulted in patterns of flow and wall shear stress significantly different from those found in simplified planar carotid bifurcation models. Comparisons between the predicted flow patterns and MR measurement demonstrated good quantitative agreement.

Arteriosclerosis↗
PubMed1979

Aortic input impedance during nitroprusside infusion. A reconsideration of afterload reduction and beneficial action.

Beneficial effects of nitroprusside infusion in heart failure are purportedly a result of decreased afterload through "impedance" reduction. To study the effect of nitroprusside on vascular factors that determine the total load opposing left ventricular ejection, the total aortic input impedance spectrum was examined in 12 patients with heart failure (cardiac index <2.0 liters/min per m(2) and left ventricular end diastolic pressure >20 mm Hg). This input impedance spectrum expresses both mean flow (resistance) and pulsatile flow (compliance and wave reflections) components of vascular load. Aortic root blood flow velocity and pressure were recorded continuously with a catheter-tip electromagnetic velocity probe in addition to left ventricular pressure. Small doses of nitroprusside (9-19 mug/min) altered the total aortic input impedance spectrum as significant (P < 0.05) reductions in both mean and pulsatile components were observed within 60-90 s. With these acute changes in vascular load, left ventricular end diastolic pressure declined (44%) and stroke volume increased (20%, both P < 0.05). Larger nitroprusside doses (20-38 mug/min) caused additional alteration in the aortic input impedance spectrum with further reduction in left ventricular end diastolic pressure and increase in stroke volume but no additional changes in the impedance spectrum or stroke volume occurred with 39-77 mug/min. Improved ventricular function persisted when aortic pressure was restored to control values with simultaneous phenylephrine infusion in three patients. These data indicate that nitroprusside acutely alters both the mean and pulsatile components of vascular load to effect improvement in ventricular function in patients with heart failure. The evidence presented suggests that it may be possible to reduce vascular load and improve ventricular function independent of aortic pressure reduction.

Adult↗
PubMed1995

Accuracy and precision of time-averaged flow as measured by nontriggered 2D phase-contrast MR angiography, a phantom evaluation.

The purpose of this study was to assess the accuracy and precision of time-averaged flow as measured by nontriggered 2D PC. Mono-, bi-, and triphasic flow patterns, modelling waveforms encountered in the human vascular system, were generated by a computer-controlled flow system. Time-averaged flow velocity was measured by conventional 2D cardiac-triggered cine PC and by nontriggered 2D PC for different settings of the excitation flip angle and the velocity sensitivity. Accuracy and precision were determined by repeating the measurements (N = 6) and comparing the results against precisely known calibration values. Measurements revealed waveform-specific deviations between triggered and nontriggered acquisitions that depended on the velocity sensitivity and, more strongly, on the flip angle of the nontriggered experiment. This confirmed the theoretically predicted predominance of amplitude over phase effects. Systematic errors could be reduced by decreasing the flip angle and the velocity sensitivity, although at the expense of signal-to-noise, so that additional signal averaging was required to maintain a specified precision. The attainable accuracy appeared to be acceptable only for waveforms with a relatively low pulsatility index. The study demonstrates the feasibility of accurate and precise nontriggered velocity measurements for weakly pulsatile flow and indicates a route towards improving the reliability for highly pulsatile flow.

Blood Flow Velocity↗
PubMed1980

Use of noninvasive electromagnetic flowmetry in the assessment of peripheral arterial disease.

The need for noninvasive techniques capable of quantitating peripheral arterial insufficiency is becoming increasingly obvious. We have shown the technique of noninvasive elctromagnetic flowmetry to be capable of distinguishing three relatively discrete clinical zones by quantitating the peak pulsatile flow of blood through the thigh and calf. The obtained peak pulsatile flow values were in close agreement with ischemic index values previously reported as grading the degree of ischemia in a patient. In certain patients, the noninvasive electromagnetic flowmeter has yielded information not readily available from Doppler systolic pressure measurements. With the noninvasive technique of electromagnetic flowmetry and Doppler ultrasound, it is possible to confirm and quantitate patient complaints, follow disease progression and document improvement following arterial reconstructive operations. The noninvasive electromagnetic flowmeter has also been shown to be invaluable in the selection of the operative procedure by providing information about arterial run-on, run-in and run-off.

Adult↗
PubMed1990

Model studies of nonsteady flow using magnetic resonance imaging.

A bolus-tracking magnetic resonance imaging (MRI) method has been employed to measure velocity profiles for oscillatory flow with and without a steady flow component as well as pulsatile flow in an axisymmetric tube model. A range of flow conditions within normal physiological limits was tested. The imaged velocity profiles were observed to be generally in accord with theoretical predictions. Instantaneous flow rates calculated from the MR images agreed well with those assessed using an ultrasonic flowmeter. Because MRI is noninvasive and poses few risks to subjects, this technique is potentially useful for studying vascular hemodynamics in vivo.

Blood Flow Velocity↗
PubMed2001

Osteoblasts respond to pulsatile fluid flow with short-term increases in PGE(2) but no change in mineralization.

Although there is no consensus as to the precise nature of the mechanostimulatory signals imparted to the bone cells during remodeling, it has been postulated that deformation-induced fluid flow plays a role in the mechanotransduction pathway. In vitro, osteoblasts respond to fluid shear stress with an increase in PGE(2) production; however, the long-term effects of fluid shear stress on cell proliferation and differentiation have not been examined. The goal of this study was to apply continuous pulsatile fluid shear stresses to osteoblasts and determine whether the initial production of PGE(2) is associated with long-term biochemical changes. The acute response of bone cells to a pulsatile fluid shear stress (0.6 +/- 0.5 Pa, 3.0 Hz) was characterized by a transient fourfold increase in PGE(2) production. After 7 days of static culture (0 dyn/cm(2)) or low (0.06 +/- 0.05 Pa, 0.3 Hz) or high (0.6 +/- 0.5 Pa, 3.0 Hz) levels of pulsatile fluid shear stress, the bone cells responded with an 83% average increase in cell number, but no statistical difference (P > 0.53) between the groups was observed. Alkaline phosphatase activity per cell decreased in the static cultures but not in the low- or high-flow groups. Mineralization was also unaffected by the different levels of applied shear stress. Our results indicate that short-term changes in PGE(2) levels caused by pulsatile fluid flow are not associated with long-term changes in proliferation or mineralization of bone cells.

Animals↗
PubMed1990

Evidence of a possible link between poststenotic dilation and wall shear stress.

The effects of an axisymmetric 65% area reduction stenosis on a pulsatile flow were investigated by use of an in vitro model that permits simultaneous visualization of the flow velocity profiles at seven sites. By use of seven lenses to focus the ultraviolet light from a nitrogen laser, seven thin blue lines were produced in the photochromic solution flowing through the tube. The displacement profiles of the dye traces were photographed, resulting in the acquisition of the velocity profiles. From these traces, the flow pattern was determined, and the wall shear stresses were measured. Turbulence was generated 3.3 to 6.5 tube diameters downstream from the edge of the stenosis, depending on the time in the pulsatile flow cycle. Maximum wall shear stress fluctuations between positive and negative values appeared to lie within 1.6 to 3.3 tube diameters downstream of the stenosis. In several illustrative clinical cases of thoracic outlet arterial compression, the poststenotic dilation was maximum at 2.0 +/- 0.3 vessel diameters downstream. Based on these observations, it is postulated that wall shear stress fluctuations may be important in the development of poststenotic dilation.

Arteries↗
PubMedDate not supplied

Intervillous and spiral artery flows in normal pregnancies between 5 and 10 weeks of amenorrhea using color Doppler ultrasonography.

OBJECTIVE: The aim of our study was to investigate early placental circulation development and spiral and uterine artery flows in normal 1st-trimester pregnancies. METHODS: A prospective study of intervillous and spiral artery flows in 49 normal pregnancies (5-10 weeks of amenorrhea) was performed. Transvaginal color and pulsed-wave Doppler techniques (6-MHz probe) were used as routine ultrasound scanning modalities before pregnancy termination for psychosocial reasons. RESULTS: In all pregnancies, between 5 and 10 weeks, continuous nonpulsatile intervillous flow (mean V(max) 3.55 cm/s) and spiral artery flow (mean peak systolic velocity 16.2 cm/s, mean diastolic index D/S 0.49 +/- 0.089) were detected. In the 47 women in whom the uterine artery flow was measured, the mean peak systolic velocity was 67.5 cm/s, the mean diastolic index was 0.12, and bilateral notching was observed. CONCLUSIONS: In all cases, between 5 and 10 weeks, slow and continuous nonpulsatile intrachorionic flow could be detected, whereas pulsatile flow was detected in spiral arteries. The true nature of this early intervillous circulation remains to be determined.

Adolescent↗
PubMed1990

[Spectral analysis of the arterial pulse during extracorporeal circulation. Experimental study in dogs].

PURPOSE: Spectral analysis of arterial pulse was performed during cardiopulmonary bypass with both pulsatile and continuous flow in order to evaluate the pulse model best suitable to reproduce physiological circulatory conditions. MATERIAL AND METHODS: Ten adult mongrel dogs were submitted to cardiopulmonary bypass with a roller pump for continuous flow and pulsatile flow pump in parallel. The physiological pressure waves, the roller pump waves and the pulsatile pump flow waves were recorded. During the pulsatile flow we varied the ejection period of the pump in relation to the total cycle by 70%, 60%, 50%, 40% and 30%. RESULTS: The roller pump flow showed a bifid wave followed by single peak wave. During spectral analysis we observed three harmonic components of the same amplitude. The using of the pulsatile pump flow proportioned, by spectral analysis, harmonic components whose amplitudes are inversely proportional for ejection/cycle ratio. CONCLUSION: The fundamental component of the pressure wave during the physiological flow, the pulsatile flow, and that of the roller pump stays the same, if the same blood flow is maintained; the pulse of the flow is inversely proportional to the ejection/cycle ratio; the roller pump produces a flow pattern that cannot be described as laminar; the ejection/cycle ratio of 30% seemed ideal for the performance of pulsatile flow perfusion.

Animals↗
PubMed2000

Local anaesthetic techniques and pulsatile ocular blood flow.

AIM: To compare pulsatile ocular blood flow (POBF) and intraocular pressure (IOP) between eyes of patients receiving either peribulbar (with and without balloon compression) or subconjunctival local anaesthesia (LA). METHODS: 30 eyes of 30 patients undergoing cataract surgery by phacoemulsification were investigated in a study of parallel group design. Ten patients had peribulbar LA and 10 minutes compression with a Honan's balloon (group A). A further 10 patients who received peribulbar LA alone (group B) acted as controls for the effects of balloon compression. Ten other patients were given subconjunctival LA (group C). POBF and IOP were measured using a modified Langham pneumatonometer. Three measurements were made in each eye, the first recording immediately before LA, the second 1 minute after, and the third 10 minutes after LA. RESULTS: No significant change in POBF or IOP was recorded in eyes receiving subconjunctival LA. In the peribulbar groups (A and B), there was a drop in median POBF of 252 and 138 microl/min respectively 1 minute after LA, which was statistically significant in both groups (p<0. 01). By 10 minutes, POBF tended to return to baseline levels, but remained significantly reduced in group B (p<0.05). In addition, there was a significant (p<0.05) reduction in IOP (mean drop of 4.82 mm Hg) in group A following peribulbar LA with balloon compression. CONCLUSIONS: POBF was significantly reduced after peribulbar LA but was unchanged after subconjunctival LA. Balloon compression reduced IOP and improved POBF following peribulbar LA. The findings may have clinical implications in patients with compromised ocular circulation or significant glaucomatous optic neuropathy.

Aged↗
PubMed1996

Estimation of increased flow resistance in a narrow catheterized artery--a theoretical model.

The changed flow pattern in a narrow catheterized artery is studied and an estimate of the increased flow resistance is made. The anomalous behaviour of blood in small blood vessels has been taken into account by modelling blood as a Casson fluid possessing some finite yield stress. Both the cases of steady and pulsatile flow situations are studied. The pulsatile flow is analysed by considering the pressure gradient as a periodic function of time with small inertial effects. The resulting quasi-steady non-linear coupled implicit system of differential equations governing the flow are solved using a perturbation analysis, where it is assumed that the Womersley frequently parameter is small (alpha < 1) which is reasonable for physiological situations in small blood vessels as well as in coronary arteries. The effect of pulsatility, catheter radius and yield stress of the fluid on the yield plane locations, velocity distribution, flow rate, shear stress and frictional resistance are investigated. Because of the yield stress theta, two yield surfaces are found to be located in the flow field. Depending on the ration kappa (catheter size/vessel size) ranging from 0.3 to 0.7 (which is widely used in coronary angioplasty procedures), the frictional resistance to flow in large blood vessels, where the effect of yield stress can be neglected (i.e. theta = 0), increases by a factory ranging from 3 to 33. In small blood vessels with the same range of catheter size and an unit pressure gradient, frictional resistance increase was by a factor of 7-21 when theta = 0.05 and 11-294 when theta = 0.1. For small values of kappa and theta, the frictional resistance increased to several hundred times thus implying that the combined effect of increased catheter radius and yield stress is to obstruct the fluid movement considerably.

Animals↗
PubMed2001

Factors influencing blood flow patterns in the human right coronary artery.

Evidence suggests that atherogenesis is linked to local hemodynamic factors such as wall shear stress. We investigated the velocity and wall shear stress patterns within a human right coronary artery (RCA), an important site of atherosclerotic lesion development. Emphasis was placed on evaluating the effect of flow waveform and inlet flow velocity profile on the hemodynamics in the proximal, medial, and distal arterial regions. Using the finite-element method, velocity and wall shear stress patterns in a rigid, anatomically realistic model of a human RCA were computed. Steady flow simulations (ReD=500) were performed with three different inlet velocity profiles; pulsatile flow simulations utilized two different flow waveforms (both with Womersley parameter=1.82, mean ReD=233), as well as two of the three inlet profiles. Velocity profiles showed Dean-like secondary flow features that were remarkably sensitive to the local curvature of the RCA model. Particularly noteworthy was the "rotation" of these Dean-like profiles, which produced large local variations in wall shear stress along the sidewalls of the RCA model. Changes in the inlet velocity profiles did not produce significant changes in the arterial velocity and wall shear stress patterns. Pulsatile flow simulations exhibited remarkably similar cycle-average wall shear stress distributions regardless of waveform and inlet velocity profile. The oscillatory shear index was very small and was attributed to flow reversal in the waveform, rather than separation. Cumulatively, these results illustrate that geometric effects (particularly local three-dimensional curvature) dominate RCA hemodynamics, implying that studies attempting to link hemodynamics with atherogenesis should replicate the patient-specific RCA geometry.

Arteriosclerosis↗
PubMed1999

A new flow model for Doppler ultrasound study of prosthetic heart valves.

BACKGROUND AND AIM OF THE STUDY: Steady and pulsatile flow models used to assess the hydrodynamic aspects of prosthetic heart valves are generally made of Plexiglas and Lucite tubing. They often allow continuous-wave and pulsed-wave Doppler ultrasound velocity measurements to be made parallel to the flow, but cannot be used as such for ultrasound scanning of valve inflow and outflow velocities because of ultrasonic reverberation and refraction by the tubing. The aim of the study was to develop a new flow model which allowed ultrasonic scanning of the prosthetic valve flow for three-dimensional (3D) reconstruction of color Doppler flow distributions. METHODS: The flow model, designed with left ventricular and aortic chambers composed of agar gel which mimics the ultrasound characteristics of biological tissues, was developed and tested for comparative in vitro hydrodynamic and Doppler ultrasonic studies of aortic prosthetic valves. An electromagnetic flowmeter and a pressure monitor provided the flow and pressure signals for the hydrodynamic tests. The Doppler ultrasonic evaluation was performed with an Ultramark 9 HDI ultrasound system and a 3D ultrasound imaging system. The model was designed to enable assessment of prosthetic valve performance by pulsed-wave and continuous-wave Doppler velocity measurements, as well as by 3D color Doppler velocity measurements obtained by ultrasonic scanning of the left ventricle or aortic chamber with an ultrasound probe mounted on a motorized translation assembly. RESULTS: The study results showed that this new flow model can provide 3D color Doppler velocity distributions as well as accurate comparisons of hydrodynamic parameters of mechanical and bioprosthetic heart valves derived from Doppler and catheter measurements, both under steady and pulsatile flow conditions. CONCLUSION: This new flow model can be used to evaluate the usefulness of hydrodynamic parameters for the assessment of prosthetic heart valves using both conventional Doppler echocardiography, as currently used in patients, and 3D color Doppler ultrasonic imaging.

Blood Flow Velocity↗
PubMed2002

Evaluation technique for bileaflet mechanical valves.

BACKGROUND AND AIMS OF THE STUDY: Several techniques were utilized to evaluate the performance of bileaflet mechanical heart valves and improve upon current valve designs. METHODS: Particle image velocimetry (PIV), computational fluid dynamics (CFD) and video analysis were used to evaluate St. Jude Medical (SJM) and ATS valves in an abrupt enlargement outlet chamber. Video analysis and PIV provided information on the opening angle of the leaflets and 2D velocity fields. PAM-FLOW CFD software was used to predict flow through the valves with leaflets in the fully open position, which corresponds to steady flow conditions in the experimental study. The ATS valve was also modeled at its reported incomplete leaflet opening angle, and with an orifice modification. Additional CFD techniques were employed to find the natural opening angle of the ATS valve. RESULTS: In steady and pulsatile flow, the SJM leaflets opened completely. PIV showed three fairly uniform jets passing through the SJM valve. CFD analysis of the pressure distribution across the SJM valve showed a resultant moment in the open direction, indicating that the leaflets were held against the open stops at 85 degrees. In both steady and pulsatile flow, the leaflets in the ATS valve did not open to the designed opening angle. From video analysis, the ATS leaflet opening angle was estimated at 72-76 degrees. PIV showed that the incomplete opening angle of the ATS leaflets produced a large wake region behind the leaflets, and lateral jets that impinged on the side walls of the test chamber. CFD analysis showed a pressure distribution across the ATS valve which produced a moment causing the leaflets not to open to 85 degrees. The equilibrium position of the leaflet was approximately 75 degrees. The leaflets in the CFD model opened to the full 85 degrees when the orifice was increased by 2 mm on the outflow side. CONCLUSION: The combination of techniques used in this study provided a method that will be useful in evaluating new valve designs. It was learned that leaflet position, pivot location and orifice height influence pressure distribution across the leaflets, thereby affecting the opening angle.

Blood Flow Velocity↗
PubMed1996

Defining the limitations of measurements from Doppler spectral recordings.

PURPOSE: The purpose of this study was to determine whether Doppler measurements of peak velocity and four other quantitative measures of spectral shape are affected significantly by the site of the Doppler recording in relation to the location of the maximum stenosis. METHOD: Continuous-wave and pulsed Doppler recordings were made distal to a 70% (area reduction or 45% diameter reduction) asymmetric stenosis in an in vitro flow model under steady and pulsatile flow conditions. Recordings were taken at six different locations proximal and distal to the stenosis. A photochromic dye technique was used to visualize the actual flow field in the model. RESULTS: Distal to the stenosis, the flow visualization results demonstrated a strong radial and axial variation of the velocity field and thus explained why the Doppler measurements of peak frequency and spectral broadening were strongly dependent on the recording site. The peak frequency was maximum within the throat of the stenosis and returned to the prestenotic value five tube diameters distal to the stenosis. Other measurements of spectral broadening and spectral shape varied greatly depending on the location of the recording site in the poststenotic region. Higher order spectral moments such as the coefficient of kurtosis were found to exhibit large temporal variability, which makes them inappropriate as diagnostic indicators. CONCLUSIONS: Because of the complex nature of the poststenotic flow field, these results clearly demonstrate that no single Doppler measurement can accurately quantify the severity of a stenosis. Of the Doppler measurements only peak velocity is related to the severity of stenosis. Reproducible peak velocity measurements are obtained only if the Doppler sample volume is positioned at or very near the throat of the stenosis and at an appropriate radial site that may not necessarily be at the center of the vessel.

Blood Flow Velocity↗
PubMed1999

MR imaging of flow with locally high spatial resolution.

Locally focused magnetic resonance imaging (LF MRI) allows imaging with variable spatial resolution within the field of view (FOV). Because LF MRI uses a priori information to provide locally high resolution in regions with rapid spatial variations in intensity (e.g., blood/tissue interface), it allows accurate reproduction of intense sharp edges in the specimen without blurring and truncation artifacts. This study employs LF MRI for 3D imaging of stationary and pulsatile flow. In the implemented version of LF MRI analytically defined basis functions are used to determine image intensity in regions depicted with low or high resolution. It is demonstrated that LF MRI of flow allows a significant (i.e. 3-4 times) reduction in scan time as compared to conventional FT MRI. It is also shown that LF images of pulsatile flow have a decreased appearance of ghosting artifacts as compared to the images reconstructed by using the conventional method.

Carotid Arteries↗
PubMed1990

A two-dimensional numerical analysis of unsteady flow in the carotid artery bifurcation. A comparison with three-dimensional in-vitro measurements and the influence of minor stenoses.

In the present study a two-dimensional finite element model for incompressible Newtonian flow is applicated to the modelling of carotid artery flow. In earlier studies, the numerical model was validated experimentally for several flow configurations. In general the pulsatile flow is characterized by reversed flow regions at the non-divider side walls of both the internal and external carotid arteries. The unsteadiness of the flow is associated with rather complex spatial and temporal velocity distributions and leads to temporal variations of the location and length of the reversed flow regions. As a consequence, pronounced spatial and temporal variations in the wall shear stresses are found. At the non-divider side walls, wall shear stresses are relatively low and exhibits an oscillatory behaviour in space and time. At the divider side walls, wall shear stresses are relatively high and approximately follow the flow rate distribution in time. The aim of this study is not only to present two-dimensional calculations but also to compare the calculated two-dimensional velocity profiles with those from three-dimensional experiments. It is observed that in the common carotid artery and in the proximal parts of the internal and external carotid arteries, the two-dimensional numerical model provides valuable information with respect to the three-dimensional configuration. In the more distal parts of especially the internal carotid artery, deviations are found between the two-dimensional numerical and three-dimensional experimental model. These deviations can mainly be attributed to the neglect of the secondary velocity distribution in the two-dimensional model. In the two-dimensional numerical model the influence of a minor stenosis in the internal carotid artery is hardly distinguishable from a minor geometrical variation without stenosis. Full three-dimensional analyses of the influence of minor stenoses are needed to prove numerically whether in-vivo measurements of the axial velocity distribution are useful in the detection of minor stenoses.

Arterial Occlusive Diseases↗
PubMed1998

A validation of a flow quantification by MR phase mapping software.

AIM: We evaluated a Siemens software of flow quantification (FQ) by MR phase mapping, in the framework of a common practical use. METHODS: Experiments with a laminar flow phantom and in vivo pulsatile flow were performed. In particular, FQ in ascending aorta was investigated in healthy volunteers. RESULTS AND CONCLUSION: Flow phantom experiments reveal that the FQ slightly underestimates (8% on the average) actual velocities (mean velocities over a vessel area), and also that velocity uncertainties are related to the encoding velocity value, whatever the measured velocity. Furthermore, using well characterized working criteria, we found low intraobserver variability and negligible interobserver variability in ascending aorta FQs. The role played by the choice of reference area in FQ accuracy is emphasized. When recording several cardiac cycles during the same acquisition, it is shown that the FQ software may provide erroneous results. Several comments for FQ software use in the ascending aorta are added.

Adult↗