Three-dimensional numerical simulations are employed to investigate the hemodynamic effects of abnormal E/A ratios on left ventricular filling. The simulations are performed in a simplified geometric model of the left ventricle (LV) in conjunction with a specified endocardial motion. The model has been carefully designed to match the important geometric and flow parameters under the physiological conditions. A wide range of E/A ratios from 0 to infinity is employed with the aim to cover all the possible stages of left ventricle diastolic dysfunction (DD). The effects of abnormal E/A ratios on vortex dynamics, flow propagation velocity, energy consumption as well as flow transport and mixing are extensively discussed. Our results are able to confirm some common findings reported by the previous studies, and also uncover some interesting new features.

Reference

1.
Wang
,
Z.
,
Jalali
,
F.
,
Sun
Y.
,
Wang
,
J.
,
Parker
,
K.
, and
Tyberg
,
J.
,
2005
, “
Assessment of LV Diastolic Suction in Dogs Using Wave-Intensity Analysis
,”
Am. J. Physiol. Heart Circ. Physiol.
,
288
, pp.
H1641
H1651
.10.1152/ajpheart.00181.2004
2.
Courtois
,
M.
,
Kovacs
,
S. J.
, and
Ludbrook
,
P.
,
1988
, “
Transmitral Pressure-Flow Velocity Relation. Importance of Regional Pressure Gradients in the Left Ventricle During Diastole
,”
Circulation
,
78
, pp.
661
671
.10.1161/01.CIR.78.3.661
3.
Bronzino
,
J. D.
,
1999
,
The Biomedical Engineering Handbook
, 2nd ed.,
CRC Press
,
Boca, Raton
, FL.
4.
Smiseth
,
O. A.
, and
Tendera
,
M.
,
2008
,
Diastolic Heart Failure
,
Springer
,
London
.
5.
Carcia
,
J. M.
,
Smedira
,
N. G.
,
Greenberg
,
N. L.
,
Main
,
M.
,
Firstenberg
,
M. S.
,
Odabashian
,
J.
, and
Thomas
,
J. D.
,
2000
, “
Color M-Mode Doppler Flow Propagation Velocity is a Preload Insensitive Index of LV Relaxation: Animal and Human Validation
,”
J. Am. Coll. Cardiol.
,
35
, pp.
201
208
.10.1016/S0735-1097(99)00503-3
6.
Leite-Moreira
,
A. F.
,
Correia-Pinto
,
J.
, and
Gillebert
,
T. C.
,
2001
, “
Diastolic Dysfunction and Hypertension
,”
New Engl. J. Med.
,
341
, pp.
1401
1402
.
7.
Redfield
,
M.
,
Jacobsen
,
S.
,
Burnett
,
J.
,
Mahoney
,
D.
,
Balley
,
K.
, and
Rodeheffer
,
R.
,
2003
, “
Burden of Systolic and Diastolic Ventricular Dysfunction in the Community: Appreciating the Scope of the Heart Failure Epidemic
,”
JAMA
,
289
(
2
), pp.
194
202
.10.1001/jama.289.2.194
8.
Carlhäll
,
C. J.
, and
Bolger
,
A.
,
2010
, “
Passing Strange: Flow in the Failing Ventricle
,”
Circ.: Heart Failure
,
3
, pp.
326
331
.
9.
Domenichini
,
F.
,
Pederizzetti
,
G.
, and
Baccani
,
B.
,
2005
, “
Three-Dimensional Filling Flow Into a Model Left Ventricle
,”
J. Fluid Mech.
,
539
, pp.
179
198
.10.1017/S0022112005005550
10.
Lemmon
,
J. D.
, and
Yoganathan
,
A. P.
,
2000
, “
Computational Modeling of Left Heart Diastolic Function: Examination of Ventricular Dysfunction
,”
ASME J. Biomech. Eng.
,
122
, pp.
297
303
.10.1115/1.1286559
11.
Shenkel
,
T.
,
Malve
,
M.
,
Reik
,
M.
,
Markl
,
M.
,
Jung
,
B.
, and
Oertel
,
H.
,
2009
, “
MRI-Based CFD Analysis and Application to Healthy Heart
,”
Ann. Biomed. Eng.
,
37
, pp.
503
515
.10.1007/s10439-008-9627-4
12.
Kheradvar
,
A.
,
Assadi
,
R.
,
Falahatpisheh
,
A.
, and
Sengupta
,
P.
,
2011
, “
Assessment of Transmitral Vortex Formation in Patients With Diastolic Dysfunction
,”
J. Am. Soc. Echocardiogr.
,
25
, pp.
220
227
.10.1016/j.echo.2011.10.003
13.
Ishizu
,
T.
,
Seo
,
Y.
,
Ishimitsu
,
T.
,
Obara
,
K.
,
Moriyama
,
N.
,
Kawano
,
S.
,
Watanabe
,
S.
, and
Yamaguchi
, I
.
,
2006
, “
The Wake of a Large Vortex is Associated With Intraventricular Filling Delay in Impaired Left Ventricles With a Pseudonormalized Transmitral Flow Pattern
,”
Echocardiography
,
23
, pp.
368
375
.10.1111/j.1540-8175.2006.00220.x
14.
Baccani
,
B.
,
Domenichini
,
F.
, and
Pedrizzetti
,
G.
,
2002
, “
Vortex Dynamics in a Model Left Ventricle During Filling
,”
Eur. J. Mech.
, B,
21
, pp.
527
543
.10.1016/S0997-7546(02)01200-1
15.
Domenichini
,
F.
,
Querzoli
,
G.
,
Genedese
,
A.
, and
Pedrizzetti
,
G.
,
2007
, “
Combined Experimental and Numerical Analysis of the Flow Structure into the Left Ventricle
,”
J. Biomech.
,
40
, pp.
1988
1994
.10.1016/j.jbiomech.2006.09.024
16.
Hong
,
G.
,
Pedrizzetti
,
G.
,
Tonti
,
G.
,
Li
,
P.
,
Wei
,
Z.
,
Kim
,
J.
,
Baweja
,
A.
,
Liu
,
S.,
Chung
,
N.
,
Houle
,
H.
,
Narula
,
J.
, and
Vannan
,
M.
,
2008
, “
Characterization and Quantification of Vortex Flow in the Human Left Ventricle by Contrast Echocardiography Using Vector Particle Image Velocimetry
,”
JACC Cardiovasc. Imaging
,
1
, pp.
705
717
.10.1016/j.jcmg.2008.06.008
17.
Kheradar
,
A.
,
Houle
,
H.
,
Pedrizzetti
,
G.
,
Tonti
,
G.
,
Belcik
,
T.
,
Ashraf
,
M.
,
Lindner
J.
,
Gharib
,
M.
, and
Sahn
,
D.
,
2010
, “
Echocardiographic Particle Image Velocimetry: A Novel Technique for Quantificatioin of LV Blood Vorticity Pattern
,”
J. Am. Soc. Echocardiogr.
,
23
, pp.
86
94
.10.1016/j.echo.2009.09.007
18.
Gharib
,
M.
,
Rambod
,
E.
, and
Shariff
,
K.
,
1998
, “
A universal Time-Scale of Vortex Formation Time
,”
ASME J. Fluid Mech.
,
360
, pp.
121
141
.10.1017/S0022112097008410
19.
Gharib
,
M.
,
Rambod
,
E.
,
Kheradvar
,
A.
,
Sahn
,
D. J.
, and
Dabiri
,
J. O.
,
2006
, “
Optimal Vortex Formation as an Index of Cardiac Health
,”
Proc. Natl. Acad. Sci.
,
103
(
16
), pp.
6305
6308
.10.1073/pnas.0600520103
20.
Kheradvar
,
A.
,
Assadi
,
R.
,
Falahatpisheh
,
A.
, and
Sengupta
,
P. P.
,
2012
, “
Assessment of Transmitral Vortex Formation in Patients with Diastolic Dysfunction
,”
J. Am. Soc. Echocardiogr.
,
25
(
5
), pp.
220–227
.10.1016/j.echo.2011.10.003
21.
Kilner
,
P.
,
Yang
,
G.
,
Wilkes
,
A.
,
Mohiaddin
,
R.
,
Firmin
,
D.
, and
Yacoub
,
M.
,
2000
, “
Asymmetric Redirection of Flow Through the Heart
,”
Nature
,
404
, pp.
759
761
.10.1038/35008075
22.
Pedrizzetti
,
G.
, and
Domenichini
,
F.
,
2005
, “
Nature Optimizes the Swirling Flow in the Human Left Ventricle
,”
Phys. Rev. Lett.
,
95
, p.
108101
.10.1103/PhysRevLett.95.108101
23.
Mangual
,
J.
,
Krainer
,
E.
,
De Luca
,
A.
,
Toncelli
,
L.
,
Shah
,
A.
,
Solomon
,
S.
,
Galanti
,
G.
,
Domenichini
,
F.
, and
Pedrizzetti
,
G.
,
2013
, “
Comparative Numerical Study on LV Fluid Dynamics After Dilated Cardiomyopathy
,”
J. Biomech.
,
46
, pp.
1611
1617
.10.1016/j.jbiomech.2013.04.012
24.
Shorland
,
A. P.
,
Black
,
R. A.
,
Jarvis
,
J. C.
,
Henry
,
S.
,
Iudicello
,
F.
, and
Collins
,
M. W.
,
1996
, “
Formation and Travel of Vortices in Model Ventricles: Application to the Design of Skeletal Muscle Ventricles
,”
J. Biomech.
,
4
, pp.
503
511
.10.1016/0021-9290(95)00065-8
25.
Kheradvar
,
A.
,
Milano
,
M.
, and
Gharib
,
M.
,
2007
, “
Correlation Between Vortex Ring Formation and Mitral Annulus Dynamics During Ventricular Rapid Filling
,”
ASAIO J.
,
53
, pp.
8
16
.10.1097/01.mat.0000249870.44625.22
26.
Mandinov
,
L.
,
Eberli
,
F. R.
,
Seiler
,
C.
, and
Hess
,
O. M.
,
2000
, “
Review: Distolic Heart Failure
,”
Cardiovasc. Res.
,
45
, pp.
813
825
.10.1016/S0008-6363(99)00399-5
27.
Pierrakos
,
O.
, and
Vlachos
,
P.
,
2006
, “
The Effect of Vortex Formation on LV Filling and Mitral Valve Efficiency
,”
ASME J. Biomech. Eng.
,
128
, pp.
527
539
.10.1115/1.2205863
28.
Zhong
,
L.
,
Su
,
Y.
,
Gobeawan
,
L.
,
Sola
,
S.
,
Tan
,
R.
,
Navia
,
J.
,
Ghista
,
D.
,
Chua
,
T.
,
Guccione
,
J.
, and
Kassab
,
G.
,
2011
,
Impact of Surgical Ventricular Restoration on Ventricular Shape, Wall Stress, and Function in Heart Failure Patients
,”
Am. J. Physiol. Heart Circ. Physiol.
,
300
, pp.
1653
1660
.10.1152/ajpheart.00021.2011
29.
Le
,
T.
, and
Sotiropoulos
,
F.
,
2012
, “
On the Three-Dimensional Vortical Structure of Early Diastolic Flow in a Patient-Specific Left Ventricle
,”
Eur. J. Mech. B
,
35
, pp.
20
24
.10.1016/j.euromechflu.2012.01.013
30.
Nakanura
,
M.
,
Wada
,
S.
,
Mikami
,
T.
,
Kitabatake
,
A.
, and
Karino
,
T.
,
2003
, “
Computational Study on the Evolution of an Intraventricular Vortical Flow During Early Diastole for the Interpretation of Color M-Mode Doppler Echocardiograms
,”
Biomech. Model. Mechanobiol.
,
2
, pp.
59
72
.10.1007/s10237-003-0028-1
31.
Georgiadis
,
M.
, and
Pasipoularides
,
A.
,
1992
, “
Computational Fluid Dynamics of LV Ejection
,”
Ann. Biomed. Eng.
,
20
, pp.
81
97
.10.1007/BF02368507
32.
Domenichini
,
F.
, and
Pedrizzetti
,
G.
,
2011
, “
Intraventricular Vortex Flow Changes in the Infracted Left Ventricle: Numerical Results in a Idealized 3D Shape
,”
Comput. Methods Biomech. Biomed. Eng.
,
14
(
1
), pp.
95
101
.10.1080/10255842.2010.485987
33.
Talor
,
T.
,
Okino
,
H.
, and
Yamaguchi
,
T.
,
1994
, “
Three Dimensional Analysis of LV Ejection Using Computational Fluid Dynamics
,”
ASME J. Biomech. Eng.
,
116
, pp.
127
130
.10.1115/1.2895696
34.
Watanabe
,
H.
,
Sugiura
,
S.
,
Kafuku
,
H.
, and
Hisada
,
T.
,
2004
, “
Multiphysics Simulation of Left Ventricle Filling Dynamics Using Fluid-Structure Interaction Finite Element Method
,”
Biophys. J.
,
87
, pp.
2074
2085
.10.1529/biophysj.103.035840
35.
Nichols
,
W.
,
O'Rourke
,
M.
, and
Vlachopoulos
,
C.
,
2011
,
McDonald's Blood Flow in Arteries: Theoretical, Experimental and Clinical Principles
, 6th ed.,
CRC Press
, Boca Raton, FL.
36.
Mittal
,
R.
,
Dong
,
H.
,
Bozkuittas
,
M.
,
Najiar
,
F. M.
,
Vargas
,
A.
, and
Loebbecke
,
A.
,
2008
, “
A Versatile Sharp Interface Immersed Boundary Method for Incompressible Flows With Complex Boundaries
,”
J. Comput. Phys.
,
227
(
10
), pp.
4825
4852
.10.1016/j.jcp.2008.01.028
37.
Arts
,
W. C.
,
Hunter
,
A.
,
Douglas
,
M. M.
,
Muijtjens
, and
R. S.
Reneman
,
1992
, “
Description of the Deformation of the LV by a Kinematic Model
,”
J. Biomech.
,
25
, pp.
1119
1127
.10.1016/0021-9290(92)90068-C
38.
Yoganathan
,
A.
,
He
,
Z.
, and
Jones
,
S. C.
,
2004
, “
Fluid Mechanics of Heart Valves
,”
Annu. Rev. Biomed. Eng.
,
6
, pp.
331
362
.10.1146/annurev.bioeng.6.040803.140111
39.
Eriksson
,
J.
,
Carlhall
,
C.
,
Dyverfeldt
,
P.
,
Engvall
,
J.
,
Bolger
,
A.
, and
Ebbers
,
T.
,
2010
, “
Semi-Automatic Quantification of 4d LV Blood Flow
,”
J. Cardiovasc. Magn. Reson.
,
12
, p.
9
.10.1186/1532-429X-12-9
40.
Markl
,
M.
,
Kilner
,
P.
,
Ebbers
,
T.
,
2011
, “
Comprehensive 4d Velocity Mapping of the Heart and Great Vessels by Cardiovascular Magnetic Resonance
,”
J. Cardiovasc. Magn. Reson.
,
13
, p.
7
.10.1186/1532-429X-13-7
41.
Pasipoularides
,
A.
,
2009
,
Heart's Vortex: Intracardiac Blood Flow Phenomena
,
PMPH-USA
,
Shelton, CT
.
42.
Charonko
,
J.
,
Kumar
,
R.
,
Stewart
,
K.
,
Little
,
W.
, and
Vlachos
,
P.
,
2013
, “
Vortices Formed on the Mitral Valve Tips Aid Normal LV Filling
,”
Ann. Biomed. Eng.
,
41
(
5
) pp.
1049
1061
.10.1007/s10439-013-0755-0
43.
Olcay
,
A. B.
, and
Krueger
,
P. S.
,
2008
, “
Measurement of Ambient Fluid Entrainment During Laminar Vortex Ring Formation
,”
Exp. Fluids
,
44
, pp.
235
247
.10.1007/s00348-007-0397-9
44.
Töger
,
J.
,
Kanski
,
M.
,
Carlsson
,
M.
,
Kovacs
,
S. J.
,
Soderlind
,
G.
,
Arhenden
,
H.
, and
Heiberg
,
E.
,
2012
, “
Vortex Ring Formation in the Left Ventricle of the Heart: Analysis by 4D Flow MRI and Lagrangian Coherent Structure
,”
Ann. Biomed. Eng.
,
40
,
2652
2662
.10.1007/s10439-012-0615-3
45.
Hendabadi
,
S.
,
Bermejo
,
J.
,
Benito
,
Y.
,
Yotti
,
R.
,
Fernandez-Aviles
,
F.
,
Alamo
,
J. C.
, and
Shadden
,
S.
,
2013
, “
Topology of Blood Transport in the Human Left Ventricle by Novel Processing of Doppler Echocardiography
,”
Ann. Biomed. Eng.
,
41
, pp.
2603
2616
.10.1007/s10439-013-0853-z
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