Browsing by Author "Little, William C."

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    Delay of left ventricular longitudinal expansion with diastolic dysfunction: impact on load dependence of e′ and longitudinal strain rate
    Lwano, Hiroyuki; Pu, Min; Upadhya, Bharathi; Meyers, Brett; Vlachos, Pavlos P.; Little, William C. (The Physiological Society, 2014-07)
    The effect of diastolic dysfunction (DD) on the timing of left ventricular (LV) diastolic longitudinal and circumferential expansion and their load dependence is not known. This study evaluated the timing of the peak early diastolic LV inflow velocity (E), mitral annular velocity (e'), and longitudinal and circumferential global strain rates (SRE) in 161 patients in sinus rhythm. The intraventricular pressure difference (IVPD) from the left atrium to the LV apex was obtained using color M-mode Doppler data to integrate the Euler equation. The diastolic function was graded according to the guidelines. In normals (N = 57), E, e', longitudinal SRE, and circumferential SRE occurred nearly simultaneously during the IVPD. With DD (N = 104), e' and longitudinal SRE were delayed occurring after the IVPD (e': 18 +/- 23 msec, longitudinal SRE: 13 +/- 21 msec from the IVPD), whereas circumferential SRE (-8 +/- 28 msec) and E (-2 +/- 13 msec) were not delayed. The normal dependence of e' and longitudinal SRE on IVPD was reduced in DD; while the relation of circumferential SRE and E to IVPD were unchanged in DD. Thus, normally, the LV expands symmetrically during early diastole and both longitudinal and circumferential expansions are related to the IVPD. With DD, early diastolic longitudinal LV expansion is delayed, occurring after the IVPD and LV filling, resulting in their relative independence from the IVPD. In contrast, with DD, circumferential SRE and mitral inflow are not delayed and their normal relation to the IVPD is unchanged.
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    Hydrodynamics of Cardiac Diastole
    Stewart, Kelley Christine (Virginia Tech, 2011-03-30)
    Left ventricular diastole (filling) is a complex process with many features and coupled compensatory mechanisms which coordinate to maintain optimal filling and ejection of the left ventricle. Diastolic filling is controlled by the left ventricular recoil, relaxation, and compliance as well as atrial and ventricular pressures making left ventricular diastolic dysfunction very difficult to understand and diagnose. An improved understanding of these unique flows is important to both the fundamental mechanics of the cardiac diastolic filling as well as the development of novel and accurate diagnostic techniques. This work includes studies of in-vivo and in-vitro vortex rings. Vortex rings created in the left ventricle past the mitral valve during diastole are produced in a confined domain and are influenced by the left ventricular walls. Therefore, an in-vitro analysis of the formation and decay of vortex rings within confined cylindrical domains using particle image velocimetry was conducted. Varying mechanisms of vortex ring breakdown were observed over a wide range of Reynolds numbers, and an analytical model for vortex ring circulation decay of laminar vortex rings was developed. Also, in this work a novel method for analyzing color M-mode echocardiography data using a newly developed automated algorithm is introduced which examines the pressure gradients and velocities within the left ventricle. From this analysis, a new diagnostic filling parameter is introduced which displays a greater probability of detection of diastolic dysfunction over the conventionally used diagnostic parameter.
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    Studies of Stented Arteries and Left Ventricular Diastolic Dysfunction Using Experimental and Clinical Analysis with Data Augmentation
    Charonko, John James (Virginia Tech, 2009-04-01)
    Cardiovascular diseases are among the leading causes of deaths worldwide, but the fluid mechanics of many of these conditions and the devices used to treat them are only partially understood. This goal of this dissertation was to develop new experimental techniques that would enable translational research into two of these conditions. The first set of experiments examined in-vitro the changes in Wall Shear Stress (WSS) and Oscillatory Shear Index (OSI) caused by the implantation of coronary stents into the arteries of the heart using Particle Image Velocimetry. These experiments featured one-to-one scaling, commercial stents, and realistic flow and pressure waveforms, and are believed to be the most physiologically accurate stent experiments to date. This work revealed distinct differences in WSS and OSI between the different stent designs tested, and showed that changes in implantation configuration also affected these hemodynamic parameters. Also, the production of vortices near the stent struts during flow reversal was noted, and an inverse correlation between WSS and OSI was described. The second set of experiments investigated Left Ventricular Diastolic Dysfunction (LVDD) using phase contrast magnetic resonance imaging (pcMRI). Using this technique, ten patients with and without LVDD were scanned and a 2D portrait of blood flow through their heart was obtained. To augment this data, pressure fields were calculated from the velocity data using an omni-directional pressure integration scheme coupled with a proper-orthogonal decomposition-based smoothing. This technique was selected from a variety of methods from the literature based on an extensive error analysis and comparison. With this coupled information, it was observed that healthy patients exhibited different flow patterns than diseased patients, and had stronger pressure differences during early filling. In particular, the ratio of early filling pressure to late filling pressure was a statistically significant predictor of diastolic dysfunction. Based on these observations, a novel hypothesis was presented that related the motion of the heart walls to the observed flow patterns and pressure gradients, which may explain the differences observed clinically between healthy and diseased patients.