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Left ventricular vortex formation is unaffected by diastolic impairment
Kelley C Stewart1, John C Charonko, Casandra L Niebel
1Department of Mechanical Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
American Journal of Physiology. Heart and Circulatory Physiology
|September 11, 2012
Summary
The vortex ring formation time, crucial for diastolic filling, ends when the vortex ring pinches off, not at the end of early diastole. This timing is invariant to diastolic dysfunction in heart failure.
Area of Science:
- Cardiology
- Fluid Dynamics
- Biomedical Engineering
Background:
- Normal left ventricular (LV) filling relies on pressure gradients.
- Diastolic dysfunction in heart failure alters LV filling patterns.
- The hydrodynamic mechanisms of early diastolic filling are not fully understood.
Purpose of the Study:
- To investigate the hydrodynamic mechanisms of early diastolic filling.
- To redefine the vortex ring formation time based on observed phenomena.
- To assess the relationship between vortex ring formation time and diastolic dysfunction.
Main Methods:
- Analysis of early diastolic filling wave propagation velocity.
- Identification of vortex ring pinch-off events.
- Calculation of vortex ring formation time from initiation to pinch-off.
Main Results:
- The left ventricular (LV) pressure difference driving early diastolic filling becomes zero at vortex ring pinch-off.
- Vortex ring pinch-off coincides with the deceleration of early filling wave propagation velocity.
- The calculated vortex ring formation time is invariant to changes in intraventricular pressure difference and diastolic dysfunction.
Conclusions:
- Vortex ring pinch-off occurs before the completion of early diastole.
- The vortex ring formation time is a consistent measure, unaffected by the degree of diastolic dysfunction.
- This finding refines the understanding of diastolic filling dynamics in health and heart failure.