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The flow patterns in the heart, in health and disease, have been of great interest for several years. Modern fluid dynamics analyses elucidate how underlying inefficient energetic or mixing characteristics of these flow patterns correlate with adverse effects. Unfortunately, translation of such modern analyses to the clinical stage remains a challenge. In this experimental work, we propose and demonstrate that braids of random and sparse particle trajectories provide an intuitive, global and practical description of cardiovascular flows. Moreover, we expose the flow pattern in an experimental healthy left ventricle model as a highly effective blood mixer at the topological level. Flow topologies that deviate from this pattern are accompanied by a reduction in energetic efficiency, as shown through comparisons with diseased flow models. These results suggest an ideal clinical approach to patient follow-up and the evaluation of the performance of medical devices. [ABSTRACT FROM AUTHOR]

Although flow characteristics in abdominal aortic aneurysms (AAAs) have been extensively studied, they have not found their way into the clinical evaluation of the disease. We, therefore, present experimental AAA flow models, optimized using spectral proper orthogonal decomposition, to aid in gauging AAA severity based on the underlying flow. The resulting reduced-order AAA flow models capture pertinent pathological flow features. With progressive aneurysm expansion, the flow becomes increasingly complex, accompanied by larger vortical structures and elevated particle residence time. The presented models can lead to a more comprehensive clinical evaluation that includes patient-specific flow information. [ABSTRACT FROM AUTHOR]

In cardiovascular flows, Lagrangian coherent structures have been used to explore the skeleton of blood transport. Revealing these transport barriers is instrumental to quantify the mixing and stagnation of blood as well as to highlight locations of elevated strain rate on blood elements. Nevertheless, the clinical use of Lagrangian coherent structures in cardiovascular flows is rarely reported due largely to its non-intuitive nature and computational expense. Here, we explore a recently developed approach called "Lagrangian descriptors," which quantifies the finite time Euclidean arc length of Lagrangian trajectories released from a grid of initial positions. Moreover, the finite time arc lengths of a set of trajectories capture signatures of Lagrangian coherent structures computed from the same initial condition. Remarkably, the Lagrangian descriptors approach has the most rapid computational performance among all its Lagrangian counterparts. In this work, we explore the application of Lagrangian descriptors for the first time in cardiovascular flows. For this purpose, we consider two in vitro flow models studied previously by our group: flow in an abdominal aortic aneurysm and that in a healthy left ventricle. In particular, we will demonstrate the ability of the Lagrangian descriptors approach to reveal Lagrangian coherent structures computed via the classical geometrical approach, though at a significantly reduced computational cost. [ABSTRACT FROM AUTHOR]

This experimental study aims to explore the Lagrangian nature of fluid transport downstream of a bileaflet mechanical aortic valve under different malfunction scenarios that might be encountered clinically. Time-resolved planar particle image velocimetry measurements are performed to extract instantaneous velocity fields downstream of the bileaflet mechanical valve implanted in an elastic aortic model. The results show an increase in particle residence time with the severity of malfunction. This is attributed to the expansion of the recirculation regions downstream of the valve. The time-evolution of Lagrangian coherent structures over one cardiac cycle (using finite-time Lyapunov exponent fields) shows the effect of valve dysfunction on the material transport and its barriers inside the aorta. The unbalanced flow through the dysfunctional leaflets leads to a significant redistribution of the LCS, thus the fluid transport along the ascending aorta. Moreover, a new technique for the evaluation of the highest accumulated shear stresses is applied along the Lagrangian trajectory of particles being released from the extracted Lagrangian coherent structures where the highest stretching occurs. Finally, the induced non-laminar flow behavior by the valve dysfunction is analyzed using the time-frequency spectra of velocity signals at selected points in the ascending aorta. [ABSTRACT FROM AUTHOR]

There is much debate in the literature surrounding the effects of heart rate on aortic regurgitation (AR). Despite the contradictory information, it is still widely believed that an increase in heart rate is beneficial due to the disproportionate shortening of the duration of diastole relative to systole, permitting less time for the left ventricle to fill from regurgitation. This in vitro work investigates how a change in heart rate affects the left ventricular fluid dynamics in the absence and presence of acute AR. The experiments are performed on a novel double-activation left heart simulator previously used for the study of chronic AR. The intraventricular velocity fields are acquired via time-resolved planar particle image velocimetry (PIV) in a clinically relevant plane. Considering fluid dynamic factors, an increase in heart rate was observed to have a limited benefit in the case of mild AR and a detrimental effect for more severe AR. With increasing heart rate, mild AR was associated with a decrease in regurgitant volume, a negligible change in regurgitant volume per diastolic second, and a limited reduction in the fraction of retained regurgitant inflow. More severe AR was accompanied by an increase in both regurgitant volume and the fraction of retained regurgitant inflow, implying a less effective pumping efficiency and a longer relative residence time of blood in the ventricle. Globally, the left ventricle's capacity to compensate for the increase in energy dissipation associated with an increase in heart rate diminishes considerably with severity, a phenomenon which may be exploited further as a method of noninvasive assessment of the severity of AR. These findings may affect the clinical belief that tachycardia is preferred in acute AR and should be investigated further in the clinical setting. [ABSTRACT FROM AUTHOR]

Mechanical heart valve replacement is the preferred alternative in younger patients with severe symptomatic aortic valve disease. However, thrombus and pannus formations are common complications associated with bileaflet mechanical heart valves. This leads to risks of valve leaflet dysfunction, a life‐threatening event. In this experimental study, we investigate, using time‐resolved planar particle image velocimetry, the flow characteristics in the ascending aorta in the presence of a dysfunctional bileaflet mechanical heart valve. Several configurations of leaflet dysfunction are investigated and the induced flow disturbances in terms of velocity fields, viscous energy dissipation, wall shear stress, and accumulation of viscous shear stresses are evaluated. We also explore the ability of a new set of parameters, solely based on the analysis of the normalized axial velocity profiles in the ascending aorta, to detect bileaflet mechanical heart valve dysfunction and differentiate between the different configurations tested in this study. Our results show that a bileaflet mechanical heart valve dysfunction leads to a complex spectrum of flow disturbances with each flow characteristic evaluated having its own worst case scenario in terms of dysfunction configuration. We also show that the suggested approach based on the analysis of the normalized axial velocity profiles in the ascending aorta has the potential to clearly discriminate not only between normal and dysfunctional bilealfet heart valves but also between the different leaflet dysfunction configurations. This approach could be easily implemented using phase‐contrast MRI to follow up patients with bileaflet mechanical heart valves. [ABSTRACT FROM AUTHOR]

The present focus of heart flow studies is largely based on flow within the left ventricle and how this flow changes when subject to disease. However, despite recent advancements, a simple tractable model of even healthy left ventricular flow has not been produced and made available. Reduced-order modeling techniques, such as proper orthogonal decomposition (POD) and dynamic mode decomposition (DMD), offer an effective means of expressing the large datasets obtained from experiments or numerical simulations using low-dimensional models. While POD and DMD are often used to identify coherent structures in fluid dynamics, their use as a modeling tool has not found much merit in the cardiovascular flow community. In this work, we use POD and DMD to construct reduced-order models for a healthy left ventricular flow as well as for that under the influence of a particular disease shown to exhibit rich and unique intraventricular fluid dynamics, namely, aortic regurgitation (a leaking aortic valve). The performance of the two methods in reconstructing the intraventricular flows and derived quantities is evaluated, and the selected reduced-order models are made available. [ABSTRACT FROM AUTHOR]

Abstract Unnatural dynamics of the notorious vortex in the left ventricle is often associated with cardiac disease. Understanding how different cardiac diseases alter the flow physics in the left ventricle may therefore provide a powerful tool for disease detection. In this work, the fluid dynamics in the left ventricle subject to different severities of aortic regurgitation is experimentally investigated by performing time-resolved particle image velocimetry in a left heart duplicator. Diastolic vortex reversal was observed in the left ventricle accompanied by an increase in viscous energy dissipation. Vortex dynamics and energy dissipation may provide useful insights on sub-optimal flow patterns in the left ventricle. [ABSTRACT FROM AUTHOR]

Interactions between an internal flow and wall deformation occur in many biological systems. Such interactions can involve a complex and rich dynamical behavior and a number of peculiarities which depend on the flow parameter range. The aim of this paper is to present a variant (obtained via a weighted residual approach) of the averaged one-dimensional model derived by Stewart et al. ["Local and global instabilities of flow in a flexible-walled channel," Eur. J. Mech. B/Fluids 28, 541-557 (2009)]. The asymptotic expansions for small Reynolds numbers of these two models, compared to the exact solution obtained from the lubrication approach, reveal some quantitative difference, even at higher Reynolds numbers. Qualitatively, the two models give similar results at least at a linear level. It is shown that for relatively low membrane tension (T), there are distinct regions in the (T, R) parameter space where steady bifurcating flows may occur. These flows can also be observed at vanishingly small Reynolds numbers combined with relatively high membrane tension. At sufficiently high T and R, the bifurcating flow is rather time periodic. A weakly nonlinear analysis is then performed in both cases leading to the derivation of evolution equations for the amplitudes of the bifurcating flows. The amplitude equations show that the saddle node bifurcation has a transcritical character while the Hopf bifurcation is either subcritical or supercritical, depending both on the mode number and membrane tension. [ABSTRACT FROM AUTHOR]