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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]

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]

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]