Pulsatile flow

About: Pulsatile flow is a research topic. Over the lifetime, 6278 publications have been published within this topic receiving 149638 citations.

Experimental measurement of dynamic fluid shear stress on the aortic surface of the aortic valve leaflet.

Abstract: Aortic valve (AV) calcification is a highly prevalent disease with serious impact on mortality and morbidity. Although exact causes and mechanisms of AV calcification are unclear, previous studies suggest that mechanical forces play a role. Since calcium deposits occur almost exclusively on the aortic surfaces of AV leaflets, it has been hypothesized that adverse patterns of fluid shear stress on the aortic surface of AV leaflets promote calcification. The current study characterizes AV leaflet aortic surface fluid shear stresses using Laser Doppler velocimetry and an in vitro pulsatile flow loop. The valve model used was a native porcine valve mounted on a suturing ring and preserved using 0.15% glutaraldehyde solution. This valve model was inserted in a mounting chamber with sinus geometries, which is made of clear acrylic to provide optical access for measurements. To understand the effects of hemodynamics on fluid shear stress, shear stress was measured across a range of conditions: varying stroke volumes at the same heart rate and varying heart rates at the same stroke volume. Systolic shear stress magnitude was found to be much higher than diastolic shear stress magnitude due to the stronger flow in the sinuses during systole, reaching up to 20 dyn/cm2 at mid-systole. Upon increasing stroke volume, fluid shear stresses increased due to stronger sinus fluid motion. Upon increasing heart rate, fluid shear stresses decreased due to reduced systolic duration that restricted the formation of strong sinus flow. Significant changes in the shear stress waveform were observed at 90 beats/min, most likely due to altered leaflet dynamics at this higher heart rate. Overall, this study represents the most well-resolved shear stress measurements to date across a range of conditions on the aortic side of the AV. The data presented can be used for further investigation to understand AV biological response to shear stresses.

Flow behaviour of blood cells and rigid spheres in an annular vortex.

Abstract: The behaviour of human and frog red cells, platelets and rigid spheres were studied in the annular vortex formed in steady or pulsatile flow at the sudden concentric expansion of a 151 $\mu$ m into 504 $\mu$ m diameter glass tube. During a single orbit the measured particle velocities and paths in steady flow were in good agreement with those calculated for the fluid, predicted by theory to circulate in closed orbits. Over longer periods, however, single blood cells and latex spheres $\mu$ m diameter migrated across the streamlines out of the vortex at a rate depending on the Reynolds number whereas spheres and aggregates of red cells > 30 $\mu$ m diameter remained in the vortex at all Reynolds numbers. Similar behaviour was noted in pulsatile flow when the vortex moved in phase with upstream fluid velocity and particles described spiral orbits of continually changing diameter. With red cell suspensions of 15-45% haematocrit in steady flow, migration of the corpuscles was also observed and resulted in the formation of a particle-free vortex. In pulsatile flow, cells were always present in the vortex, but their concentration which varied periodically was lower than that in the mainstream. The formation of aggregates of latex spheres and human platelets through collisions occurring in orbit, and their migration to the vortex centre was also observed.

Cellular and hemodynamics responses of failing myocardium to continuous flow mechanical circulatory support using the DeBakey-Noon left ventricular assist device: a comparative analysis with pulsatile-type devices.

Abstract: Background An increasing number of continuous flow pumps are currently under clinical studies, however very little data exist on the hemodynamic and cellular responses of the failing heart to continuous flow support. The purpose of this investigation was to characterize the response of the failing myocardium to continuous flow support. Methods We compared echocardiographic and cellular markers of failing myocardium at the time of left ventricular assist device (LVAD) implantation and explantation in 20 consecutive patients (12 pulsatile flow [Novacor] and 8 continuous flow [DeBakey-Noon]). Results The use of mechanical support with both continuous- or pulsatile-type LVADs resulted in a reduction of left ventricular end-diastolic dimension (LVEDD), end-diastolic volume (EDV), end-systolic volume (ESV) and left atrial volume (LAV), as well as a decrease in mitral E/A ratio, tricuspid regurgitation velocity (TRV) and pulmonary valve acceleration time (PVAT). Comparative analyses for patients treated with a continuous- vs pulsatile-type LVAD support showed a greater degree of unloading with the latter type, as shown by the effect on LVEDD (−13.7% vs −33.7%, p = 0.0.004), EDV (−23.5% vs −41.2%, p = 0.015), ESV (−25.6% vs −57.6%, p = 0.001) and LAV (−25.2% vs −40.4%, p = 0.071). The hemodynamic effects of continuous vs pulsatile LVAD support were similar, as shown by their effect on mitral E/A ratio (−23.9% vs −39.9%, p = NS), TRV (−26.4% vs −23.8%, p = NS) and PVAT (28.5% vs 38.5%, p = NS). Only pulsatile support demonstrated a statistically significant percent change in mass (−6.3% vs −20.6%, p = 0.038). Continuous and pulsatile forms of mechanical support demonstrated equivalent reductions in myocardial tumor necrosis factor-α (TNF-α), total collagen and mycocyte size. Conclusions Our findings show that, although there are differences between these 2 devices in magnitude of unloading, both forms of support effectively normalize cellular markers of the failing phenotype.