Feasibility of Computational Fluid Dynamics for Evaluating the Intraventricular Hemodynamics in Single Right Ventricle Based on Echocardiographic Images.

Li-Jun Chen,Jin-Long Liu,Qian Wang,Yu-Qi Zhang,Zhi-Rong Tong

doi:10.1155/2018/1042038

Li-Jun Chen, Jin-Long Liu + Show 3 more

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https://doi.org/10.1155/2018/1042038

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Abstract

This study introduced a combined computational fluid dynamics (CFD) and echocardiography methodology to simulate blood flow in the single right ventricle (SRV) and normal ventricles to study the intraventricular flow. Derived from echocardiographic image loops, CFD-based three-dimensional (3D) flow models of normal subject's left ventricle (LV) and right ventricle (RV) and SRV with and without heart failure at three characteristic diastolic statuses were reconstructed. The CFD derived morphological and functional measurements in normal ventricles and the SRV were validated with echocardiography. The vortex in the normal ventricles and the SRV were studied. The morphological and functional measurements derived from CFD modeling and echocardiography were comparable, and both methods demonstrated the larger volume and higher spherical index in the SRV, in particular the SRV with heart failure. All the vortices in the SRV were smaller than those in the normal control subject's LV and RV, notably with heart failure. Unlike normal LV and RV, no vortex ring was observed in the SRV. Echocardiography-based CFD demonstrated the feasibility of quantifying ventricular morphology and function; in addition, CFD can detect the abnormal flow pattern (smaller or obliterated vortices) in the SRV when compared with normal ventricles.

Highlights

Single right ventricle (SRV) is a congenital heart disease which causes severe cyanosis
This study aimed to provide a primary step in the numerical simulation of fluid dynamics in a SRV with and without heart failure and to compare them with those of normal left and right ventricle using computational fluid dynamics (CFD), in particular, to analyze vortices during diastole to provide detailed information for physicians to give patients timely intervention as soon as possible
The study was performed on a male subject who was diagnosed with SRV at two stages, and an age- and gender-matched normal child (Table 1)

Summary

Introduction

Single right ventricle (SRV) is a congenital heart disease which causes severe cyanosis. The SRV has the right ventricle anatomy but works as both pulmonic and systemic circulation ventricles; it is usually unable to sustain separate pulmonary and systemic circulations in sequence, offering normal ventricular performance. The SRV has impaired systolic and diastolic function compared with that of the respective ventricles in a normal biventricular heart [1]. Systolic dysfunction of the ventricle accompanied with abnormal diastolic function can be gauged by the ventricular filling impairment [2]. The Working Group for the European Society of Cardiology proposed that diagnosis of diastolic heart failure requires presence of clinical signs or symptoms, and evidence of abnormal filling [3]. Visualization of the flow pattern inside the ventricle during filling phase provides incremental value of understanding the flow dynamics; it allows better insights into both

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