Blood Flow Vortex Research Articles

Changes in blood flow vortices inside the left ventricle in COVID-19 patients with intraventricular clot despite a normal coronary and myocardial motion.

Our clinical observations showed clot formations in different regions of the left ventricle of the heart in some COVID-19 patients with normal myocardial motion and coronary artery. The aim of this study was to examine the changes caused by COVID-19 disease on blood flow inside the heart as a possible etiology of intracardiac clot formation. In a synergic convergence of mathematics, computer science, and cardio-vascular medicine, we evaluated patients hospitalized due to COVID-19 without cardiac symptoms who underwent two-dimensional echocardiography. Patients with normal myocardial motions on echocardiography, normal coronary findings on noninvasive cardio-vascular diagnostic tests, and normal cardiac biochemical examinations but who presented with a clot in their left ventricle were included. To display the velocity vectors of the blood in the left ventricle, motion and deformation echocardiographic data were imported into MATLAB software. Analysis and output of the MATLAB program indicted anomalous blood flow vortices inside the left ventricular cavity, indicating irregular flow and turbulence of the blood inside the left ventricle in COVID-19 patients. Our results suggest that in some COVID-19 patients, cardiac wall motion is not satisfactorily able to circulate the blood fluid in normal directions and that, despite normal myocardium, changes in the directions of blood flow inside the left ventricle might lead to clots in different zones. This phenomenon may be related to changes in blood properties, such as viscosity.

Blood flow vortices adapt their behaviour to the presence of kent accessory pathway

Abstract Funding Acknowledgements Type of funding sources: None. Background Blood speckle imaging (BSI) is a new speckle-tracking-based technique for the evaluation of blood flow. Ventricular flow vortices have been studied in sinus rhythm in normal and dysfunctional hearts, however, data are lacking in patients with Kent accessory pathway (KAP) and short atrio-ventricular (AV) conduction. Purpose We aimed to evaluate the characteristics of left ventricle blood vortices in children with KAP. Methods Nineteen paediatric patients (age 7 ± 2.9 years) were included in the study: 13 patients with manifest KAP (KAP group) and 6 age and sex -matched controls with normal AV conduction (CTR group). A thorough echocardiographic evaluation with 2D, color doppler and BSI was performed in all the included patients. BSI was recorded in apical 3-chamber view with a 6S-D probe. Vortices characteristic were analysed during filling phase of the left ventricle. We focused on the anterior vortex generated by mitral valve, which persisted longer during the cardiac cycle and is assumed to contribute to optimizing cardiac function. A standard 12-lead ECG was also recorded for each child in KAP group to esteem KAP localization. Results According to Arruda criteria for KAP localization, all patients in KAP group manifested the accessory pathway in the septal region. All patients in CTR group presented one major anterior vortex during filling phase, while in KAP group 10 patients out of 13 (p= 0.009) lacked of this main anterior vortex, showing instead fragmented different vortices. There were no differences in term of left ventricle function (KAPg 59.8 ± 4.02% vs CTRg 59.0 ± 2.5%, p= 0.6) and global longitudinal strain (KAPg -18.6 ± 1.0% vs CTRg -19.6 ± 3.1%, p= 0.5) between the two groups. Conclusion In our preliminary analysis, in patients with septal KAP, blood vortices adapted their diastolic traces to the septal dyssynchrony showing a fragmented pattern. We speculate this fragmentation may contribute to impair the performance of the left ventricle. Abstract Figure. BSI in control vs patient with WPW

A Hybrid Approach for Cardiac Blood Flow Vortex Ring Identification Based on Optical Flow and Lagrangian Averaged Vorticity Deviation.

Objective: The measurement of cardiac blood flow vortex characteristics can help to facilitate the analysis of blood flow dynamics that regulates heart function. However, the complexity of cardiac flow along with other physical limitations makes it difficult to adequately identify the dominant vortices in a heart chamber, which play a significant role in regulating the heart function. Although the existing vortex quantification methods can achieve this goal, there are still some shortcomings: such as low precision, and ignoring the center of the vortex without the description of vortex deformation processes. To address these problems, an optical flow Lagrangian averaged vorticity deviation (Optical flow-LAVD) method is proposed.Methodology: We examined the flow within the right atrium (RA) of the participants’ hearts, by using a single set of scans pertaining to a slice at two-chamber short-axis orientation. Toward adequate extraction of the vortex ring characteristics, a novel approach driven by the Lagrangian averaged vorticity deviation (LAVD) was implemented and applied to characterize the trajectory integral associated with vorticity deviation and the spatial mean of rings, by using phase-contrast magnetic resonance imaging (PC-MRI) datasets as a case study. To interpolate the time frames between every larger discrete frame and minimize the error caused by constructing a continuous velocity field for the integral process of LAVD, we implemented the optical flow as an interpolator and introduced the backward warping as an intermediate frame synthesis basis, which is then used to generate higher quality continuous velocity fields.Results: Our analytical study results showed that the proposed Optical flow-LAVD method can accurately identify vortex ring and continuous velocity fields, based on optical flow information, for yielding high reconstruction outcomes. Compared with the linear interpolation and phased-based frame interpolation methods, our proposed algorithm can generate more accurate synthesized PC-MRI.Conclusion: This study has developed a novel Optical flow-LAVD model to accurately identify cardiac vortex rings, and minimize the associated errors caused by the construction of a continuous velocity field. Our paper presents a superior vortex characteristics detection method that may potentially aid the understanding of medical experts on the dynamics of blood flow within the heart.

Comprehensive Cardiovascular Magnetic Resonance Diastolic Dysfunction Grading Shows Very Good Agreement Compared With Echocardiography

ObjectivesThe aims of this study were to develop a comprehensive cardiovascular magnetic resonance (CMR) approach to diastolic dysfunction (DD) grading and to evaluate the accuracy of CMR in the diagnosis of DD compared with echocardiography. BackgroundLeft ventricular DD is routinely assessed using echocardiography. MethodsConsecutive clinically referred patients (n = 46; median age 59 years; interquartile range: 46 to 68 years; 33% women) underwent both conventional echocardiography and CMR. CMR diastolic transmitral velocities (E and A) and myocardial tissue velocity (e′) were measured during breath-hold using a validated high–temporal resolution radial sector-wise golden-angle velocity-encoded sequence. CMR pulmonary artery pressure was estimated from 4-dimensional flow analysis of blood flow vortex duration in the pulmonary artery. CMR left atrial volume was measured using the biplane long-axis area-length method. Both CMR and echocardiographic data were used to perform blinded grading of DD according to the 2016 joint American and European recommendations. ResultsGrading of DD by CMR agreed with that by echocardiography in 43 of 46 cases (93%), of which 9% were normal, 2% indeterminate, 63% grade 1 DD, 4% grade 2 DD, and 15% grade 3 DD. There was a very good categorical agreement, with a weighted Cohen kappa coefficient of 0.857 (95% confidence interval: 0.73 to 1.00; p < 0.001). ConclusionsA comprehensive CMR protocol for grading DD encompassing diastolic blood and myocardial velocities, estimated pulmonary artery pressure, and left atrial volume showed very good agreement with echocardiography.

Color Flow Doppler Echocardiography in Healthy Racing Pigeons (Columba livia f. domestica) and the Evidence of Physiological Blood Flow Vortex Formations

In avian medicine, Doppler sonographic techniques are used to visualize and estimate blood flow in the heart. In the literature there is a lack of standardized studies of the use of color Doppler flow on healthy avian species. For this purpose, we examined blood flow in the heart in the four-chamber view of clinically healthy awake racing pigeons (n = 43) by color flow Doppler sonography. With this technique the diastolic and systolic blood flow in the heart chambers and the heart valve regions were well visualized. However, the pulse repetition frequency must be adapted to the specific blood flow velocities of the heart region to be measured to reduce aliasing in higher velocities and to visualize blood flow of lower velocities. With the help of color Doppler imaging in the four-chamber view, typical physiological atrial and ventricular blood flow vortex formations were visualized in the avian heart for the first time. In the left ventricle an asymmetric vortex ring in the passive and active ventricular filling, in the right ventricle a great counter-clockwise blood vortex in the active ventricular filling, in the left atrium a vortex clockwise, and in the right atrium counter-clockwise were observed. The knowledge of these physiological blood flow vortices is important to identify pathological blood flow.

Cardiovascular magnetic resonance 4D flow analysis has a higher diagnostic yield than Doppler echocardiography for detecting increased pulmonary artery pressure

BackgroundPulmonary hypertension is definitively diagnosed by the measurement of mean pulmonary artery (PA) pressure (mPAP) using right heart catheterization. Cardiovascular magnetic resonance (CMR) four-dimensional (4D) flow analysis can estimate mPAP from blood flow vortex duration in the PA, with excellent results. Moreover, the peak systolic tricuspid regurgitation (TR) pressure gradient (TRPG) measured by Doppler echocardiography is commonly used in clinical routine to estimate systolic PA pressure. This study aimed to compare CMR and echocardiography with regards to quantitative and categorical agreement, and diagnostic yield for detecting increased PA pressure.MethodsConsecutive clinically referred patients (n = 60, median [interquartile range] age 60 [48–68] years, 33% female) underwent echocardiography and CMR at 1.5 T (n = 43) or 3 T (n = 17). PA vortex duration was used to estimate mPAP using a commercially available time-resolved multiple 2D slice phase contrast three-directional velocity encoded sequence covering the main PA. Transthoracic Doppler echocardiography was performed to measure TR and derive TRPG. Diagnostic yield was defined as the fraction of cases in which CMR or echocardiography detected an increased PA pressure, defined as vortex duration ≥15% of the cardiac cycle (mPAP ≥25 mmHg) or TR velocity > 2.8 m/s (TRPG > 31 mmHg).ResultsBoth CMR and echocardiography showed normal PA pressure in 39/60 (65%) patients and increased PA pressure in 9/60 (15%) patients, overall agreement in 48/60 (80%) patients, kappa 0.49 (95% confidence interval 0.27–0.71). CMR had a higher diagnostic yield for detecting increased PA pressure compared to echocardiography (21/60 (35%) vs 9/60 (15%), p < 0.001). In cases with both an observable PA vortex and measurable TR velocity (34/60, 56%), TRPG was correlated with mPAP (R2 = 0.65, p < 0.001).ConclusionsThere is good quantitative and fair categorical agreement between estimated mPAP from CMR and TRPG from echocardiography. CMR has higher diagnostic yield for detecting increased PA pressure compared to echocardiography, potentially due to a lower sensitivity of echocardiography in detecting increased PA pressure compared to CMR, related to limitations in the ability to adequately visualize and measure the TR jet by echocardiography. Future comparison between echocardiography, CMR and invasive measurements are justified to definitively confirm these findings.

Fluid dynamics of thoracic cavity venous flow in multiple sclerosis

This paper hypothesizes, based on fluid dynamics principles, that in multiple sclerosis (MS) non-laminar, vortex blood flow occurs in the superior vena cava (SVC) and brachiocephalic veins (BVs), particularly at junctions with their tributary veins. The physics-based analysis demonstrates that the morphology and physical attributes of the major thoracic veins, and their tributary confluent veins, together with the attributes of the flowing blood, predict transition from laminar to non-laminar flow, primarily vortex flow, at select vein curvatures and junctions.Non-laminar, vortex flow results in the development of immobile stenotic valves and intraluminal flow obstructions, particularly in the internal jugular veins (IJVs) and in the azygos vein (AV) at their confluences with the SVC or BVs.Clinical trials’ observations of vascular flow show that regions of low and reversing flow are associated with endothelial malformation. The physics-based analysis predicts the growth of intraluminal flaps and septa at segments of vein curvature and flow confluences. The analysis demonstrates positive correlations between predicted and clinically observed elongation of valve leaflets and between the predicted and observed prevalence of immobile valves at various venous flow confluences. The analysis predicts the formation of sclerotic plaques at venous junctions and curvatures, in locations that are analogous to plaques in atherosclerosis.The analysis predicts that increasing venous compliance increases the laminarity of venous flow and reduces the prevalence and severity of vein malformations and plaques, a potentially significant clinical result.An over-arching observation is that the correlations between predicted phenomena and clinically observed phenomena are sufficiently positive that the physics-based approach represents a new means for understanding the relationships between venous flow in MS and clinically observed venous malformations.

ANALYSIS OF DIASTOLIC VORTEX FLOW AS A MARKER OF VENTRICULAR DETERIORATION IN AORTIC REGURGITATION

Background: Current characterization of ventricular state and timing of potential intervention in patients with aortic regurgitation (AR) use simple indices with limited predictive value. The dynamics of left ventricle (LV) diastolic vortex blood flow and its impact on energy consumption is emerging

Non-invasive evaluation of pulmonary arterial blood flow and wall shear stress in pulmonary arterial hypertension with 3D phase contrast magnetic resonance imaging.

BackgroundRecently, time-resolved 3D phase contrast magnetic resonance imaging (4D-flow) allows flow dynamics in patients with pulmonary arterial hypertension to be measured. Abnormal flow dynamics, such as vortex blood flow pattern in the pulmonary artery (PA), may reflect progression of pulmonary arterial hypertension (PAH). Some reports suggested that abnormal blood flow parameters including wall shear stress (WSS) could be markers of PAH. However, it was not fully assessed clinical usefulness of these variables. We aimed to assess whether these flow dynamic parameters, such as vortex formation time (VFT) and WSS, were associated with right ventricular (RV) function.ResultsFifteen subjects, nine with PAH and six healthy volunteers, underwent 4D-flow. Differences of Blood flow patterns, blood flow velocities and WSS between PAH patients and healthy volunteers were evaluated. We also assessed the association between VFT, WSS and RV function in PAH patients. Both vortex blood flow patterns and early systolic retrograde flow in the main PA were observed in all patients with PAH. The PA flow velocities and WSS in patients with PAH were lower than those in healthy volunteers, but that blood flow volumes in the MPA, RPA and LPA and SV in the MPA were broadly comparable between the groups. The mean VFT was 35.0 ± 16.6 % of the cardiac cycle. The VFT significantly correlated with RV ejection fraction, RV end systolic volume, and RV end systolic volume index (RVEF = 75.1 + (−85.7)·VFT, p = 0.003, RVESV = 12.4 + 181.8·VFT, p = 0.037 and RVESVI = 10.6 + 114.8·VFT, p = 0.038, respectively) in PAH patients, whereas WSS did not correlate with RV function.ConclusionsWe confirmed that abnormal blood flow dynamics, including the vortex formation and the early onset of retrograde flow, low WSS in the PA were characteristics of PAH. The VFT may be associated with right ventricular dysfunction, whereas WSS was not. Our results suggest that 4D-flow is an effective means of detecting right heart failure as well as diagnosing PAH.Clinical trial registration URL: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi. Unique identifier: UMIN000011128Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-016-2755-7) contains supplementary material, which is available to authorized users.

Echo motion imaging with adaptive clutter filter for assessment of cardiac blood flow

Visualization of the vortex blood flow in the cardiac chamber is a potential diagnostic tool for the evaluation of cardiac function. In the present study, a method for automatic selection of the desirable cutoff frequency of a moving target indicator filter, namely, a clutter filter, was proposed in order to visualize complex blood flows by the ultrahigh-frame-rate imaging of echoes from blood particles while suppressing clutter echoes. In this method, the cutoff frequency was adaptively changed as a function of the velocity of the heart wall (clutter source) in each frame. The feasibility of the proposed method was examined through the measurement of a healthy volunteer using parallel receive beamforming with a single transmission of a non-steered diverging beam. Using the moving target indicator filter as above with the cutoff frequency determined by the proposed method, the vortex-like blood flow in the cardiac chamber was visualized as movements of echoes from blood particles at a very high frame rate of 6024 Hz while suppressing clutter echoes.

Blood flow vortices along the main pulmonary artery measured with MR imaging for diagnosis of pulmonary hypertension.

To approximate the functional relationship between invasively measured mean pulmonary arterial pressure (mPAP) and the phase-contrast magnetic resonance (MR) imaging-derived duration of vortical blood flow along the main pulmonary artery and to analyze its applicability for noninvasive diagnosis of pulmonary hypertension (PH) and borderline mPAP. The local ethics review board approved this prospective study of 145 patients suspected of having PH (69 patients with PH, 19 patients with borderline mPAP, and 57 patients with normal mPAP) who underwent right heart catheterization (RHC) and three-directional phase-contrast MR imaging of the main pulmonary artery. Velocity fields were viewed with dedicated software and evaluated for the duration of vortical blood flow in the main pulmonary artery (tvortex, the percentage of cardiac phases with vortex present). The relationship between mPAP at RHC and tvortex was assessed by means of a segmented linear regression model, and by Bland-Altman and receiver operating characteristic curve analyses. The relationship between mPAP and tvortex was described adequately (R(2) = 0.95) as linearly increasing, from tvortex of 0% (mPAP ≤ 16.0 mm Hg) with a slope of 1.59% per millimeter of mercury. The standard deviation between mPAP values derived from RHC and those estimated by using tvortex was 3.9 mm Hg. The area under the curve for tvortex-based diagnosis of PH was 0.994 (95% confidence interval [CI]: 0.982, 0.998), and the calculated PH cut-off value (tvortex ≥ 14.3%) resulted in sensitivity of 0.97 (95% CI: 0.90, 0.99) and specificity of 0.96 (95% CI: 0.89, 0.99). Vortical blood flow with tvortex less than 14.3% was specific for borderline mPAP. Duration of vortical blood flow in the main pulmonary artery that is determined by using phase-contrast MR imaging allows accurate estimation of elevated mPAP and diagnosis of PH. Clinical trial registration no. NCT00575692.

Vortex formation ratio in heart failure compared to healthy volunteers at rest and during exercise

Background Heart failure is associated with high mortality, and diagnosis lacks reliable quantitative measures. Therefore, new measures of heart failure are needed. Vortex formation ratio (VFR) [1] is a method to describe the optimal vortex blood flow during rapid filling of the left ventricle (LV) of the heart. VFR has previously been determined using echocardiography [2] and has been proposed as a new measure of heart failure. Since magnetic resonance imaging (MRI) is the gold standard for measuring LV volumes, MRI may give more accurate VFR measurements than echocardiography. Furthermore, it is unknown if VFR is preserved during physical exercise due to the larger inflowing blood volume. Therefore, the aim was to assess VFR using MRI in heart failure and in healthy volunteers at rest and during exercise.

Vortex formation time: an emerging echocardiographic index of left ventricular filling efficiency?

ARTICLE The mere existence of the formation number is intriguing since it hints at the possibility that nature uses this time scale for some evolutionary incentives such as optimum ejection of blood from the left atrium to the heart's left ventricle.—Gharib et al .1 About 500 years ago, Leonardo da Vinci conducted a haemodynamic study of the sinus of Valsalva in which he deduced and explained formation of a blood flow vortex.2 Fast forwarding to the present, Gharib et al .1 used an experimental arrangement of a piston producing a wide range of jets and vortex rings alongside those jets by pushing columns of fluid of length L through an orifice with diameter D . They referred to the length-to-diameter ratio, i.e. L / D , as the formation number . While settings with low L / D generated merely a single and rather weak vortex ring, settings with large L / D resulted in a vortex ring that could no longer grow and was followed by a less-efficient fluid transport by a trailing jet.3 The maximum growth of the vortex ring without a trailing jet was observed when the L / D ratio was within a limited value range of 3.6–4.6 for an otherwise wide variety of flow conditions.1 Because …

Numerical simulations of the discontinuous progression of cerebral aneurysms based on fluid-structure interactions study

Investigations into the characteristics of hemodynamics will provide a better understanding of the pathology of cerebral aneurysms for clinicians. In this work, a steady state discontinuous-growth model of the cerebral aneurysms was proposed. With the assumption of the fluid-structure interaction between the wall of blood vessel and blood, a fluid-structure coupling numerical simulation for this model was built using software ANSYS and CFX. The simulation results showed that as the aneurysm volume increased, a blood flow vortex came forth, the vortex region became asymptotically larger, and eddy density became gradually stronger in it. After the emergence of the vortex region, the blood flow in the vicinity of the downstream in the aneurysms volume turned into bifurcated flow, and the location of the flow bifurcated point was shifted with the aneurysm volume growing while directions of the shear stress applied to two sides of the bifurcated point were opposite. The Von Mises stress distribution along the wall of aneurysm volume decreased in the prior period and increased gradually in the later period. The maximum stress was in the neck of the volume and the minimum was on the distal end in the whole process of growth. It was shown that as the aneurysm increased the maximum deformation location of the aneurysm, vertical to the streamline, was transferred from the distal end of the aneurysm to its neck, then back to its distal end of the aneurysm again.

Negative regulation of vascular smooth muscle cell migration by blood shear stress

Vortex blood flow with reduced blood shear stress in a vein graft has been hypothesized to promote smooth muscle cell (SMC) migration and intimal hyperplasia, pathological events leading to vein graft restenosis. To demonstrate that blood shear stress regulates these processes, we developed a modified vein graft model where the SMC response to reduced vortex blood flow was compared with that of control vein grafts. Vortex blood flow induced SMC migration and neointimal hyperplasia in control vein grafts, whereas reduction of vortex blood flow in the modified vein graft strongly suppressed these effects. A venous polymer implant with known fluid shear stress was employed to clarify the molecular mechanism of shear-dependent SMC migration in vivo. In the polymer implant, the phosphorylation of extracellular signal-regulated kinase (ERK1/2) and myosin light chain kinase (MLCK), found primarily in SMCs, increased from day 3 to day 5 and returned toward the control level from day 5 to day 10, with the peak phosphorylation associated with the maximal speed of SMC migration. Treatment with PD-98059 (an inhibitor specific to the ERK1/2 activator MEK1/2) significantly suppressed the phosphorylation of MLCK, suggesting a role for ERK1/2 in regulating the activity of MLCK. Treatment with PD-98059 or ML-7 (an inhibitor specific to MLCK) reduced shear stress-dependent SMC migration, resulting in an SMC distribution independent of fluid shear stress. These results suggest that fluid shear stress regulates SMC migration via the mediation of ERK1/2 and MLCK.

Cardiac torsion and electromagnetic fields: The cardiac bioinformation hypothesis

Although in physiology the heart is often referred to as a simple piston pump, there are in fact two additional features that are integral to cardiac physiology and function. First, the heart as it contracts in systole, also rotates and produces torsion due to the structure of the myocardium. Second, the heart produces a significant electromagnetic field with each contraction due to the coordinated depolarization of myocytes producing a current flow. Unlike the electrocardiogram, the magnetic field is not limited to volume conduction and extends outside the body. The therapeutic potential for interaction of this cardioelectromagnetic field both within and outside the body is largely unexplored. It is our hypothesis that the heart functions as a generator of bioinformation that is central to normative functioning of body. The source of this bioinformation is based on: (1) vortex blood flow in the left ventricle; (2) a cardiac electromagnetic field and both; (3) heart sounds; and (4) pulse pressure which produce frequency and amplitude information. Thus, there is a multidimensional role for the heart in physiology and biopsychosocial dynamics. Recognition of these cardiac properties may result in significant implications for new therapies for cardiovascular disease based on increasing cardiac energy efficiency (coherence) and bioinformation from the cardioelectromagnetic field. Research studies to test this hypothesis are suggested.

Pattern formation of vascular smooth muscle cells subject to nonuniform fluid shear stress: mediation by gradient of cell density.

Smooth muscle cells (SMCs) are organized in various patterns in blood vessels. Whereas straight blood vessels mainly contain circumferentially aligned SMCs, curved blood vessels are composed of axially aligned SMCs in regions with vortex blood flow. The vortex flow-dependent feature of SMC alignment suggests a role for nonuniform fluid shear stress in regulating the pattern formation of SMCs. Here, we demonstrate that, in experimental models with vascular polymer implants designed for the observation of neointima formation and SMC migration under defined fluid shear stress, nonuniform shear stress possibly plays a role in regulating the direction of SMC migration and alignment in the neointima of the vascular implant. It was found that fluid shear stress inhibited cell growth, and the presence of nonuniform shear stress influenced the distribution of total cell density and induced the formation of cell density gradients, which in turn directed SMC migration and alignment. In contrast, uniform fluid shear stress in a control model influenced neither the distribution of total cell density nor the direction of SMC migration and alignment. In both the uniform and nonuniform shear models, the gradient of total cell density was consistent with the alignment of SMCs. These observations suggest that nonuniform shear stress may regulate the pattern formation of SMCs, possibly via mediating the gradient of cell density in the neointima of vascular polymer implants.

The effects of cardiac infarction on realistic three-dimensional left ventricular blood ejection.

The effect of cardiac infarction on the flow patterns in cardiac left ventricular ejection was studied using a realistic model which was made from the profile of the left ventricle of a dog heart in diastole. A coordinate measuring machine was used to measure the left ventricular coordinates, and these were input into a three-dimensional flow simulation package. The left ventricular wall motion was described by having the walls moved towards the center of the aortic outlet, and in the case of infarcted tissue, the ventricular wall movement was diminished to simulate infarction flow behavior. The final ventricular volume varied from 25 percent to 54.1 percent of the initial volume in cases without and with infarction, respectively. The maximum blood ejection velocities and ventricular pressure decreased significantly in the presence of infarction. Infarcted areas showed complex blood flow vortex formation not present in the healthy ventricles. The computational technique presented here predicts infarction flow effects which could be observed with measurement techniques such as ultrasound and magnetic resonance imaging, allowing a finer detail of understanding than using either simulation or experimental measurements alone.