Numerical investigation of cardiac function parameters in left heart hemodynamics with stenosed mitral

Document Type : Research Article

Authors

1 Mechanical Engineering Department, Razi University, Kermanshah, Iran

2 Energy Research Center, Amirkabir University of Technology, Tehran, Iran

Abstract

This work studies the effect of cardiac function parameters on ventricular flow pattern in a stenosed mitral.A three-dimensional simulation is performed employing dynamic mesh based on a geometry and valve flow rates extracted from medical images. Different mitral areas from 6 to 2 cm2 then different parameters for stenosed 2 cm2 case are investigated. Special attention has been drawn to compare wall shear stress, blood velocity and pressure distribution, while the power used by ventricle and atrium to pump the blood are also highlighted. Computing the power used by the heart walls to move the blood shows that the stenosed mitral increases the needed force and the energy for the blood flow suction during the early diastole (from 0.06 W for mitral area of 6 cm2 to 1.28 W for mitral area of 2 cm2). For the stenosed mitral area of 2 cm2, in the systole, decreasing the ejection fraction to half decreased the maximum ventricle power to around half. In the diastole, decreasing the E/A which is the ratio of early diastole (E wave) and late diastole (A wave) ratio from 4.8 to 1 decreased the maximum ventricle power to one-third. The numerical results confirmed that the compensation mechanism to afford the pumping power could be changing the E/A ratio which leads to enlarged atrium.

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References

[1]    F.F. Faletra, Echocardiography in mitral valve disease, Springer, Milan, 2013.
[2]    F. Sotiropoulos, T.B. Le, A. Gilmanov, Fluid mechanics of heart valves and their replacements, Annual Review of Fluid Mechanics 48, (2016) 259-283.
[3]    C.W. Baird, G.R. Marx, M. Borisuk, S. Emani, P.J.D. Nido, Review of congenital mitral valve stenosis: analysis, repair techniques and outcomes, Cardiovascular Engineering and Technology, 6 (2015) 167-173.
[4]    S.C. Harb, B.P. Griffin, Mitral valve disease: a comprehensive review, Current cardiology reports 19(8) (2017) 73.
[5]    J. Liao, I., Vesely, A structural basis for the size-related mechanical properties of mitral valve chordae tendineae, Journal of biomechanics, 36(8) (2003) 1125-1133.
[6]    K. Vellguth, J. Brüning, L. Goubergrits, L. Tautz, A. Hennemuth, U. Kertzscher, F. Degener, M. Kelm, S. Sündermann, T. Kuehne, Development of a modeling pipeline for the prediction of hemodynamic outcome after virtual mitral valve repair using image-based CFD, International journal of computer assisted radiology and surgery, 13(11) (2018) 1795-1805.
[7]    K.L. Chan, K. Hay, B.K. Lam, Prognostic significance of mitral stenosis indices on outcomes in patients following mitral valve repair for degenerative mitral regurgitation, Journal of the American College of Cardiology, 69 (2017) 1971.
[8]    D. Goldstein, A.J. Moskowitz, A.C. Gelijns, G. Ailawadi, M.K. Parides, L.P. Perrault, J.W. Hung, P. Voisine, F. Dagenais, A.M. Gillinov, V. Thourani, Two-year outcomes of surgical treatment of severe ischemic mitral regurgitation, New England Journal of Medicine 374(4) (2016) 344-353.
[9]    Y.N. Nguyen, M. Ismail, F. Kabinejadian, E.L.W. Tay, H.L. Leo, Post-operative ventricular flow dynamics following atrioventricular valve surgical and device therapies: A review, Medical engineering & physics, 54 (2018) 1-13.
[10]  E. Votta, T.B. Le, M. Stevanella, L. Fusini, E.G. Caiani, A. Redaelli, F. Sotiropoulos, Toward patient-specific simulations of cardiac valves: state-of-the-art and future directions, Journal of biomechanics, 46(2) (2013) 217-228.
[11]  S.A. Esfahani, K. Hassani, D.M. Espino, Fluid-structure interaction assessment of blood flow hemodynamics and leaflet stress during mitral regurgitation, Computer methods in biomechanics and biomedical engineering, 22(3) (2019) 288-303.
[12]  B. Su, X. Wang, F. Kabinejadian, C. Chin, T.T. Le, J.M. Zhang, Effects of left atrium on intraventricular flow in numerical simulations, Computers in Biology and Medicine, 106 (2019) 46-53.
[13]  V. Meschini, F. Viola, R. Verzicco, Modeling mitral valve stenosis: A parametric study on the stenosis severity level. Journal of biomechanics, 84 (2019) 218-226.
[14]  V. Meschini, F. Viola, R. Verzicco, Heart rate effects on the ventricular hemodynamics and mitral valve kinematics, Computers & Fluids, 197 (2020) 104359.
[15]  B. Su, L. Zhong, X-K. Wang, J-M. Zhang, R.S. Tan, J.C. Allen, S.K. Tan, S. Kim, H.L. Leo, Numerical simulation of patient-specific left ventricular model with both mitral and aortic valves by FSI approach, Computer Methods and Programs in Biomedicine, 113 (2014) 474-482.
[16]  H. Kitajima, A.P. Yoganathan, Blood flow-the basics of the discipline. In: Fogel, M.A., (Ed.). Ventricular Function and Blood Flow in Congenital Heart Disease, Blackwell Publishing, (2005) http://doi.org/10.1002/9780470994849.ch3.
[17]  J. Smagorinsky, General Circulation Experiments with the Primitive Equations. I. The Basic Experiment, Monthly Weather Review, 91 (1963) 99-164.
[18]  Fluent, ANSYS, (2015) Theory guide. Ansys Inc.
[19]  R. Mittal, J.H. Seo, V. Vedula, Y.J. Choi, H. Liu, H.H. Huang, ... & R.T. George, Computational modeling of cardiac hemodynamics: Current status and future outlook, J. Comput. Phys., 305 (2016) 1065-1082.
[20]  C. Chnafa, S. Mendez, F. Nicoud, Image-based large-eddy simulation in a realistic left heart, Comput. Fluids, 94 (2014) 173-187.
[21]  R. Samian, M. Saidi, Investigation of left heart flow using a numerical correlation to model heart wall motion, Journal of Biomechanics, 93 (2019) 77-85.
[22]  T. Schenkel, M. Malve, M. Reik, M. Markl, B. Jung, H. Oertel, MRI-based CFD analysis of flow in a human left ventricle: methodology and application to a healthy heart, Annals of biomedical engineering, 37(3) (2009) 503-515.
[23]  C. Celotto, L. Zovatto, D. Collia, G. Pedrizzetti, Influence of mitral valve elasticity on flow development in the left ventricle, European Journal of Mechanics-B/Fluids, 75 (2019) 110-118.
[24]  M. Nakamura, S. Wada, T. Mikami, A. Kitabatake, T. Karino, Computational study on the evolution of an intraventricular vortical flow during early diastole for the interpretation of color M-mode Doppler echocardiograms, Biomechanics and Modeling in Mechanobiology 2(2) (2003) 59-72.
[25]  K.H. Olesen, The natural history of 271 patients with mitral stenosis under medical treatment, British heart journal, 24(3) (1962) 349.
[26]  S.S. Khalafvand, E.Y.K. Ng, L. Zhong, T.K. Hung, Fluid-dynamics modeling of the human left ventricle with dynamic mesh for normal and myocardial infarction: Preliminary study, Computers in Biology and Medicine 42 (2012) 863-870.
AUT Journal of Mechanical Engineering
Volume 5, Issue 3
September 2021
Pages 465-476

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