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Factors influencing the structure and shape of stenotic and regurgitant jets: an in vitro investigation using Doppler color flow mapping and optical flow visualization.

To evaluate factors influencing the structure and shape of stenotic and regurgitant jets, Doppler color flow mapping and optical flow visualization studies were performed with use of a syringe model with a constant rate of ejection to simulate jets of valvular regurgitation and a pulsatile flow model of the right heart chambers to simulate jets of mild, moderate and severe valvular pulmonary stenosis. Ink-(0 to 40%) glycerol-water jets (viscosity 1 to 3.5 centiPoise) were produced by injecting the fluid at a constant rate into a 10 gallon rectangular reservoir of the same still fluid through 1.4 and 3.4 mm needles. The Doppler color flow scanners imaged the laminar jet length within 3 mm of actual jet length (2 to 6 cm) and the jet width within 2 to 3 mm of the actual jet width. Jet flows with Reynolds numbers ranging from 230 to 1,200 injected into still fluid yielded jet length/width ratios that decreased with increasing Reynolds numbers and leveled off to a length/width ratio of 5-6:1 at a Reynolds number near 600. When the fluid reservoir was swirled to better mimic the effect of flow entering the same cardiac chamber from a second source, the jets showed diminution of the jet length/width ratio and a clearly defined zone of turbulence. Studies of the pulsatile flow model were performed at cardiac outputs of 1 to 6 liters/min for the normal and each stenotic valve. Mild stenosis had an orifice area of 2.8 cm2, moderate stenosis an area of 1.0 cm2 and severe stenosis an area of 0.5 cm2. Laminar jet length represented the length of the total jet, which had a symmetric width and was measured from the valve opening to a region where the jet exhibited a spray effect. Laminar jet lengths (0.2 to 1.1 cm) were imaged by Doppler color flow mapping and optical visualization only in the moderate and severely stenotic valves and only at flows less than or equal to 3 liters/min (mean Reynolds numbers less than or equal to 3,470). Beyond this flow rate the jets exhibited a spray effect. Laminar jet length/width ratio approached unity with an increased amount of valvular stenosis and higher flow volumes (cardiac output). Proximal aliasing was present in each valve studied. the length of aliasing (0 to 3.2 cm) proximal to the valve was longer with increased flow rates and increased amounts of stenosis.(ABSTRACT TRUNCATED AT 400 WORDS)

Blood Flow Velocity↗

Influence of imaging parameters, flow velocity, and pulsatile flow on three-dimensional time-of-flight MR angiography: experimental studies.

OBJECTIVE: The purpose of this study is to evaluate the influence of imaging parameters (TR and flip angle), velocity and pulsatility of flow on three-dimensional time-of-flight magnetic resonance (3D TOF MR) angiography by using a flow phantom. METHODS: The 3D TOF MR angiography of a flow phantom was performed at 1.5-T with various TRs, flip angles and flow velocity. The influence of pulsatile flow was also evaluated. RESULTS: The imaging parameters and flow velocity affected the saturation effects of inflowing spins. Signal loss due to saturation of inflowing spins was more pronounced with a shorter TR, larger flip angle, or lower flow velocity. However signal intensity of stationary tissue were more suppressed with a shorter TR resulting in a larger signal difference to noise ratio of the flowing fluid. Velocity of the flow also affected the signal loss due to intravoxel phase dispersion, which was apparently observed with a stenotic tube. Pulsatility of flow resulted in decreased intensity of flowing fluid and in ghost artifacts along the phase-encoding and slice-select directions. The spacing between these ghosts and intensity of them were dependent on TR, flip angle and pulse rates. CONCLUSIONS: Understanding the influence of imaging parameters and flow characteristics is essential for evaluating the MR angiograms or for improving their quality.

Blood Flow Velocity↗

The effect of pulmonary arterial flow and positive end-expiratory pressure on retrograde bronchial mucosal blood flow.

Bronchial viability within the first few days after lung transplantation depends on collateral blood flow from the pulmonary to the bronchial circulation. In the present study the relationship between pulmonary arterial flow and retrograde bronchial blood flow, and the effect of positive end-expiratory pressure on bronchial blood flow were evaluated by laser Doppler velocimetry in an isolated in situ lung perfusion model. Nine adult mongrel dogs were exsanguinated by way of a left atrial cannula. Blood was pumped by a roller pump into the main pulmonary artery. Lungs were perfused at random flow (in 0.5 L/min increments) at rates of 1 to 3 L/min. Steady-state laser Doppler velocimetric measurements at each level of flow were made at the tracheal carina and both bronchial carina. Pump flow was then set at baseline cardiac output and positive end-expiratory pressure was applied. Steady-state laser Doppler velocimetric measurements were obtained at each level of positive end-expiratory pressure (5 cm H2O and 10 cm H2O). Bronchial blood flow correlated well with pulmonary arterial flow (for the tracheal carina; rs = 0.912 and p less than 0.0005; for the right bronchial carina, rs = 0.799, p less than 0.0005; for the left bronchial carina, rs = 0.917, p less than 0.0005; where rs is the common correlation coefficient). The bronchial blood flow at the left bronchial carina and the right bronchial carina were significantly higher than at the tracheal carina (p less than 0.005 and p less than 0.05, respectively). At baseline cardiac output, bronchial blood flow in the in situ model was approximately 50% lower than observed in the intact animals. Positive end-expiratory pressure increased the bronchial blood flow at the tracheal carina and both bronchial carina (p less than 0.05).

Animals↗

Determination of hydrogen peroxide by micro-flow injection-chemiluminescence using a coupled flow cell reactor chemiluminometer.

A novel flow cell reactor was developed for micro-flow injection determination of hydrogen peroxide (H(2)O(2)) using horseradish peroxide (HRP)-catalysed luminol chemiluminescence. The newly developed flow cell reactor for a chemiluminometer allowed mixing of the chemiluminescent reagents in front of a photomultiplier for maximum detection of the emitted light. The rapid mixing allowed a decrease in the flow rate of the pump to 0.1-0.01 mL/min, resulting in increased sensitivity of detection of light. The flow cell reactor was made by packing HRP-immobilized gels into a flow cell (Teflon tube; 6 cm x 0.98 mm i.d.) located in the cell holder of a chemiluminometer (flow-through type). The HRP-immobilized gels were made by immobilizing HRP onto the Chitopearl gel by the periodate method. H(2)O(2) specimens (50 microL) were injected into a stream of water delivered at a flow rate of 0.1 mL/min and mixed with a luminol solution (0.56 mmol/L in Tricine buffer, pH 9.2) delivered at 0.1 mL/min in the flow cell reactor. Within-run reproducibility of the assay of H(2)O(2) was 2.4% (4.85 micromol/L; flow rate 0.1 mL/min, injection interval 10 min). The reproducibility of the H(2)O(2) assay was influenced by the flow rates and the injection intervals of the H(2)O(2) specimens. As the flow rates decreased, both the light intensity and the light duration increased. Optimal light intensity was obtained at a luminol concentration of 3-8 mmol/L, but 0.56 mmol/L was sufficient for assay of H(2)O(2) in clinical specimens. At a luminol concentration of 0.56 mmol/L, the regression equation of the standard curve for H(2)O(2) (0-9.7 micromol/L) was Y = 27.5 X(2) + 394 X + 58.9 (Y = light intensity; X = concentration of H(2)O(2)) and the detection limit of H(2)O(2) was 0.2 micromol/L. This method was used to assay glucose (2.7-16.7 mmol/L) based on a glucose oxidase (20 U/mL, pH 7.4) reaction. The standard curve for glucose was Y = 167 X(2) - 351 X + 1484 (Y = light intensity; X = glucose). The within-run reproducibility for an aqueous glucose standard (2.7 mmol/L) and a control serum (glucose, 5 mmol/L) was 4.48% (n = 5) and 5.70% (n = 9), respectively.

Enzymes, Immobilized↗

Laser Doppler flowmetry for bone blood flow measurement: correlation with microsphere estimates and evaluation of the effect of intracapsular pressure on femoral head blood flow.

Laser Doppler flowmetry (LDF) was used to measure bone blood flow in the rabbit femoral head and femoral condyles. To correlate the LDF output signal blood cell flux to in vivo blood flow, simultaneous measurements using LDF and 85Sr-labeled microspheres were made in an adult rabbit model. There was no correlation between the two methods for blood flow in the femoral condyles and the correlation between the two methods for blood flow in the femoral head does not achieve statistical significance. An LDF signal of 0.4 V was approximately equal to a microsphere measured flow rate of 0.4 ml blood/g bone/min. The strength of the correlation in the latter case may have been affected by (a) large arteriovenous shunts, (b) inadequate mixing of the microspheres with a left ventricular injection, and (c) insufficient numbers of microspheres present in the bone samples with which to satisfy the mathematical requirements of the microsphere method. When LDF was used to evaluate the effect of elevated intracapsular pressure on femoral head blood flow in skeletally mature rabbits, femoral head subchondral bone blood flow declined with increasing intracapsular pressure from a baseline value of 0.343 +/- 0.036 to a value of 0.127 +/- 0.27 at 120 cm of water pressure. The decline in femoral head blood flow was statistically significant at pressures of 40 cm of water or higher (p less than 0.001), and evaluation of sections of the proximal femora made from preterminal disulphine blue injections confirmed these findings. Intracapsular tamponade has an adverse effect on femoral head blood flow beginning well below central venous pressure and should be considered in the pathophysiology of posttraumatic and nontraumatic necrosis of the femoral head. Laser Doppler flowmetry was easy to use and appears to be a reproducible technique for evaluating femoral head blood flow, offering distinct advantages over the microsphere technique for measuring bone blood flow. Further studies of the in vivo calibration of the LDF method for bone blood flow are necessary for the method to have potential for clinical application.

Animals↗

Blood flow during pregnancy in the rat: I. Flow patterns to maternal organs.

Normal blood flow patterns to several maternal organs were characterized in individual CD rats, nonpregnant (NP) or on day 6, 7, 8, 10, 11, 12, 13, 16, 18, or 20 of gestation using the radioactive microsphere technique. Weights and flow values were determined for several uterine tissue samples as well as maternal organs. No significant changes were found in blood flow to the stomach, spleen, and urinary bladder of these animals. There also were no remarkable changes as pregnancy progressed in blood flow to the lungs, suggesting that no marked arterial-venous shunting occurs in maternal placental tissues over gestation. Slight but consistent decreases in absolute (ml/min) and relative (ml/min/g tissue) blood flow to the brain were noted, and percent cardiac output (CO) was significantly decreased on all days of gestation except day 7. Complex changes were observed in blood flow to the kidneys, liver, adrenals, and heart. Absolute flow to the kidneys and liver reached maximum values on day 11, although percent CO delivered to both organs was consistently reduced throughout gestation. Absolute flow to the heart and adrenals peaked on day 13 and days 11-12, respectively. Absolute flow to the ovaries increased nearly 5-fold from the NP state (0.36 +/- 0.11) to day 20 of pregnancy (1.61 +/- 0.33). Interlitter differences in ovarian blood flow during midgestation were found to be a result of differences in litter size and distribution of embryo/fetuses between the two uterine horns. The fact that the majority of changes observed in maternal organ flow coincide with placental development, rapid augmentation of total uterine flow, and/or maternal hormonal changes suggests that these patterns may be important indicators of the dynamic physiology of pregnancy.

Animals↗

Carotid arterial blood flow in the ovine fetus as a continuous measure of cerebral blood flow.

OBJECTIVE: The purpose of this study was to establish a continuous measure of cerebral blood flow in the ovine fetus with a transit time flow probe. METHODS: Seven chronically catheterized fetal sheep were studied near term with placement of a 3R Transonic flow probe on the external carotid artery, just proximal to the internal maxillary artery. Blood flow changes were induced by altering maternal inspired oxygen and carbon dioxide concentrations, with cerebral and extracerebral blood flows also determined by the microsphere technique. RESULTS: Although absolute carotid and cerebral blood flow values were only modestly related under the present study conditions (r = 0.60, P < .05), both the percent change and the actual change in carotid arterial blood flow showed a strong linear correlation with that for cerebral blood flow (r = 0.84, P < .01, and r = 0.72, P < .02) but less so with that for extracerebral blood flow (r = 0.44 and r = 0.28). CONCLUSION: Measurements of carotid blood flow as studied with a transit time flow probe and induced blood gas changes can provide for a continuous assessment of changes in blood flow to the ovine fetal brain.

Animals↗

Evaluation of intra-aneurysmal blood flow by digital subtraction angiography: blood flow change after coil embolization.

BACKGROUND: The natural course of cerebral aneurysms is related to many factors, and it is very important that intra-aneurysmal blood flow is considered. Our group developed a method that allowed the simultaneous evaluation of blood flow in human cerebral aneurysms using digital subtraction angiography (DSA) with no special devices. The intra-aneurysmal blood flow measurement would also be very useful for coil embolization. Since the Guglielmi detachable coil (GDC) was developed, many patients with cerebral aneurysm have been treated with GDC, but coil compaction has sometimes caused a problem after the coil embolization of a cerebral aneurysm. We believed that an intra-aneurysmal flow measurement would suggest the final result of embolization during the procedure. METHODS: We performed DSA to examine 17 aneurysms in 17 patients. The video signal of serial DSA images was stored on a personal computer, and time-density curves were obtained for each individual pixel. The formula, determined by a two-exponential model, was fitted to the time-density curve 1000 times by least square approximation for each individual pixel. We indirectly substituted the coefficient of the flow-in curve for the blood flow. We were therefore able to display the distribution of intra-aneurysmal blood flow in color. We could compare the blood flow in each portion of the cerebral aneurysm and parent artery during coil embolization. RESULTS: The blood flow k(a) in a small aneurysm was faster than that in a large aneurysm, and it slowed in accordance with the coil embolization. The blood flow in a large aneurysm was sometimes accelerated by incomplete coil embolization. CONCLUSION: We can detect the flow distribution in cerebral aneurysms and the flow change during coil embolization, using existing equipment. Our method would be useful in elucidating the natural history of cerebral aneurysms, treating cerebral aneurysms with coils, and following patients after treatment.

Aged↗

Pulmonary venous flow velocity: relation to hemodynamics, mitral flow velocity and left atrial volume, and ejection fraction.

Abnormal pulmonary venous flow velocity patterns are present in multiple cardiac disease states, but the determinants of pulmonary venous flow velocity have not been fully elucidated. To determine the relative importance of several proposed factors that could influence pulmonary venous flow, anatomic, hemodynamic, and Doppler mitral and pulmonary venous flow velocity data were compared in 50 consecutive patients undergoing cardiac catheterization for clinical reasons. Pulmonary venous diastolic flow velocity was most strongly related to left ventricular isovolumetric relaxation time (r = -0.59), left ventricular end-diastolic pressure (LVEDP, r = 0.50), left atrial minimum volume (r = 0.50), mitral deceleration time (r = -0.50), and early diastolic mitral flow velocity (r = 0.45). Pulmonary venous systolic flow velocity related best with left atrial minimum volume (r = -0.45) and left atrial ejection fraction (r = 0.44). Pulmonary venous systolic flow velocity integral also showed the strongest relation with left atrial minimum volume (r = -0.48). Relations between pulmonary venous flow velocity and velocity time integrals and other variables were sometimes significantly different, apparently caused in part to differences in heart rate. These results suggest that pulmonary venous diastolic flow velocity is influenced by the same factors that influence early left ventricular diastolic filling; pulmonary venous systolic flow velocity relates best to left atrial volume and atrial ejection fraction and does not relate to left ventricular ejection fraction. Future studies analyzing pulmonary venous flow velocity variables should include data on both peak velocities and velocity time integrals as well as left atrial size and function.

Aged↗

Relationship of left atrial pressure and pulmonary venous flow velocities: importance of baseline mitral and pulmonary venous flow velocity patterns studied in lightly sedated dogs.

Prior clinical and animal studies have shown a markedly different relationship between left atrial pressure and the systolic fraction of pulmonary venous flow but have not discussed possible reasons for this discrepancy. To examine the possibility that these disparate results are due to differences in baseline mitral and pulmonary venous flow velocities, we recorded both velocities with left atrial and left ventricular pressure under different loading conditions in eight lightly sedated normal dogs. With constant atrial pacing at 85 beats/min, mean left atrial pressure was increased from 5.3 +/- 1.1 mm Hg at baseline to 16.1 +/- 1.7 mm Hg with volume and methoxamine infusion (p < 0.05). As left atrial pressure increased, the operating compliance of the left atrium decreased, whereas left atrial volumes and ejection fraction increased. Baseline pulmonary venous diastolic flow velocity was larger than systolic velocity (66 +/- 9 versus 36 +/- 11 cm/sec), with the systolic fraction of pulmonary venous flow 31% +/- 8%. With increasing left atrial pressure, pulmonary venous diastolic velocity did not change, but peak systolic velocity (57 +/- 16 cm/sec) and the systolic fraction (48% +/- 9%) both increased (p < 0.05). Changes in pulmonary venous diastolic flow velocity closely followed changes in early diastolic mitral flow velocity (r = 0.85, p < 0.05). Mean left atrial pressure, or change in mean left atrial pressure, was related to the ratio of pulmonary venous systolic to diastolic velocity time integral (r = 0.59 to 0.62, p < 0.01) and the pulmonary venous systolic fraction (r = 0.58 to 0.60; p < 0.01). When expressed as change from baseline, these variables showed even stronger correlations with left atrial pressure (r = 0.72 to 0.76, p < 0.001). These results are consistent with previous animal and clinical results that indicate pulmonary venous diastolic flow is closely related to early mitral flow velocity, whereas systolic flow is determined primarily by left atrial systolic function. The markedly different relationships observed between left atrial pressure and pulmonary venous systolic flow in animal and clinical studies are most likely due to different baseline flow velocity patterns and differences in left atrial systolic reserve. Future studies investigating these relationships should include data on mitral and pulmonary venous flow velocities as well as left atrial size and systolic function.

Animals↗

Quantitative assessment of regurgitant flow with total digital three-dimensional reconstruction of color Doppler flow in the convergent region: in vitro validation.

BACKGROUND: This study was designed to develop and test a total digital 3-dimensional (3D) color flow map reconstruction for proximal isovelocity surface area (PISA) measurement in the convergent region. METHODS: Asymmetric flow convergent velocity field was created in an in vitro pulsatile model of mitral regurgitation. Image files stored in the echocardiographic scanner memory were digitally transferred to a computer workstation, and custom software decoded the file format, extracted velocity information, and generated 3D flow images automatically. PISA and volume flow rate were calculated without geometric assumption. For comparison, regurgitant volume was also calculated, using continuous wave Doppler, 2-dimensional (2D), and M-mode color flow Doppler with the hemispheric approach. RESULTS: Flows from 3D digital velocity profiles showed a closed, excellent relation with actual flow rates, especially for instantaneous flow rate. Regurgitant volume calculated with the 3D method underestimated the actual flow rate by 2.6%, whereas 2D and the M-mode method show greater underestimation (44.2% and 32.1%, respectively). CONCLUSION: Our 3D reconstruction of color flow Doppler images gives more exact information of the flow convergent zone, especially in complex geometric flow fields. Its total digital velocity process allows accurate measurement of convergent surface area and improves quantitation of valvular regurgitation.

Blood Flow Velocity↗

Simultaneous measurement of velocity, diameter, flow and pressure in the ascending aorta of cats. Evaluation of an extractable Doppler ultrasound probe for continuous monitoring of aortic blood flow.

To evaluate an extractable Doppler ultrasound probe designed for monitoring postoperative aortic flow in infants, simultaneous measurements of velocity, diameter, electromagnetic flow estimates, and pressure in the ascending aorta were recorded in cats. Doppler flow calculators were designed to provide flow estimates based on preset constant or measured instantaneous aortic diameter. Doppler sample volume was extended to about 1.2 X 1.6 X 4.0 mm. By pharmacological interventions, a wide range of flow rates and pressures were obtained, some of which were outside physiological values. The prototype probe described here was well suited for implantation in aortas with outer diameter 8-12 mm. Correlation coefficients between Doppler and electromagnetic estimated flow for 140 samples were 0.908 and 0.959 for constant and instantaneous diameter, respectively. Mean difference between the two methods was calculated, as well as the 95% confidence limits (2SD) of the differences. Limits of agreement, in stable haemodynamic situations without drugs, were -20.0 and 22.4% of mean average flow for constant diameter Doppler flow estimates, and -14.5 and 15.1% of electromagnetic flow values for instantaneous diameter estimates. These limits increased when all samples were taken into account, but the limits for instantaneous diameter estimates were reduced from -33.1 and 32.4 to -23.9 and 19.3% after removal of data obtained during isoprenaline infusion, which introduced extreme high flow/low pressure situations. This Doppler method seems well suited for postoperative monitoring of aortic flow in infants. Errors observed in larger aortas with an asymmetric flow profile do not seem to be present in smaller vessels within normal values of flow and pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Evidence that the arterial baroreceptors influence muscle blood flow and not subcutaneous flow in man.

Studies in man indicate that skeletal muscle blood flow is modulated via high pressure baroreceptors located in the carotid body. However, whether subcutaneous blood flow is influenced in this way remains controversial. Therefore, the aim of the present study was to determine whether subcutaneous as well as skeletal muscle blood flow was influenced by direct carotid body stimulation; this was done by means of neck suction. Six young healthy males were investigated. Subcutaneous and skeletal muscle blood flow in the forearm was measured by the local 133Xe washout technique. Neck suction of -20 mmHg was applied through a tight helmet covering the head and neck. In the supine position heart rate increased about 10%, mean arterial pressure was unchanged, subcutaneous blood flow was unchanged, but skeletal muscle blood flow increased about 70%. Measurements were repeated during neck suction, -20 mmHg, and 45 degrees head-up tilt (which is known to decrease subcutaneous blood flow and skeletal muscle blood flow by increasing sympathetic vasoconstrictor activity). Heart rate increased by about 20%, mean arterial pressure was unchanged, subcutaneous blood flow was unchanged and skeletal muscle blood flow increased about 100%. These results indicate that skeletal muscle blood flow is modulated through carotid baroreceptors. Subcutaneous blood flow seems not to be influenced by high pressure baroreceptor modulation, although a vasoconstrictor response to head-up tilt was demonstrated in this as well as other recent studies.

Adult↗

Balance between myogenic, flow-dependent, and metabolic flow control in coronary arterial tree: a model study.

Myogenic response, flow-dependent dilation, and direct metabolic control are important mechanisms controlling coronary flow. A model was developed to study how these control mechanisms interact at different locations in the arteriolar tree and to evaluate their contribution to autoregulatory and metabolic flow control. The model consists of 10 resistance compartments in series, each representing parallel vessel units, with their diameters determined by tone depending on either flow and pressure [flow-dependent tone reduction factor (TRF(flow)) x Tone(myo)] or directly on metabolic factors (Tone(meta)). The pressure-Tone(myo) and flow-TRF(flow) relations depend on the vessel size obtained from interpolation of data on isolated vessels. Flow-dependent dilation diminishes autoregulatory properties compared with pressure-flow lines obtained from vessels solely influenced by Tone(myo). By applying Tone(meta) to the four distal compartments, the autoregulatory properties are restored and tone is equally distributed over the compartments. Also, metabolic control and blockage of nitric oxide are simulated. We conclude that a balance is required between the flow-dependent properties upstream and the constrictive metabolic properties downstream. Myogenic response contributes significantly to flow regulation.

Algorithms↗

Effects of exercise and respiration on blood flow in total cavopulmonary connection: a real-time magnetic resonance flow study.

BACKGROUND: Little is known about blood flow and its relationship to respiration during exercise in patients with total cavopulmonary connection (TCPC). METHODS AND RESULTS: We studied 11 patients 12.4+/-4.6 years (mean+/-SD) of age 5.9+/-2.8 years (mean+/-SD) after TCPC operation. Real-time MRI was used to measure blood flow in the superior vena cava (SVC), inferior vena cava (IVC), and ascending aorta under inspiration and expiration during supine lower-limb exercise (rest, 0.5 and 1.0 W/kg) on an ergometer bicycle. IVC and aortic flow increased from 1.60+/-0.52 and 2.99+/-0.83 L/min per m2 at rest to 2.58+/-0.71 and 3.97+/-1.20 L/min per m2 at 0.5 W/kg and to 3.25+/-1.23 and 4.62+/-1.49 L/min per m2 at 1.0 W/kg (P< or =0.05). SVC flow remained unchanged. Resting flow in the IVC was greater during inspiration (2.99+/-1.25 L/min per m2) than during expiration (0.83+/-0.44 L/min per m2) (inspiratory/mean flow ratio, 1.9+/-0.5), and retrograde flow was present during expiration (11+/-12% of mean flow). The predominance of inspiratory flow in IVC diminished with exercise to an inspiratory/mean flow ratio of 1.5+/-0.2 (P< or =0.05) and 1.4+/-0.3 at 0.5 and 1.0 W/kg, respectively. CONCLUSIONS: In the TCPC, circulation IVC and aortic but not SVC flows increase with supine leg exercise. Inspiration facilitates IVC flow at rest but less so during exercise, when the peripheral pump seems to be more important.

Aorta↗

Relationship between brain blood flow and carotid arterial flow in the sheep fetus.

The present study investigates whether changes in total brain blood flow can be reliably estimated by changes in carotid arterial blood flow in fetal and perinatal lambs. We therefore compared carotid arterial blood flow, measured with implanted transit-time ultrasound transducers, with brain blood flow, measured by radioactive microspheres in fetal lambs during normal oxygenation and during pulmonary ventilation with oxygen, with PO2 ranging from levels normal for the healthy fetus to levels normally seen postnatally. Cerebral perfusion pressure was modified over a wide range to alter brain blood flow: it was decreased by balloon occlusion of the brachiocephalic trunk and increased by a balloon occluder around the aortic isthmus. Carotid arterial blood flow and brain blood flow were closely related (r = 0.97, p < 0.0001). The relationship was not altered at different levels of oxygenation. However, measurements during higher cerebral perfusion pressures, obtained during aortic isthmus occlusion, had a negative influence on the agreement between carotid arterial blood flow and brain blood flow. When excluding values obtained by aortic isthmus occlusion, changes of 20% or more in brain blood flow could be predicted with carotid arterial blood flow within a confidence limit of 95%. Blood flow measurements in the carotid artery may be useful to estimate changes in brain perfusion.

Animals↗

Improvement of phase-contrast flow measurements: opposite directional flow-encoding technique to eliminate the influence of the Maxwell term phase errors.

A new method termed the opposite directional flow-encoding (ODFE) technique is proposed to increase the accuracy and the reproducibility of phase-contrast flow measurements by correcting the non-linear background of velocity images induced by concomitant magnetic fields (Maxwell terms). In this technique, the volume flow rate is calculated from the difference of two region of interest (ROI) values derived from two velocity images obtained by reversing the flow-encoding direction. To evaluate the technique, various phantom experiments were carried out and volume blood flow rates of internal carotid arteries (ICAs) were measured in four volunteers. The technique could measure the volume flow rates of the phantom with higher accuracy (mean absolute percentage error = 1.04%) and reproducibility (coefficient of variation = 1.18%) than conventional methods. Flow measurements with the technique was not significantly affected by ROI size variation, measuring position, and flow obliquity not exceeding 30 degrees. The volume flow rates in the ICAs of a volunteer were measured with high reproducibility (coefficient of variation = 2.89% on the right, 1.48% on the left), and the flow measurement was not significantly affected by ROI size variation. The ODFE technique can minimize the effect of the non-linear background due to Maxwell terms. The technique allows use of ROIs of approximate size including the flow signal and provides accurate and objective phase-contrast flow measurements.

Adult↗

Capillaries and flow redistribution play an important role in muscle blood flow reserve capacity.

Perfusion of skeletal muscle varies considerably during rest, exercise, or when arteries are occluded. The extent that a muscle can adapt to changes in flow demand is often expressed as the ratio of the highest inducible flow and control flow, the microvascular blood flow reserve capacity (MBFRC). However, perfusion of the nutritive capillaries of skeletal muscle may not only be improved by the increase in blood flow proportional to the increase in arterial flow, but also by diverting originally shunted flow towards the muscle proper. Consequently, MBFRC is not a good measure of capillary flow reserve, unless the assessed flow in both conditions is purely nutritive in nature. Therefore, in critical conditions, flow measurements in large vessels are not appropriate to assess MBFRC. In muscle, capillaries are compliant, i.e., with varying transmural pressure capillary diameter varies. During high perfusion states, when capillary transmural pressure is increased, capillary compliance results in increased capillary diameter and, hence, in reduced resistance and increased exchange surface area. This results in improved perfusion and enlarged capillary exchange surface area. In low perfusion states, capillary diameter is reduced. This augments the detrimental effects of the low perfusion status. Operative restoration of perfusion pressure not only increases the driving force for perfusion, but also leads to (passive) dilatation of the capillary bed and an extra reduction in resistance to flow, and, hence, a disproportional increase in flow.

Blood Flow Velocity↗