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PubMedDate not supplied

Quantitative study of flow dependence in NMR images at low flow velocities.

A basic theoretical model that describes the effects of flow in and out of the imaging plane in nuclear magnetic resonance (NMR) images, obtained with the standard pulse sequences single spin echo, multiple spin echo, and inversion recovery, is presented. Theoretically calculated signal values are compared with experimental results obtained from single-slice images of a flow phantom for variable flow velocity v as well as for variable echo time and inversion time at flow velocities less than 10 mm/s, corresponding to those found in cerebrospinal fluid, in capillary systems, and in smaller veins. The quantitative correspondence between theory and experiment is good in the range of velocities studied and for the imaging parameters used, but discrepancies occur when higher velocities are studied. In addition, flow in a capillary model is demonstrated qualitatively for very low linear flow velocities, less than 1 mm/s. It is concluded that the model describes the essentials of the inflow-outflow effect and that this effect can predict the flow dependence of the NMR signal for low flow velocities. Observed differences between model and experiment may be due to effects of flow-induced phase alterations and due to uncertainty in measurements of the relaxation times T1 and T2. The model described here can be extended to suit other types of pulse sequences and to suit multislice imaging. It can also be extended to incorporate flow-induced phase effects.

Blood Flow Velocity↗

PubMed2004

Disturbed flow promotes deposition of leucocytes from flowing whole blood in a model of a damaged vessel wall.

Departure from simple laminar flow in arteries may promote the local attachment of leucocytes either to intact endothelium or platelet thrombi. We perfused blood through a chamber with a backward facing step, to observe whether adhesion from whole blood to P-selectin was indeed localized to a region of recirculating flow, and whether platelets binding to collagen in such a region could capture leucocytes. Blood flowing over the step established a stable vortex, a reattachment point where forward and backward flow separated, and a simple laminar flow with wall shear rate c. 400/s further downstream. Fluorescently labelled leucocytes were observed to attach to P-selectin immediately upstream or downstream of the reattachment point, and to roll back towards the step or away from it, respectively. There was negligible adhesion further downstream. When a P-selectin-Fc chimaera was used to coat the chamber, stable attachment occurred, again preferentially in the disturbed flow region. Numerous platelets adhered to a collagen coating throughout the chamber, although there were local maxima either side of the reattachment point. The adherent platelets captured flowing leucocytes in these regions alone. Leucocytes may adhere from flowing blood in vessels with high shear rate if the flow is disturbed. While platelets can adhere over a wider range of shear rates, their ability to capture leucocytes may be restricted to regions of disturbed flow.

Adult↗

PubMed1995

A fluid dynamic analysis using flow visualization of the Baylor/NASA implantable axial flow blood pump for design improvement.

The Baylor/NASA Axial Blood Flow Pump has been developed for use as an implantable left ventricular assist device (LVAD). The pump is intended as an assist device for either pulmonary or systemic circulatory support for more than 3-months' duration. To date the pump provides acceptable results in terms of thrombus formation and hemolysis (IH of 0.018 g/100 L). A fluid dynamics analysis using flow visualization was performed to investigate the flow fields and to determine areas within the pump that could be improved. These studies focused upon the inflow area in front of the pump. A prototype axial flow pump assembly was constructed to facilitate the flow visualization studies. Particle image tracking velocimetry techniques were used to measure Amberlite particles suspended in a blood analog fluid composed of 63% water and 37% glycerin. This method used a pulsed (612 Hz) laser light to determine flow velocity profiles, shear stress, Reynolds numbers, and stagnant areas within the axial pump. These studies showed that the flow straightener (a vaned assembly in the pump inflow) reduced Reynolds numbers from 4,640 to 2,540 (at 8.5 L/min) and that the flow straightener exacerbates a discontinuity found between it and the impeller. Within the inflow area, a maximum of 80 N/m2 shear stress was measured, which is well below published blood damage thresholds. Design variations were investigated resulting in a smoother flow transition between flow straightener and impeller. These variations must be investigated further to establish a correlation with hemolysis and thrombus formation.

Blood Flow Velocity↗

PubMedDate not supplied

Vascular thrombosis during support with continuous flow ventricular assist devices: correlation with computerized flow simulations.

Continuous flow pumps are increasingly used to treat severe heart failure. These pumps alter flow physiology by lowering pulsatility in the arterial circulation. In patients with peripheral stenosis, continuous flow pumps may lead to thrombosis of peripheral vessels, possibly predisposing to vascular thrombosis in areas of non-flow-limiting stenosis. The authors performed a computerized flow modeling simulation to analyze the effects of altered hemodynamics in a stenotic area. Drawing on previous clinical experience, we modeled a stenotic area in the common carotid artery. Computerized flow modeling revealed blood stagnation zones with low shear stress and velocity adjacent to the stenotic area during nonpulsatile flow. Such stagnation was not present during pulsatile flow. These results indicate a mechanism by which altered physiologic flow may accelerate occlusion of arterial conduits in patients with preexisting stenosis. This finding may be important for patients with continuous flow devices who have peripheral vascular disease; therefore, further study is warranted.

Blood Flow Velocity↗

PubMed1979

Intramural blood flows and flow distribution in the feline small intestine during arterial hypotension.

The vascular reactions of the parallel-coupled vascular sections of the small intestine were studied during hypotension at two different levels of intestinal arterial inflow pressure, using a 85Kr elimination technique. The regional hypotension was accomplished by partially occluding the superior mesenteric artery with a clamp and maintained for 2 h. At the higher level (50-55 mmHg) total intestinal blood flow decreased but not to the same relative extent as blood pressure due to the autoregulatory capacity of the intestinal vascular bed. The flow autoregulation was also reflected in a decreased blood flow resistance. The distribution of blood to the muscularis and mucosa-submucosa layer, respectively, did not change significantly during or after hypotension as compared to the prehypotensive level, since the relative flow decrease was the same in the mucosa-submucosa and in themuscularis. At the lower arterial pressure level (30-35 mmHg) a more marked decrease of intestinal blood flow and flow resistance was observed as compared to the experiments performed at the 50-55 mmHg pressure level. Moreover, muscularis blood flow was relatively more decreased than blood flow in the mucosa-submucosa implying the fraction of total blood flow diverted to the muscularis was significantly decreased. Despite this redistribution of blood flow, a histological damage was apparent only in the mucosa, particularly at the villous tips.

Animals↗

PubMed1994

Quantitative measurements of blood flow velocity in basal cerebral arteries with transcranial duplex color-flow imaging. A comparative study with conventional transcranial Doppler sonography.

Transcranial duplex color-flow imaging is a new diagnostic method that allows visual display of blood flow in the basal cerebral arteries. This method allows determination of and correction for the Doppler angle of insonation. Conventional transcranial Doppler sonography has no imaging component and assumes a 0-degree Doppler angle for the calculation of flow velocities. The magnitude of the angle of insonation and the effect on flow velocity estimates have not been clearly defined. In order to evaluate the angle of insonation and the effect of angle correction on velocity readings, 50 patients referred for evaluation of cerebrovascular disease were studied. The mean age was 45 years (range, 24-62 yr). All were examined with conventional transcranial Doppler and transcranial duplex color-flow imaging. Specific vessels of the circle of Willis were identified by location, course, and direction of flow on color-flow images and by depth, direction of flow, and transducer orientation with conventional Doppler sonography. Visually controlled measurements of the Doppler angle of insonation were made by color-flow imaging. The data show that the mean angle of insonation was 33 degrees (+/- 15) in the middle cerebral artery, 35 degrees (+/- 17) in the anterior cerebral artery, 45 degrees (+/- 18) in the posterior cerebral artery, and 15 degrees (+/- 14) in the basilar artery. Angle-corrected peak systolic flow velocities were higher in all vessel segments (middle cerebral = 15%, anterior cerebral = 18%, posterior cerebral = 30%, and basilar = 3%), compared to uncorrected velocity readings by conventional Doppler sonography.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2002

Which to measure, systemic or organ blood flow? Middle cerebral artery and superior vena cava flow in very preterm infants.

AIM: To describe, in very preterm babies, postnatal changes in measures of middle cerebral artery (MCA) Doppler variables. To relate these peripheral measures to echocardiographic measures of systemic blood flow and ductal shunting, and to study their relation to subsequent intraventricular haemorrhage (IVH). METHODS: 126 babies born before 30 weeks were studied with serial echocardiography and cerebral and Doppler ultrasound of the MCA at 5, 12, 24, and 48 hours of age. Echocardiographic measures included superior vena cava (SVC) flow and colour Doppler diameter of the ductal shunt. MCA Doppler measures included mean velocity, pulsatility index (PI), and estimated colour Doppler diameter. RESULTS: MCA mean velocity increased whereas the PI decreased significantly over the first 48 hours. Babies with low SVC flow had significantly lower MCA mean velocity and estimated diameter than babies with normal SVC flow. There was no difference in PI. On multivariant analysis, the significant associations with MCA mean velocity were mean blood pressure (MBP), heart rate, SVC flow, and lower calculated vascular resistance. The significant associations with PI were larger ductal diameter and lower mean MBP. The significant associations with MCA diameter were higher SVC flow and lower calculated vascular resistance. After controlling for gestation, there was a highly significant association between lowest SVC flow and subsequent IVH but no association between IVH and lowest MCA mean velocity, estimated diameter, PI, or MBP. CONCLUSIONS: These data are consistent with the speculation that SVC flow is a reflection of cerebral blood flow. Low SVC flow is more strongly associated with subsequent IVH than cerebral artery Doppler measures or MBP.

Blood Flow Velocity↗

PubMed1993

Blood flow to respiratory muscles and major organs during inspiratory flow resistive loads.

To determine whether diaphragmatic fatigue in the intact animal subjected to loaded breathing is associated with a decrease in diaphragmatic blood flow, seven unanesthetized sheep were subjected to severe inspiratory flow resistive (IFR) loads that led to a decrease in transdiaphragmatic pressure (Pdi) and a rise in arterial PCO2 (PaCO2). Blood flow to the diaphragm, other respiratory muscles, limb muscles, and major organs was measured using the radionuclide-labeled microsphere method. With these loads blood flow increased to the diaphragm (621 +/- 242%) and all the other inspiratory and expiratory diaphragm (621 +/- 242%) and all the other inspiratory and expiratory muscles; there was no statistically significant change in blood flow to these muscles at the time when Pdi decreased and PaCO2 rose. Blood flow also increased to the heart (103 +/- 34%), brain (212 +/- 39%), and adrenals (76 +/- 9%), whereas pancreatic flow decreased (-66 +/- 14%). Limb muscle blood flow remained unchanged. We conclude that in unanesthetized sheep subjected to IFR loads 1) we did not demonstrate a decrease in respiratory muscle blood flow associated with diaphragmatic fatigue and ventilatory failure, and 2) there is a redistribution of blood flow among major organs.

Animals↗

PubMed1990

Quantification of jet flow by momentum analysis. An in vitro color Doppler flow study.

Previous investigations have shown that the size of a regurgitant jet as assessed by color Doppler flow mapping is independently affected by the flow rate and velocity (or driving pressure) of the jet. Fluid dynamics theory predicts that jet momentum (given by the orifice flow rate multiplied by velocity) should best predict the appearance of the jet in the receiving chamber and also that this momentum should remain constant throughout the jet. To test this hypothesis, we measured jet area versus driving pressure, flow rate, velocity, orifice area, and momentum and showed that momentum is the optimal jet parameter: jet area = 1.25 (momentum).28, r = 0.989, p less than 0.0001. However, the very curvilinear nature of this function indicated that chamber constraint strongly affected jet area, which limited the ability to predict jet momentum from observed jet area. To circumvent this limitation, we analyzed the velocities per se within the Doppler flow map. For jets formed by 1-81-mm Hg driving pressure through 0.005-0.5-cm2 orifices, the velocity distribution confirmed the fluid dynamic prediction: Gaussian (bell-shaped) profiles across the jet at each level with the centerline velocity decaying inversely with distance from the orifice. Furthermore, momentum was calculated directly from the flow maps, which was relatively constant within the jet and in good agreement with the known jet momentum at the orifice (r = 0.99). Finally, the measured momentum was divided by orifice velocity to yield an accurate estimate of the orifice flow rate (r = 0.99). Momentum was also divided by the square of velocity to yield effective orifice area (r = 0.84). We conclude that momentum is the single jet parameter that best predicts the color area displayed by Doppler flow mapping. Momentum can be measured directly from the velocities within the flow map, and when combined with orifice velocity, momentum provides an accurate estimate of flow rate and orifice area.

Animals↗

PubMed1991

A new method for quantitation of mitral regurgitation based on color flow Doppler imaging of flow convergence proximal to regurgitant orifice.

BACKGROUND: Imaging of the flow convergence region (FCR) proximal to a regurgitant orifice has been shown to provide a method for quantifying the regurgitant flow rate. According to the continuity principle, the FCR is constituted by concentric hemispheric isovelocity surfaces centered at the orifice. The flow rate is constant across all isovelocity surfaces and equals the flow rate through the orifice. For any isovelocity surface the flow rate (Q) is given by: Q = 2 pi r2 Vr, where 2 pi r2 is the area of the hemisphere and Vr is the velocity at the radial distance (r) from the orifice. METHODS AND RESULTS: We studied 52 consecutive patients with mitral regurgitation (mean age, 49 years; age range, 21-66 years) verified by left ventricular angiography using color flow mapping. The FCR r was measured as the distance between the first aliasing limit--at a Nyquist limit obtained by zero-shifting the velocity cutoff to 38 cm/sec--and the regurgitant orifice. Seven patients without evidence of an FCR had only grade 1+ mitral regurgitation angiographically. There was a significant relation between the Doppler-derived maximal instantaneous regurgitant flow rate and the angiographic degree of mitral regurgitation in the other patients (rs = 0.91, p less than 0.001). The regurgitant flow rate by Doppler also correlated with the angiographic regurgitant volume (r = 0.93, SEE = 123 ml/sec) in the 15 patients in normal sinus rhythm and without other regurgitant lesions in whom it could be measured. The correlation between regurgitant jet area within the left atrium and the angiographic grade was only fair (rs = 0.75, p less than 0.001). CONCLUSIONS: Color flow Doppler provides new velocity information about the proximal FCR in patients with mitral regurgitation. According to the continuity principle, the maximal instantaneous regurgitant flow rate, obtained with the FCR method, may provide a quantitative estimate of the severity of mitral regurgitation, which is relatively independent of technical factors.

Angiocardiography↗

PubMed1996

Peak expiratory flow and the resistance of the mini-wright peak flow meter.

The purpose of this study was to examine whether the resistance of the peak flow meter influences its recordings. One hundred and twelve subjects, (healthy nonsmokers and smokers and subjects with lung diseases) performed three or more peak expiratory flow (PEF) manoeuvres through a Fleisch pneumotachograph with and without a mini-Wright peak flow meter added in random order as a resistance in series. The results were as follows. In comparison with a pneumotachograph alone, peak flow measured with an added mini-Wright meter had a smaller within-test variation, defined as the difference between the highest and second highest values of PEF in a series of blows. The mean (SE) variation was 14 (1.3) L.min-1 and 19 (1.5) L.min-1 with and without meter added, respectively. In comparison with the pneumotachograph alone, the addition of the mini-Wright meter caused PEF to be underread, especially at high flows. The difference (PEF with meter minus PEF without meter) = -0.064 (average PEF) -8 L.min-1; R2 = 0.13. The mean difference was -7.8 (1.1) %, and increased numerically for a given PEF, when maximal expiratory flow when 75% forced vital capacity remains to be exhaled (MEF75%FVC) decreased. The reproducibility criteria for repeated measurements of peak flow are more appropriately set at 30 L.min-1 than the commonly used 20 L.min-1, because a within-test variation of less than 30 L.min-1 was achieved in 76% of the subjects without PEF meter inserted and in 88% with meter inserted, with no difference between healthy untrained subjects and patients. The resistance of the peak expiratory flow meter causes less variation in recordings but reduces peak expiratory flow, especially at high values and when the peak is large as compared with the rest of the maximal expiratory flow-volume curve.

Adolescent↗

PubMed2005

Quantitative assessment of harmonic power doppler myocardial perfusion imaging with intravenous Levovist in patients with myocardial infarction: comparison with myocardial viability evaluated by coronary flow reserve and coronary flow pattern of infarct-related artery.

BACKGROUND: Myocardial contrast echocardiography and coronary flow velocity pattern with a rapid diastolic deceleration time after percutaneous coronary intervention has been reported to be useful in assessing microvascular damage in patients with acute myocardial infarction. AIM: To evaluate myocardial contrast echocardiography with harmonic power Doppler imaging, coronary flow velocity reserve and coronary artery flow pattern in predicting functional recovery by using transthoracic echocardiography. METHODS: Thirty patients with anterior acute myocardial infarction underwent myocardial contrast echocardiography at rest and during hyperemia and were quantitatively analyzed by the peak color pixel intensity ratio of the risk area to the control area (PIR). Coronary flow pattern was measured using transthoracic echocardiography in the distal portion of left anterior descending artery within 24 hours after recanalization and we assessed deceleration time of diastolic flow velocity. Coronary flow velocity reserve was calculated two weeks after acute myocardial infarction. Left ventricular end-diastolic volumes and ejection fraction by angiography were computed. RESULTS: Pts were divided into 2 groups according to the deceleration time of coronary artery flow pattern (Group A; 20 pts with deceleration time > or = 600 msec, Group B; 10 pts with deceleration time < 600 msec). In acute phase, there were no significant differences in left ventricular end-diastolic volume and ejection fraction (Left ventricular end-diastolic volume 112 +/- 33 vs. 146 +/- 38 ml, ejection fraction 50 +/- 7 vs. 45 +/- 9 %; group A vs. B). However, left ventricular end-diastolic volume in Group B was significantly larger than that in Group A (192 +/- 39 vs. 114 +/- 30 ml, p < 0.01), and ejection fraction in Group B was significantly lower than that in Group A (39 +/- 9 vs. 52 +/- 7%, p < 0.01) at 6 months. PIR and coronary flow velocity reserve of Group A were higher than Group B (PIR, at rest: 0.668 +/- 0.178 vs. 0.248 +/- 0.015, p < 0.0001: during hyperemia 0.725 +/- 0.194 vs. 0.295 +/- 0.107, p < 0.0001; coronary flow velocity reserve, 2.60 +/- 0.80 vs. 1.31 +/- 0.29, p = 0.0002, respectively). CONCLUSION: The preserved microvasculature detecting by myocardial contrast echocardiography and coronary flow velocity reserve is related to functional recovery after acute myocardial infarction.

Blood Flow Velocity↗

PubMed1986

Red blood cell flow in the fetal scalp during hypoxemia in the chronic sheep experiment: a laser Doppler flow study.

Reliable monitoring of arterial blood gas values in the fetal scalp microcirculation requires an unimpaired local skin blood flow. Previous studies have shown that in the fetus blood flow to "nonvital" organs and tissues is reduced during hypoxemia. However, data on fetal scalp blood flow during hypoxemia have not been reported. Therefore, the influence of hypoxemia on scalp blood flow was studied in four chronically catheterized fetal lambs of 125-135 days of gestation. Red blood cell flow in the fetal scalp was continuously measured by the laser Doppler method during nine experiments. Reducing the oxygen saturation of fetal carotid arterial blood from an average control value of 52 to 21% for 20 min resulted in an average decrease of the laser Doppler flow index of 7%. In vitro studies revealed that more than half of the observed decrease in laser Doppler flow index could be attributed to enhanced absorption of light from the HeNe-laser caused by the deoxygenation of oxyhemoglobin itself. In the first 20 min after hypoxia, fetal scalp blood flow remained below the prehypoxic value. It is concluded that moderate hypoxemia causes only a small decrease in fetal scalp blood flow, certainly when compared to the dramatic fall in scalp blood flow that has been observed when local or circular pressure is exerted onto the fetal scalp.

Animals↗

PubMed2001

Blood flow structure related to red cell flow: determinant of blood fluidity in narrow microvessels.

The review article deals with phenomena of the blood flow structure (structuring) in narrow microvessels-capillaries and the adjacent arterioles and venules. It is particularly focused on the flow behavior of red blood cells (RBCs), namely, on their specific arrangements of mutual interaction while forming definite patterns of self-organized microvascular flow. The principal features of the blood flow structure in microvessels, including capillaries, include axial RBC flow and parietal plasma layer, velocity profile in larger microvessels, plug (or bolus) flow in narrow capillaries, and deformation and specific behavior of the RBCs in the flow. The actual blood flow structuring in microvessels seems to be a most significant factor in the development of pathological conditions, including arterial hypertension, brain and cardiac infarctions, inflammation, and many others. The blood flow structuring might become a basic concept in determining the blood rheological properties and disorders in the narrow microvessels. No solid theoretical (biorheological) basis of the blood flow structuring in microvessel has been found, but in the future it might become a foundation for a better understanding of the mechanisms of these properties under normal and pathological conditions in the narrowest microvessels 5 to 25 microm large. It is also a topic for further biorheological research directed to find the background of actual physiopathological phenomena in the microcirculation.

Animals↗

PubMed2002

Parallel-plate flow chamber for studies of 3D flow-endothelium interaction.

Flow induced shear stress influences vascular cellular biology and pathophysiology in numerous ways. Previous in vitro studies on interactions between flow and endothelial cells using parallel-plate flow chambers involve two-dimensional flows, whereas flows in larger vessels are commonly three-dimensional. We have constructed a parallel plate flow chamber with a backward facing step aligned oblique to the axis of the chamber. Flow visualisation by steady injection of ink through a hypodermic tube reveals swirling flow in the recirculation region downstream of the step. At given angles of the step, theta; (to the axis of the chamber), the pitch of the swirl and the width of the separation region, as measured in the direction perpendicular to the step, increase with the Reynolds number (Re). On the other hand, at given values of Re, reduction of theta; results in increases in the swirl pitch but decreases in the width of the separation zone. Furthermore, clearance time of ink from the separation region is shorter with an oblique step than a perpendicular one at given Re. Computer simulation confirms the 3D swirling flow created by the oblique step and provides detailed distribution of wall shear stresses in the flow chamber.

Arteries↗

PubMedDate not supplied

Effects of nilvadipine on regional cerebral blood flow and skin blood flow in anesthetized cats.

The effects of an intravenous injection of the novel calcium channel blocker, nilvadipine, on the relative regional cerebral blood flow and relative regional skin blood flow were studied in anesthetized cats using the laser-Doppler method. The effects of nilvadipine were compared with those of nicardipine hydrochloride (nicardipine). Nilvadipine and nicardipine both increased the relative regional cerebral blood flow dose-dependently, in spite of their hypotensive effect. At a dose of 32 micrograms/kg, nilvadipine and nicardipine increased the relative regional cerebral blood flow by 61 +/- 8% and 25 +/- 10% of the predrug value, respectively, 15 min after administration. At this time, both drugs induced a comparable degree of hypotension: -18 +/- 3% of the predrug value for nilvadipine and -25 +/- 2% for nicardipine. After nilvadipine, the relative regional cerebral blood flow enhanced by 45 +/- 10% 180 min after drug administration, whereas after nicardipine, it returned to the predrug value within 60 min. In contrast, the increase in relative regional skin blood flow produced by nilvadipine (32 micrograms/kg) and nicardipine (32 micrograms/kg) was 23 +/- 15% and 32 +/- 8% of the predrug value, respectively, 5 min after drug administration. The effect of nicardipine on the relative regional skin blood flow, compared with that of control, was significantly higher. These results indicate that nilvadipine exhibits a pronounced and longer-lasting effect on the relative regional cerebral blood flow, compared with the relative regional skin blood flow, and that its action on the relative regional cerebral blood flow is more potent than that of nicardipine.

Anesthesia↗

PubMed2005

Novel doppler assessment of intracoronary volumetric flow reserve: validation against PET in patients with or without flow-dependent vasodilation.

UNLABELLED: Volumetric blood flow (Q) determination requires simultaneous assessment of mean blood flow velocity and vessel cross-sectional area. At present, no method provides both values. Intracoronary Doppler-based assessment of coronary flow velocity reserve (CFVR) relies on average peak velocity (APV). Because this does not account for changes in velocity profile or vessel area usually occurring with flow-dependent vasodilation, results can be misleading. The aim of this clinical study was to validate against the current gold standard (measurement of myocardial perfusion reserve [MPR] by PET) a new, Doppler-based method for calculating coronary Q and coronary flow reserve (CFR). METHODS: Doppler-based intracoronary Q was measured with a proprietary guidewire device in a nonstenotic coronary artery at baseline and during adenosine-induced hyperemic flow (140 mug/kg/min intravenously during 7 min). Three gate positions were assessed, of which 2 were lying within the vessel and 1 was intersecting the vessel. The zeroth (M(0)) and the first (M(1)) Doppler moments of the intersecting gate were used to calculate mean blood flow velocity (M(1)/M(0)) and vessel area (M(0)), and M(0) of the 2 proximal gates was used to correct for scattering and attenuation. CFR was calculated as hyperemic/resting flow with Q and compared with APV-derived CFVR and with the corresponding segmental MPR obtained with (15)O-labeled water and PET. RESULTS: Q (CFR, 2.60 +/- 1.07) correlated well with PET (MPR, 2.58 +/- 1.11) (r = 0.832, P < 0.005; Bland-Altman limits, -1.42 to 1.09), whereas CFVR did not (r = 0.09, P = not statistically significant; Bland-Altman limits, -3.36 to 2.24). However, in vessels without dilation, there was no difference between CFR, CFVR, and MPR. CONCLUSION: This procedure for intracoronary Q measurement using the proprietary Doppler guidewire system, which accounts for both changes in flow profile and changes in vessel area, allows invasive, accurate assessment of CFR even in the presence of flow-dependent vasodilation.

Adult↗

PubMed1989

[Left ventricular diastolic flow dynamics in dilated cardiomyopathy: a color flow imaging and pulsed Doppler echocardiographic study].

Left ventricular filling flow was evaluated at the mitral orifice and in the left ventricle (LV) using color flow imaging and pulsed Doppler echocardiography in seven patients with dilated cardiomyopathy (DCM) and 10 normal subjects. Using the apical approach, filling flow in early and late diastole was observed by two-dimensional color and M-mode color flow imaging, and flow velocity patterns at the mitral orifice and in the LV, 3 cm below the orifice, were analyzed by pulsed Doppler echocardiography. Color flow imaging disclosed slower movement of the inflow signals toward the apex in DCM than in the normal. With pulsed Doppler echocardiography, the delay in timing of peak velocity in the LV was distinctly greater in DCM than in the normal, although the mitral inflow velocity did not differ between DCM and the normal. The width of the filling flow, the rate of velocity reduction and the flow velocity in the LV did not differ between DCM and the normal. Thus, in DCM, the timing of filling flow in the LV is clearly delayed compared to the timing at the mitral orifice, and this cannot be explained solely by the mitral flow velocity pattern.

Adult↗