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Pulsatile flow in fusiform models of abdoiminal aortic aneurysms: flow fields, velocity patterns and flow-induced wall stresses.

As one important step in the investigation of the mechanical factors that lead to rupture of abdominal aortic aneurysms, flow fields and flow-induced wall stress distributions have been investigated in model aneurysms under pulsatile flow conditions simulating the in vivo aorta at rest. Vortex pattern emergence and evolution were evaluated, and conditions for flow stability were delineated. Systolic flow was found to be forward-directed throughout the bulge in all the models, regardless of size. Vortices appeared in the bulge initially during deceleration from systole, then expanded during the retrograde flow phase. The complexity of the vortex field depended strongly on bulge diameter In every model, the maximum shear stress occurred at peak systole at the distal bulge end, with the greatest shear stress developing in a model corresponding to a 4.3 cm AAA in vivo. Although the smallest models exhibited stable flow throughout the cycle, flow in the larger models became increasingly unstable as bulge size increased, with strong amplification of instability in the distal half of the bulge. These data suggest that larger aneurysms in vivo may be subject to more frequent and intense turbulence than smaller aneurysms. Concomitantly, increased turbulence may contribute significantly to wall stress magnitude and thereby to risk of rupture.

Animals↗

Programmed cross flow asymmetrical flow field-flow fractionation for the size separation of pullulans and hydroxypropyl cellulose.

Different functions for the programming of the cross flow in asymmetrical flow field-flow fractionation were studied with the aim to find the flow conditions most suitable for the molar mass distribution analysis of high molecular weight polysaccharides. A mixture of four differently sized pullulans covering the molar mass range 5.8 x 10(3)-1.6 x 10(6) g mol(-1) were used as a model sample. Two types of programs were studied, linear and exponential decays, both with and without initial periods of a constant cross flow. For comparison, nonprogrammed runs, i.e. using constant cross flow, were studied. It was found that exponentially decaying cross flow gave the most uniform molar mass selectivity across the fractogram. The programmed cross flow was applied to the molar mass distribution analysis of a technical quality of hydroxypropyl cellulose.

Cellulose↗

Measurement of anterior and posterior circulation flow contributions to cerebral blood flow. An ultrasound-derived volumetric flow analysis.

Ultrasound-derived volumetric flow analysis may be useful in answering questions of basic physiological interest in the cerebrovascular circulation. Using this technique, the authors have sought to describe quantitatively the complete concurrent flow relations among all four arteries supplying the brain. The aim of this study of normal subjects was to determine the relative flow contributions of the anterior (internal carotid arteries) and posterior (vertebral arteries) cerebral circulation. Comparisons between the observed and theoretically expected anterior and posterior flow distribution would provide an opportunity to assess traditional rheological conceptions in vivo. Pulsed color Doppler ultrasonography was used to measure mean flow rates in the internal carotid and vertebral arteries in 21 normal adults. The anterior circulation (internal carotid arteries bilaterally) carried 82% of the brain's blood supply and comprised 67% of the total vascular cross-sectional area. These values demonstrate precise concordance between observations in vivo and the theoretically derived (Hagen-Poiseuille) expected flow distribution. These cerebrovascular findings support the traditional conception of macroscopic blood flow. Further studies using ultrasound-derived volumetric analysis of the brain's arterial flow relations may illuminate the vascular pathophysiology underlying aging, cerebral ischemia, and dementias.

Adult↗

B-flow and B-flow spatio-temporal image correlation in visualizing fetal cardiac blood flow.

AIM: To evaluate the clinical usefulness of two-dimensional B-flow imaging and four-dimensional (4D) B-flow spatio-temporal image correlation (STIC) as real-time three-dimensional technology in visualizing fetal cardiac blood flow. METHOD: We examined 65 normal singleton fetuses between 21 and 39 weeks of gestation, using VOLUSON 730 Expert ultrasound device with transabdominal 3D/4D transducer. After visualizing fetal cardiac blood flow by two dimensional B-flow mode, B-flow STIC images were acquired .The acquisition angle was 40 degrees and acquisition time 15 s. The cardiac vascular system was analyzed off-line on multiplanar and reconstructed 3D/4D rendered images. RESULTS: In 38 out of 65 cases, all extracardiac vessels of aortic arch, descending aorta, inferior vena cava, ductus venosus and hepatic vein could be detected on reconstructed 3D/4D images. In all 65 cases, two or more pulmonary veins were easily depicted. On a cardiac back-front view created by rotating 4D reconstructed image, two pulmonary veins among a total of four were depicted in 34 cases (52.3%), three veins in 28 cases (43.1%) and all four pulmonary veins in three cases (4.6%). CONCLUSION: B-flow and/or B-flow STIC allow visualization of fine small vessels with low velocity, such as pulmonary veins, and may have a great potential for detailed detection of an abnormality of small cardiac vessels, such as total anomalous pulmonary venous return.

Blood Flow Velocity↗

Grading the angiographic extent of collateral filling. Comparison with coronary flow, collateral flow, and regional coronary flow distribution measurements.

Angiography frequently demonstrates a collateral circulation in severe coronary artery disease. An easily applicable method to quantify collateral flow might be a useful adjunct for the assessment of the hemodynamic effects of coronary artery disease. The purpose of this study was to validate a visual scaling of the extent of angiographic collateral filling by comparison with flowmeter- and microsphere-derived measurements of collateral flow. In 12 open-chest dogs, collaterals from the circumflex artery were angiographically visualized (n = 80) by creating acute critical left anterior descending artery occlusion. The extent of collateral filling was graded in four levels from 0 = no visible filling to 3 = complete epicardial filling. Collateral filling correlated with the change in flow of the collateral supplying circumflex artery (delta Q; r = 0.84) which was + 5.3 +/- 4.6% with grade 1, + 9.1 +/- 3.5% with grade 2 and + 14.6 +/- 4.7% with grade 3 (p < 0.01). In parallel, coronary flow reserve decreased from 4.1 +/- 0.8 with grade 0 to 2.9 +/- 0.2 with grade 3 (p < 0.01). Colored microspheres were injected subselectively into the circumflex artery of 9 dogs (45 injections). The ratio of microspheres counted in the collateralized myocardium of the left anterior descending artery to the total number injected increased from 0.6 +/- 0.9% for grade 0 to 17.1 +/- 2.8% with grade 3 (p < 0.01). Absolute collateral flow derived from the microsphere counts averaged 5.5 +/- 0.9 ml/min with grade 3 and closely correlated with collateral filling grade (r = 0.88). Semiquantitative grading of angiographic collateral filling in response to acute coronary occlusion in a canine model correlates with an increase in collateral source artery flow, absolute collateral flow and a decrease in source artery flow reserve. These data suggest that this scale might be a simple but useful adjunct tool to assess the hemodynamic significance of a collateral circulation.

Animals↗

Effects of blood viscosity on proximal flow convergence calculations of regurgitant flow rate and jet dimensions as evaluated by color Doppler flow mapping: an in vitro study.

There are limited data on the potential influence of blood viscosity on the quantification of valvular regurgitation by color Doppler in the clinical setting. This study was designed to evaluate the effects of blood viscosity on jet dimensions and the proximal flow convergence (proximal isovelocity surface area, PISA) method of estimating valvular insufficiency severity. We used an in vitro flow model filled with human blood at varying hematocrits (15%, 35%, and 55%) and blood viscosity (blood/water viscosity: 2.6, 4.8, 9.1) in which jets were driven through a known orifice (16 mm(2)) into a 110-mL compliant receiving chamber (compliance: 2.2 mL/mm Hg) by a power injection pump. Blood injections (2 and 4 mL) at flow rates of 4, 6, 8, 10, and 12 mL/s were performed. Proximal flow convergence and spatial distribution of jets were imaged by a 3.5-MHz transducer. Pressure and volume in the flow model were kept constant before each injection. Ultrasound settings were the same for all experiments. Jet area decreased significantly with increasing blood viscosity, but the difference in jet dimensions was much larger for lower than for higher flow rates and for highest blood viscosity. Estimation of flow rate by the PISA method was not significantly influenced by blood viscosity. Blood viscosity has a major influence in jet area, especially for lower flow rates, but did not change significantly the grading of regurgitation by the PISA method. Thus this factor should be considered for determining the method of choice when quantification of valvular regurgitation is performed in patients with anemia or polycythemia.

Blood Viscosity↗

Does coronary flow reserve assessed by blood flow velocity analysis reflect absolute coronary flow reserve?

Doppler guidewire enables us to measure phasic coronary velocity and has been used for the measurement of coronary flow reserve (CFR). Although CFR is usually calculated by the quotient of peak flow velocity during papaverine infusion and flow velocity at rest, this assumption is true only if conduit vessel size is constant. To determine the accuracy of measurement of CFR using average peak velocity (APV) with Doppler guidewire, we investigated the influence of intracoronary papaverine on coronary flow velocity and coronary arterial diameter (CAD) and examined the correlation between CFR derived using APV and that derived using coronary blood flow (CBF) in 26 patients with normal coronary arteries. We measured phasic coronary flow velocity, and performed quantitative coronary angiography in the proximal left coronary artery at control and during 10 mg of intracoronary papaverine. Compared to control value, papaverine induced a significant increase in APV (% increase: 182 +/- 101%; P < 0.001). Papaverine also significantly increased CAD (16 +/- 10%; P < 0.001). Thus, CFR derived from APV was significantly lower than that derived from CBF (2.8 +/- 1.0 vs. 4.0 +/- 1.5, P < 0.001). Although there was a significantly strong positive correlation between these two methods (R2 = 0.83, P < 0.001), there was also considerable variability with regard to predicting one variable from the other. These results suggest the importance of standardizing the conditions in which coronary flow velocity is measured with regard to either controlling or measuring changes in epicardial coronary arterial diameter during changes in distal resistance vessel tone.

Adult↗

Myocardial perfusion during transient slow-flow in the patient with old vein graft intervention: assessment by serial measurement of pressure-derived fractional flow reserve and thermodilution-derived coronary flow reserve.

A patient with distal slow-flow after stenting in the old vein graft intervention was reported. This case is a first in whom guidewire-based serial measurement of pressure-derived fractional flow reserve (FFR(myo)) and thermodilution-based coronary flow reserve (CFR(thermo)) clearly demonstrated the serial change of microvascular circulation. During slow-flow, CFR(thermo) remained in low value despite significant improvement of FFR(myo) from 0.61 to 0.90. After thrombus aspiration and nicorandil injection, coronary flow reestablished immediately. CFR(thermo) improved significantly from 1.3 during slow-flow to 3.6 after restoration of flow.

Aged↗

Autoregulation of cochlear blood flow. A comparison of cerebral blood flow with muscular blood flow.

The cochlear blood flow of healthy adult guinea pigs was measured with a laser Doppler flowmeter and flow dynamics were analyzed on the basis of autoregulation. Angiotensin II infusion was used to raise blood pressure, while phlebotomy was done to lower blood pressure. The characteristics of autoregulation of cerebral blood flow and muscular blood flow were also investigated. Cochlear blood flow was considered to have some autoregulation but was less than brain blood flow, which showed significant regulation. Muscular blood flow seemed to have no similar regulatory mechanism.

Angiotensin II↗

Quantifying venous flow dynamics by flow-dephased and flow-rephased functional magnetic resonance imaging.

By combining flow-dephased and flow-rephased diffusion weighting with blood oxygenation level dependent functional magnetic resonance imaging, it is possible to study flow dynamics in the venous network of the human brain. Thereby, ballistic flow, which conserves direction and velocity during echo time, is separated from diffusive flow with many changes in direction and velocity. By using this technique with very low diffusion/flow weighting, the mean velocity of ballistic flow was quantified in this study. The result of 10.9+/-3.2 cm/s strongly indicates that large venous vessels are the source of ballistic flow.

Blood Flow Velocity↗

[Study on intracardiac blood flow with color flow mapping in human fetus--the reverse flow at tricuspid valve in human fetus during labor].

This study was performed to determine the relation among the reverse flow signal of tricuspid valve, fetal heart rate pattern and uterine contraction. The blood flow signal through the tricuspid valve was continuously recorded with color flow mapping and direct fetal electrocardiogram as well as uterine contraction in 17 human fetuses during labor. Gestational ages ranged from 36 to 41 weeks. No fetus had a congenital heart anomaly. The detection rate of the reverse flow signal at the tricuspid valve was 100% in variable deceleration, 33% in late deceleration, 5% in normocardia and none in early deceleration. In investigation of the time relation between the reverse flow signal and variable deceleration, the reverse flow signal started after the onset of the recovery phase of deceleration. The tricuspid reverse flow, which was observed in variable deceleration, was caused by an increase in the venous return when cord compression disappeared at the onset of the recovery phase of variable deceleration.

Echocardiography, Doppler↗

Particle size analysis of dilute environmental colloids by flow field-flow fractionation using an opposed flow sample concentration technique.

An on-line concentration method has been developed for the analysis of dilute suspensions of macromolecules and particles by flow field-flow fractionation (FFF). This method, termed opposed flow sample concentration (OFSC), uses two opposing flowstreams to focus sample into a narrow band near the inlet of the flow FFF channel. Large sample volumes (up to 1 L) have been successfully loaded, concentrated, and separated in a 1 mL volume flow FFF channel. Concentration factors as high as 10(5) have been achieved. The effectiveness of OFSC flow FFF was demonstrated using mixtures of monodispersed standards such as proteins and polystyrene latex beads. Retention times, peak areas, and resolution are comparable for a 10 mL and a typical 10 microL injection volume. The applicability of the method to environmental studies was demonstrated by a separation of river water colloids.

Automation↗

Estimation of coronary flow reserve with the instantaneous coronary flow velocity versus pressure relation: a new index of coronary flow reserve independent of perfusion pressure.

Our goal was to develop a new method to evaluate coronary flow reserve independent of perfusion pressure by equipping dogs with a Doppler flow probe in the left anterior descending artery. The slope of the linear portion of the velocity-pressure loop in the late diastolic phase was defined as VP slope; the hyperemic:basal ratio of the VP slope was defined as VP slope ratio, and the hyperemic:basal ratio of the mean coronary blood flow velocity was defined as coronary flow reserve (CFR). We measured VP slope ratio and CFR, altering aortic pressure by aortic banding and inferior vena cava occlusion. VP slope ratio was independent of aortic pressure, but CFR increased with increments in aortic pressure. The VP slope ratio and CFR decreased in the presence of coronary stenoses. In conclusion, VP slope ratio is considered to be a physiologic index of the severity of coronary stenosis, which is independent of perfusion pressure. This measure is easily applicable in clinical practice.

Angioplasty, Balloon, Coronary↗

[Coronary flow measurements with cine densitometry. II. Quantitative determinations of flow velocities and flow volumes through severe coronary stenoses during rest (author's transl)].

The normal flow values through healthy or moderately narrowed coronary arteries, which had been determined by a new method of cine radiography, together with a computer, were published in this Journal in 1976. In the present paper we report the results of further studies of flow velocity and flow volume through high-grade coronary artery stenosis of severity III and III--IV. Compared with the results obtained on normal and mildly stenosed arteries, measurements at rest through severely stenosed coronaries showed an almost constant flow. The first results on aorto-coronary vein graft measurement are described.

Absorptiometry, Photon↗

Decrease in cochlear blood flow with infusion of nitric oxide synthase inhibitor and its recovery with L-arginine infusion: comparison with abdominal blood flow and auricular blood flow.

We observed changes in cochlear blood flow (CoBF), abdominal blood flow (AbBF) and auricular blood flow (AuBF) in rats after administration of the nitric oxide (NO) synthase inhibitor N-nitro-L-arginine-methyl ester (L-NAME). Ten min after i.v. infusion of L-NAME, L-arginine, a substrate of NO, was infused (100 mg/kg) intravenously. Using a laser Doppler flowmeter, changes in blood flow were recorded from the basal turn of the right cochlea, abdominal wall or right auricle, and systemic blood pressure (BP) was recorded simultaneously from the left femoral artery. As another parameter of vascular response, vascular conductance (VC) was calculated from blood flow/mean BP. I.v. infusion of L-NAME produced a dose-dependent depression of cochlear VC at concentrations of 0.2 (-18.9%), 1 (-37.9%), 5 (-45.8%) and 10 mg/kg (-48.3%). Infusion of L-arginine partially reversed the decrease of CoBF caused by L-NAME. The group that received a 0.2 mg/kg infusion of L-NAME showed the largest degree of recovery (23.8%) with L-arginine, while the 10 mg/kg group showed the smallest degree of recovery (10.1%). AbBF also decreased after infusion of L-NAME (5 mg/kg) but to a lesser degree (-41.1% depression of VC) and with no significance compared to the decrease in CoBF (5 mg/kg L-NAME). Likewise, AuBF showed a decrease (-44.0% depression of VC) after infusion of L-NAME (10 mg/kg), the decrease being less than that of CoBF (10 mg/kg L-NAME). Recoveries from these decreased levels of VC in the AbBF and AuBF groups appeared to be smaller than those in the CoBF groups at the same dose of L-NAME (5.5% vs 17.3% in abdominal VC; 5.3% vs 10.1% in auricular VC). In a previous study comparing the CoBF changes caused by i.v. infusion and round window application of L-NAME, we proposed that i.v. infusion of L-NAME in rats primarily affects the precapillary arteriole of the spiral modiolar artery, which effectively regulates cochlear microcirculation as a resistance artery. Thus we assume that there may exist an active pathway of the NO/soluble guanylate cyclase/cyclic guanosine monophosphate system in the above vessels. With regard to the finding of a smaller recovery of VC with L-arginine in both the AbBF and AuBF groups, we consider that differences in L-arginine availability or uptake, and in the synthesis of NO, may exist between the cochlear and cutaneous vasculatures.

Abdominal Wall↗

On the relative contribution of viscous flow vs. diffusional (frictional) flow to the stationary state flow of water through a "tight" membrane.

The practice of calculating the diffusion contribution to the total pressure-driven flow of water through a tight membrane by using the self-diffusion coefficient for tritiated water is examined by a theoretical analysis. Equations of motion for water and membrane in pressure-driven water flow and water, membrane, and tritiated water in self-diffusion of tritiated water are adapted from Bearman and Kirkwood (1958). These equations of motion are used to develop an equation for the pressure-driven flow of water. Because of the lack of specific information about the detailed structure of most membranes, as well as considerations of the need to eliminate some of the mathematical difficulties, an "equivalent capillary" model is used to find a solution to the equation of motion. The use of the equivalent capillary model and possible ambiguities in distinctions between diffusion and hydrodynamic flow are discussed

Mathematics↗