College of Engineering and Technology, Beijing Institute of Economics and Management, Beijing, China.
College of Engineering, Peking University, Beijing, China.
Biorheology. 2021;58(1-2):27-38. doi: 10.3233/BIR-201009.
Heart failure (HF) is a common disease globally. Ventricular assist devices (VADs) are widely used to treat HF. In contrast to the natural heart, different VADs generate different blood flow waves in the aorta.
To explore whether the different inflow rate waveforms from the ascending aorta generate far-reaching hemodynamic influences on the human aortic arch.
An aortic geometric model was reconstructed based on computed tomography data of a patient with HF. A total of five numerical simulations were conducted, including a case with the inflow rate waveforms from the ascending aorta with normal physiological conditions, two HF, and two with typical VAD support. The hemodynamic parameters, wall shear stress (WSS), oscillatory shear index (OSI), relative residence time (RRT), and the strength of the helical flow, were calculated.
In contrast to the natural heart, numerical simulations showed that HF decreased WSS and induced higher OSI and RRT. Moreover, HF weakened helical flow strength. Pulsatile flow VADs that elevated the WSS, induced some helical flow, while continuous flow VADs could not.
HF leads to an adverse hemodynamic environment by decreasing WSS and reducing the helical flow strength. Based upon hemodynamic effects, pulsatile flow VADs may be more advantageous than continuous flow VADs. Thus, pulsatile flow VADs may be a better option for patients with HF.
心力衰竭(HF)是一种全球常见疾病。心室辅助装置(VAD)广泛用于治疗 HF。与自然心脏不同,不同的 VAD 在主动脉中产生不同的血流波。
探讨升主动脉不同的流入率波形是否对人体主动脉弓产生深远的血流动力学影响。
基于 HF 患者的计算机断层扫描数据重建主动脉几何模型。共进行了五项数值模拟,包括正常生理条件下升主动脉流入率波形的病例、两种 HF 病例和两种典型的 VAD 支持病例。计算了血流动力学参数、壁面剪切应力(WSS)、振荡剪切指数(OSI)、相对驻留时间(RRT)和螺旋流强度。
与自然心脏相比,数值模拟表明 HF 降低了 WSS,并导致更高的 OSI 和 RRT。此外,HF 减弱了螺旋流强度。脉动流 VAD 可提高 WSS,诱导一定的螺旋流,而连续流 VAD 则不能。
HF 通过降低 WSS 和降低螺旋流强度导致不良的血流动力学环境。基于血流动力学效应,脉动流 VAD 可能比连续流 VAD 更具优势。因此,脉动流 VAD 可能是 HF 患者的更好选择。